For CPT 90791 (Psychiatric diagnostic evaluation) in New Jersey, the CY 2026 Medicare non-facility Physician Fee Schedule amount is $182.63 to $188.58 across 2 CMS localities. Source: CMS RVU26D, October 2026 release, non-QP conversion factor 33.4009, effective 2026-10-01. Medicaid FFS stays Coming soon until that state's published file is parsed. UnitedHealthcare medians appear when we have parsed that file. Aetna and Anthem stay Coming soon.
Last updated
| Locality | Medicare non-facility | Medicare facility | Medicaid FFS | Commercial | Source |
|---|---|---|---|---|---|
Northern NJ | $188.58 | $146.74 | Coming soon | $149.12 | CMS MPFS |
Rest Of New Jersey | $182.63 | $143.24 | Coming soon | $149.12 | CMS MPFS |
Compare an offered CPT 90791 rate in New Jersey on Contract Checker v1.3 (code and state prefilled). When UnitedHealthcare publishes rates for this code and state, the tool also compares your offer to the UHC median and the middle 80% of UHC rates, alongside Medicare and Medicaid FFS. UnitedHealthcare in New Jersey (median $149.12).
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Questions
What is the 2026 Medicare rate for CPT 90791 in New Jersey?
For CPT 90791 (Psychiatric diagnostic evaluation) in New Jersey, the CY 2026 Medicare non-facility Physician Fee Schedule amount is $182.63 to $188.58 across 2 CMS localities. Source: CMS RVU26D, October 2026 release, conversion factor 33.4009, effective 2026-10-01.
What is the UnitedHealthcare commercial median for CPT 90791 in New Jersey?
UnitedHealthcare Optum Health Behavioral Services (OHBS) professional median is $149.12 (10th percentile $100.00, 90th percentile $209.17; 158 rate rows; 5,213 NPIs). Source: 2026-09-01 UnitedHealthcare of Ohio, Inc. Optum-Health-Behavioral-Services in-network-rates.json.gz, source file dated 2026-09-01. Counted by provider practice state. Aetna and Anthem stay Coming soon. Not an MCO rate.
Is this New Jersey CPT 90791 amount a Medicaid MCO or commercial contracted rate?
Medicaid FFS is fee-for-service, not MCO. The commercial column is UnitedHealthcare median ($149.12 median) when loaded; Aetna and Anthem stay Coming soon.