CPT 90791 · TN

Tennessee 90791: UHC median $148.63 vs Medicare $169.00

Published UnitedHealthcare Optum Behavioral Health professional median for CPT 90791 in Tennessee is $148.63 (middle 80% of rates $106.93 to $237.43; 112 rate rows). CY 2026 Medicare non-facility PFS is $169.00. Aetna and Anthem commercial stay Coming soon.

For CPT 90791 (Psychiatric diagnostic evaluation) in Tennessee, the CY 2026 Medicare non-facility Physician Fee Schedule amount is $169.00. 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

CPT 90791 Medicare locality amounts in Tennessee (CY 2026 RVU26D, effective 2026-10-01)
LocalityMedicare non-facilityMedicare facilityMedicaid FFSCommercialSource
Tennessee
TN locality 35
$169.00$136.21Coming soon
$148.63
UnitedHealthcare median · Optum Health Behavioral Services (OHBS)
10th percentile $106.93 · 90th percentile $237.43
112 rate rows · 468 NPIs · source file dated 2026-09-01
Aetna · Anthem Coming soon
CMS MPFS
RVU26D · eff. 2026-10-01
UnitedHealthcare · source file dated 2026-09-01

Compare an offered CPT 90791 rate in Tennessee 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 Tennessee (median $148.63).

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Questions

What is the 2026 Medicare rate for CPT 90791 in Tennessee?

For CPT 90791 (Psychiatric diagnostic evaluation) in Tennessee, the CY 2026 Medicare non-facility Physician Fee Schedule amount is $169.00 across 1 CMS locality. Source: CMS RVU26D, October 2026 release, conversion factor 33.4009, effective 2026-10-01.

What is the UnitedHealthcare commercial median for CPT 90791 in Tennessee?

UnitedHealthcare Optum Health Behavioral Services (OHBS) professional median is $148.63 (10th percentile $106.93, 90th percentile $237.43; 112 rate rows; 468 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 Tennessee CPT 90791 amount a Medicaid MCO or commercial contracted rate?

Medicaid FFS is fee-for-service, not MCO. The commercial column is UnitedHealthcare median ($148.63 median) when loaded; Aetna and Anthem stay Coming soon.