Official New York Medicaid FFS for CPT 90792 (Psychiatric diagnostic evaluation with medical services) is $200.62 (facility $116.22) from eMedNY Physician, effective 2026-07-01, verified 2026-09-10. CY 2026 Medicare non-facility PFS is $197.52 to $226.69 across 5 CMS localities. Source: CMS RVU26D, October 2026 release and the official New York fee schedule. Not an MCO or commercial rate.
Last updated
Last verified 2026-09-10. Medicare effective 2026-10-01. New York Medicaid FFS effective 2026-07-01 (eMedNY Physician).
| Locality | Medicare non-facility | Medicare facility | Medicaid FFS | Commercial | Source |
|---|---|---|---|---|---|
Manhattan | $223.60 | $173.92 | $200.62 | Coming soon | CMS MPFS |
NYC Suburbs/Long Island | $226.69 | $175.86 | $200.62 | Coming soon | CMS MPFS |
Poughkpsie/N NYC Suburbs | $214.98 | $168.16 | $200.62 | Coming soon | CMS MPFS |
Queens | $223.93 | $173.40 | $200.62 | Coming soon | CMS MPFS |
Rest Of New York | $197.52 | $156.90 | $200.62 | Coming soon | CMS MPFS |
Compare an offered CPT 90792 rate in New York 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. Aetna and Anthem stay Coming soon.
Questions
What is the New York Medicaid FFS amount for CPT 90792?
Official New York Medicaid FFS is $200.62 (facility $116.22) from eMedNY Physician, effective 2026-07-01, last verified 2026-09-10.
What is the 2026 Medicare rate for CPT 90792 in New York?
For CPT 90792 (Psychiatric diagnostic evaluation with medical services) in New York, the CY 2026 Medicare non-facility Physician Fee Schedule amount is $197.52 to $226.69 across 5 CMS localities. Source: CMS RVU26D, October 2026 release, conversion factor 33.4009, effective 2026-10-01.
How does New York Medicaid FFS compare to Medicare for CPT 90792?
New York Medicaid FFS is $200.62; Medicare non-facility PFS is $197.52 to $226.69. These are different programs. The Medicaid cell is official fee-for-service only, not an MCO or commercial contracted rate. Source: https://www.emedny.org/ProviderManuals/Physician/.
Where is the official New York Medicaid FFS source for CPT 90792?
New York State Department of Health / eMedNY: NYS Medicaid Physician Medicine Services Fee Schedule, effective July 1, 2026. Source page: https://www.emedny.org/ProviderManuals/Physician/. File: https://www.emedny.org/ProviderManuals/Physician/PDFS/Physician_Manual_Fee_Schedule_Sect2.xls. Last verified 2026-09-10.
Is this New York CPT 90792 amount a Medicaid MCO or commercial contracted rate?
The Medicaid FFS cell is the official eMedNY Physician amount $200.62. That is fee-for-service, not an MCO rate. Commercial cells remain Coming soon until a parsed in-network file is loaded.