Official Ohio Medicaid FFS for CPT 90792 (Psychiatric diagnostic evaluation with medical services) is $130.20 (facility $87.90) from ODM Appendix DD, effective 2024-01-01, verified 2026-09-10. CY 2026 Medicare non-facility PFS is $197.12. Source: CMS RVU26D, October 2026 release and the official Ohio fee schedule. Not an MCO or commercial rate.
Last updated
Last verified 2026-09-10. Medicare effective 2026-10-01. Ohio Medicaid FFS effective 2024-01-01 (ODM Appendix DD).
| Locality | Medicare non-facility | Medicare facility | Medicaid FFS | Commercial | Source |
|---|---|---|---|---|---|
Ohio | $197.12 | $158.09 | $130.20 | Coming soon | CMS MPFS |
Compare an offered CPT 90792 rate in Ohio 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 Ohio Medicaid FFS amount for CPT 90792?
Official Ohio Medicaid FFS is $130.20 (facility $87.90) from ODM Appendix DD, effective 2024-01-01, last verified 2026-09-10.
What is the 2026 Medicare rate for CPT 90792 in Ohio?
For CPT 90792 (Psychiatric diagnostic evaluation with medical services) in Ohio, the CY 2026 Medicare non-facility Physician Fee Schedule amount is $197.12 across 1 CMS locality. Source: CMS RVU26D, October 2026 release, conversion factor 33.4009, effective 2026-10-01.
How does Ohio Medicaid FFS compare to Medicare for CPT 90792?
Ohio Medicaid FFS is $130.20; Medicare non-facility PFS is $197.12. These are different programs. The Medicaid cell is official fee-for-service only, not an MCO or commercial contracted rate. Source: https://medicaid.ohio.gov/resources-for-providers/billing/fee-schedule-and-rates/schedules-and-rates.
Where is the official Ohio Medicaid FFS source for CPT 90792?
Ohio Department of Medicaid: Appendix DD to OAC 5160-1-60 (Non-Institutional Fee Schedule), updates for 2026-01-01. Source page: https://medicaid.ohio.gov/resources-for-providers/billing/fee-schedule-and-rates/schedules-and-rates. File: https://dam.assets.ohio.gov/raw/upload/medicaid.ohio.gov/Providers/FeeScheduleRates/OutpatientHospital/5160-1-60-_App_DD-_Updates_for_01_01_2026-_FINAL.xlsx. Last verified 2026-09-10.
Is this Ohio CPT 90792 amount a Medicaid MCO or commercial contracted rate?
The Medicaid FFS cell is the official ODM Appendix DD amount $130.20. That is fee-for-service, not an MCO rate. Commercial cells remain Coming soon until a parsed in-network file is loaded.