Official South Carolina Medicaid FFS for CPT 90792 (Psychiatric diagnostic evaluation with medical services) is $131.58 (facility $115.87) from SCDHHS Base Physician, effective 2024-07-01, verified 2026-09-10. CY 2026 Medicare non-facility PFS is $196.86. Source: CMS RVU26D, October 2026 release and the official South Carolina fee schedule. Not an MCO or commercial rate.
Last updated
Last verified 2026-09-10. Medicare effective 2026-10-01. South Carolina Medicaid FFS effective 2024-07-01 (SCDHHS Base Physician).
| Locality | Medicare non-facility | Medicare facility | Medicaid FFS | Commercial | Source |
|---|---|---|---|---|---|
South Carolina | $196.86 | $157.35 | $131.58 | Coming soon | CMS MPFS |
Compare an offered CPT 90792 rate in South Carolina 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 South Carolina Medicaid FFS amount for CPT 90792?
Official South Carolina Medicaid FFS is $131.58 (facility $115.87) from SCDHHS Base Physician, effective 2024-07-01, last verified 2026-09-10.
What is the 2026 Medicare rate for CPT 90792 in South Carolina?
For CPT 90792 (Psychiatric diagnostic evaluation with medical services) in South Carolina, the CY 2026 Medicare non-facility Physician Fee Schedule amount is $196.86 across 1 CMS locality. Source: CMS RVU26D, October 2026 release, conversion factor 33.4009, effective 2026-10-01.
How does South Carolina Medicaid FFS compare to Medicare for CPT 90792?
South Carolina Medicaid FFS is $131.58; Medicare non-facility PFS is $196.86. These are different programs. The Medicaid cell is official fee-for-service only, not an MCO or commercial contracted rate. Source: https://www.scdhhs.gov/providers/fee-schedules.
Where is the official South Carolina Medicaid FFS source for CPT 90792?
South Carolina Department of Health and Human Services: SCDHHS Base Physicians Fee Schedule, schedule creation date 2026-09-01. Source page: https://www.scdhhs.gov/providers/fee-schedules. File: https://img1.scdhhs.gov/fees/FEE_P1454.xlsx. Last verified 2026-09-10.
Is this South Carolina CPT 90792 amount a Medicaid MCO or commercial contracted rate?
The Medicaid FFS cell is the official SCDHHS Base Physician amount $131.58. That is fee-for-service, not an MCO rate. Commercial cells remain Coming soon until a parsed in-network file is loaded.