CPT 90792 · TX

CPT 90792 Medicare and Medicaid FFS rate in Texas (2026)

Psychiatric diagnostic evaluation with medical services. Locality amounts from CMS RVU26D, October 2026 release. Official TMHP Physician Medicaid FFS is shown beside Medicare.

Official Texas Medicaid FFS for CPT 90792 (Psychiatric diagnostic evaluation with medical services) is $155.30, 21-999 years from TMHP Physician, effective 2026-03-01, verified 2026-09-10. CY 2026 Medicare non-facility PFS is $196.50 to $205.04 across 8 CMS localities. Source: CMS RVU26D, October 2026 release and the official Texas fee schedule. Not an MCO or commercial rate.

Last updated

Last verified 2026-09-10. Medicare effective 2026-10-01. Texas Medicaid FFS effective 2026-03-01 (TMHP Physician).

CPT 90792 in Texas: Medicare localities (CMS RVU26D, October 2026 release) and Medicaid FFS (TMHP Physician, eff. 2026-03-01)
LocalityMedicare non-facilityMedicare facilityMedicaid FFSCommercialSource
Austin
TX locality 31
$205.04$159.81
$155.30
TMHP Physician · 21-999 years
eff. 2026-03-01 · verified 2026-09-10
Coming soon
Aetna · Anthem
CMS MPFS
RVU26D · eff. 2026-10-01
TMHP Physician
eff. 2026-03-01
Beaumont
TX locality 20
$196.50$157.60
$155.30
TMHP Physician · 21-999 years
eff. 2026-03-01 · verified 2026-09-10
Coming soon
Aetna · Anthem
CMS MPFS
RVU26D · eff. 2026-10-01
TMHP Physician
eff. 2026-03-01
Brazoria
TX locality 09
$201.42$159.05
$155.30
TMHP Physician · 21-999 years
eff. 2026-03-01 · verified 2026-09-10
Coming soon
Aetna · Anthem
CMS MPFS
RVU26D · eff. 2026-10-01
TMHP Physician
eff. 2026-03-01
Dallas
TX locality 11
$202.29$159.71
$155.30
TMHP Physician · 21-999 years
eff. 2026-03-01 · verified 2026-09-10
Coming soon
Aetna · Anthem
CMS MPFS
RVU26D · eff. 2026-10-01
TMHP Physician
eff. 2026-03-01
Fort Worth
TX locality 28
$201.79$159.63
$155.30
TMHP Physician · 21-999 years
eff. 2026-03-01 · verified 2026-09-10
Coming soon
Aetna · Anthem
CMS MPFS
RVU26D · eff. 2026-10-01
TMHP Physician
eff. 2026-03-01
Galveston
TX locality 15
$201.81$159.35
$155.30
TMHP Physician · 21-999 years
eff. 2026-03-01 · verified 2026-09-10
Coming soon
Aetna · Anthem
CMS MPFS
RVU26D · eff. 2026-10-01
TMHP Physician
eff. 2026-03-01
Houston
TX locality 18
$204.92$162.47
$155.30
TMHP Physician · 21-999 years
eff. 2026-03-01 · verified 2026-09-10
Coming soon
Aetna · Anthem
CMS MPFS
RVU26D · eff. 2026-10-01
TMHP Physician
eff. 2026-03-01
Rest Of Texas
TX locality 99
$198.59$158.02
$155.30
TMHP Physician · 21-999 years
eff. 2026-03-01 · verified 2026-09-10
Coming soon
Aetna · Anthem
CMS MPFS
RVU26D · eff. 2026-10-01
TMHP Physician
eff. 2026-03-01

Compare an offered CPT 90792 rate in Texas 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 Texas Medicaid FFS amount for CPT 90792?

Official Texas Medicaid FFS is $155.30, 21-999 years from TMHP Physician, effective 2026-03-01, last verified 2026-09-10.

What is the 2026 Medicare rate for CPT 90792 in Texas?

For CPT 90792 (Psychiatric diagnostic evaluation with medical services) in Texas, the CY 2026 Medicare non-facility Physician Fee Schedule amount is $196.50 to $205.04 across 8 CMS localities. Source: CMS RVU26D, October 2026 release, conversion factor 33.4009, effective 2026-10-01.

How does Texas Medicaid FFS compare to Medicare for CPT 90792?

Texas Medicaid FFS is $155.30; Medicare non-facility PFS is $196.50 to $205.04. These are different programs. The Medicaid cell is official fee-for-service only, not an MCO or commercial contracted rate. Source: https://public.tmhp.com/feeschedules/StaticFeeSchedule/FeeSchedules.aspx.

Where is the official Texas Medicaid FFS source for CPT 90792?

Texas Health and Human Services Commission / TMHP: Texas Medicaid Static Fee Schedule PHYSICIAN PRCR402C (modified 2026-07-29). Source page: https://public.tmhp.com/feeschedules/StaticFeeSchedule/FeeSchedules.aspx. File: https://public.tmhp.com/feeschedules/StaticFeeSchedule/FeeSchedules.aspx?fn=%5c%5ctmhp.net%5cFeeSchedule%5cPROD%5cStatic%5cTexas_Medicaid_Fee_Schedule_PRCR402C.xls. Last verified 2026-09-10.

Is this Texas CPT 90792 amount a Medicaid MCO or commercial contracted rate?

The Medicaid FFS cell is the official TMHP Physician amount $155.30. That is fee-for-service, not an MCO rate. Commercial cells remain Coming soon until a parsed in-network file is loaded.