Official Virginia Medicaid FFS for CPT 90792 (Psychiatric diagnostic evaluation with medical services) is $206.58 (facility $162.88) from DMAS Procedure Fee, effective 2026-07-01, verified 2026-09-10. CY 2026 Medicare non-facility PFS is $199.43. Source: CMS RVU26D, October 2026 release and the official Virginia fee schedule. Not an MCO or commercial rate.
Last updated
Last verified 2026-09-10. Medicare effective 2026-10-01. Virginia Medicaid FFS effective 2026-07-01 (DMAS Procedure Fee).
| Locality | Medicare non-facility | Medicare facility | Medicaid FFS | Commercial | Source |
|---|---|---|---|---|---|
Virginia | $199.43 | $157.40 | $206.58 | Coming soon | CMS MPFS |
Compare an offered CPT 90792 rate in Virginia 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 Virginia Medicaid FFS amount for CPT 90792?
Official Virginia Medicaid FFS is $206.58 (facility $162.88) from DMAS Procedure Fee, effective 2026-07-01, last verified 2026-09-10.
What is the 2026 Medicare rate for CPT 90792 in Virginia?
For CPT 90792 (Psychiatric diagnostic evaluation with medical services) in Virginia, the CY 2026 Medicare non-facility Physician Fee Schedule amount is $199.43 across 1 CMS locality. Source: CMS RVU26D, October 2026 release, conversion factor 33.4009, effective 2026-10-01.
How does Virginia Medicaid FFS compare to Medicare for CPT 90792?
Virginia Medicaid FFS is $206.58; Medicare non-facility PFS is $199.43. These are different programs. The Medicaid cell is official fee-for-service only, not an MCO or commercial contracted rate. Source: https://www.dmas.virginia.gov/for-providers/rates-and-rate-setting/procedure-fee-files-cpt-codes/.
Where is the official Virginia Medicaid FFS source for CPT 90792?
Virginia Department of Medical Assistance Services: DMAS Procedure Fee File CPT Part 4 (codes 80002–99607), current rows (rate end 12/31/9999). Source page: https://www.dmas.virginia.gov/for-providers/rates-and-rate-setting/procedure-fee-files-cpt-codes/. File: https://www.dmas.virginia.gov/media/cptcodes/cptmedical4.csv. Last verified 2026-09-10.
Is this Virginia CPT 90792 amount a Medicaid MCO or commercial contracted rate?
The Medicaid FFS cell is the official DMAS Procedure Fee amount $206.58. That is fee-for-service, not an MCO rate. Commercial cells remain Coming soon until a parsed in-network file is loaded.