Official Washington Medicaid FFS for CPT 90792 (Psychiatric diagnostic evaluation with medical services) is $120.20 (facility $93.26) from HCA Physician-related, effective 2026-07-01, verified 2026-09-10. CY 2026 Medicare non-facility PFS is $205.57 to $221.02 across 2 CMS localities. Source: CMS RVU26D, October 2026 release and the official Washington fee schedule. Not an MCO or commercial rate.
Last updated
Last verified 2026-09-10. Medicare effective 2026-10-01. Washington Medicaid FFS effective 2026-07-01 (HCA Physician-related).
| Locality | Medicare non-facility | Medicare facility | Medicaid FFS | Commercial | Source |
|---|---|---|---|---|---|
Rest Of Washington | $205.57 | $160.55 | $120.20 | Coming soon | CMS MPFS |
Seattle (King Cnty) | $221.02 | $168.57 | $120.20 | Coming soon | CMS MPFS |
Compare an offered CPT 90792 rate in Washington 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 Washington Medicaid FFS amount for CPT 90792?
Official Washington Medicaid FFS is $120.20 (facility $93.26) from HCA Physician-related, effective 2026-07-01, last verified 2026-09-10.
What is the 2026 Medicare rate for CPT 90792 in Washington?
For CPT 90792 (Psychiatric diagnostic evaluation with medical services) in Washington, the CY 2026 Medicare non-facility Physician Fee Schedule amount is $205.57 to $221.02 across 2 CMS localities. Source: CMS RVU26D, October 2026 release, conversion factor 33.4009, effective 2026-10-01.
How does Washington Medicaid FFS compare to Medicare for CPT 90792?
Washington Medicaid FFS is $120.20; Medicare non-facility PFS is $205.57 to $221.02. These are different programs. The Medicaid cell is official fee-for-service only, not an MCO or commercial contracted rate. Source: https://www.hca.wa.gov/billers-providers-partners/prior-authorization-claims-and-billing/provider-billing-guides-and-fee-schedules.
Where is the official Washington Medicaid FFS source for CPT 90792?
Washington State Health Care Authority: Physician-Related Services fee schedule, July 1, 2026 (updated 2026-07-21). Source page: https://www.hca.wa.gov/billers-providers-partners/prior-authorization-claims-and-billing/provider-billing-guides-and-fee-schedules. File: https://www.hca.wa.gov/assets/billers-and-providers/physician-20260701.xlsx. Last verified 2026-09-10.
Is this Washington CPT 90792 amount a Medicaid MCO or commercial contracted rate?
The Medicaid FFS cell is the official HCA Physician-related amount $120.20. That is fee-for-service, not an MCO rate. Commercial cells remain Coming soon until a parsed in-network file is loaded.