Code Reality Check
90791 reimbursement rate: Psychiatric diagnostic evaluation
Psychiatric diagnostic evaluation (CPT 90791) pays a median $227.58 in District of Columbia and $112.20 in Kentucky, against a Medicare anchor of $195.21. 51 of 51 states clear the publication floor.
spread 2x top to bottom
Medicare anchor $195.21
51/51 states published
The 50-state spread
as of 2026-07-15| State | Median | vs Medicare | Band | Rate points | Tier |
|---|---|---|---|---|---|
| District of Columbia | $227.58 | 1.17x | $180–$273 · P90 $318 | 1,885 | Benchmark |
| Rhode Island | $205.27 | 1.05x | $175–$249 · P90 $289 | 12,863 | Benchmark |
| Maryland | $193.37 | 0.99x | $148–$228 · P90 $318 | 4,756 | Benchmark |
| Virginia | $191.39 | 0.98x | $174–$228 · P90 $300 | 30,203 | Benchmark |
| Wisconsin | $190.78 | 0.98x | $148–$490 · P90 $679 | 49,372 | Benchmark |
| California | $189.58 | 0.97x | $175–$393 · P90 $576 | 130,676 | Benchmark |
| New Hampshire | $184.31 | 0.94x | $156–$222 · P90 $326 | 9,910 | Benchmark |
| Massachusetts | $184.31 | 0.94x | $150–$211 · P90 $311 | 9,700 | Benchmark |
| Indiana | $180.00 | 0.92x | $153–$185 · P90 $243 | 49,033 | Benchmark |
| Michigan | $180.00 | 0.92x | $144–$263 · P90 $427 | 5,436 | Benchmark |
| Oregon | $179.43 | 0.92x | $133–$301 · P90 $465 | 1,690 | Benchmark |
| North Carolina | $179.16 | 0.92x | $131–$301 · P90 $301 | 97,819 | Benchmark |
| Connecticut | $178.98 | 0.92x | $114–$300 · P90 $388 | 4,193 | Benchmark |
| Hawaii | $178.11 | 0.91x | $131–$249 · P90 $429 | 806 | Benchmark |
| Washington | $176.22 | 0.90x | $131–$278 · P90 $501 | 3,163 | Benchmark |
| Arizona | $176.14 | 0.90x | $136–$275 · P90 $414 | 3,176 | Benchmark |
| Delaware | $175.85 | 0.90x | $121–$237 · P90 $320 | 685 | Benchmark |
| Utah | $175.36 | 0.90x | $138–$300 · P90 $516 | 957 | Benchmark |
| Idaho | $175.10 | 0.90x | $137–$259 · P90 $361 | 583 | Benchmark |
| Montana | $172.50 | 0.88x | $136–$280 · P90 $489 | 476 | Benchmark |
| Wyoming | $171.60 | 0.88x | $132–$197 · P90 $298 | 560 | Benchmark |
| New Mexico | $171.52 | 0.88x | $131–$261 · P90 $384 | 920 | Benchmark |
| Illinois | $170.49 | 0.87x | $103–$287 · P90 $515 | 13,611 | Benchmark |
| Iowa | $170.47 | 0.87x | $145–$218 · P90 $352 | 1,468 | Benchmark |
| Minnesota | $170.47 | 0.87x | $145–$380 · P90 $461 | 7,109 | Benchmark |
| North Dakota | $170.47 | 0.87x | $136–$274 · P90 $392 | 298 | Benchmark |
| Nevada | $170.42 | 0.87x | $148–$252 · P90 $463 | 1,630 | Benchmark |
| South Dakota | $170.38 | 0.87x | $131–$274 · P90 $461 | 251 | Benchmark |
| Nebraska | $170.34 | 0.87x | $128–$277 · P90 $396 | 508 | Benchmark |
| Texas | $169.33 | 0.87x | $136–$243 · P90 $345 | 29,188 | Benchmark |
| Oklahoma | $165.27 | 0.85x | $131–$209 · P90 $319 | 1,217 | Benchmark |
| New Jersey | $163.29 | 0.84x | $122–$248 · P90 $340 | 16,926 | Benchmark |
| Louisiana | $161.15 | 0.83x | $129–$273 · P90 $418 | 1,366 | Benchmark |
| Mississippi | $157.93 | 0.81x | $131–$204 · P90 $315 | 736 | Benchmark |
| Florida | $157.45 | 0.81x | $131–$220 · P90 $310 | 15,578 | Benchmark |
| Georgia | $157.12 | 0.80x | $143–$234 · P90 $351 | 98,688 | Benchmark |
| Tennessee | $157.09 | 0.80x | $132–$202 · P90 $301 | 6,964 | Benchmark |
| Alabama | $157.06 | 0.80x | $131–$190 · P90 $301 | 2,640 | Benchmark |
| Alaska | $156.98 | 0.80x | $127–$239 · P90 $329 | 341 | Benchmark |
| South Carolina | $156.79 | 0.80x | $131–$230 · P90 $301 | 6,807 | Benchmark |
| Ohio | $155.60 | 0.80x | $137–$262 · P90 $443 | 64,071 | Benchmark |
| Vermont | $154.41 | 0.79x | $39–$184 · P90 $212 | 1,378 | Benchmark |
| West Virginia | $153.96 | 0.79x | $120–$203 · P90 $301 | 1,768 | Benchmark |
| Colorado | $151.77 | 0.78x | $83–$187 · P90 $265 | 8,698 | Benchmark |
| Maine | $150.12 | 0.77x | $140–$241 · P90 $282 | 10,193 | Benchmark |
| Arkansas | $146.17 | 0.75x | $103–$193 · P90 $310 | 1,107 | Benchmark |
| Pennsylvania | $140.95 | 0.72x | $139–$186 · P90 $301 | 21,995 | Benchmark |
| Kansas | $125.21 | 0.64x | $103–$164 · P90 $257 | 1,804 | Benchmark |
| New York | $122.24 | 0.63x | P75 $241 · P90 $385 | 178,838 | Benchmark |
| Missouri | $115.09 | 0.59x | $95–$173 · P90 $319 | 56,576 | Benchmark |
| Kentucky | $112.20 | 0.57x | $98–$146 · P90 $191 | 21,820 | Benchmark |
Payer-blind local peer percentiles per state, full verified distribution. Publication floor: 11 verified rate points and a non-degenerate spread; the P25–P75 band unlocks at 25 points, P90 at 100 (a smaller cell's P90 is one contract, not a statistic).
Documented reimbursement figures are modeled, not guaranteed. Derived from federally mandated Transparency in Coverage data (45 CFR 147.212). No PHI.
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Cite this page
Source: Reddenda Code Reality Check, CPT 90791. Reddenda. https://reddenda.health/code/90791/
Derivation federally mandated TiC MRFs, verified to provider identity992,436 verified rate points across 51 statesas of 2026-07-15 · methodology v1.0