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Psychiatric Evaluation With Medical Assessment

Illinois rates for HCPCS 90792

An in-depth first-time evaluation performed by a prescriber, such as a psychiatrist or psychiatric nurse practitioner, that combines a mental health assessment with a medical evaluation, including a review of physical health, medications, and other factors that could affect diagnosis and treatment. It's typically the starting point for care from a provider who can prescribe medication. It's more comprehensive than a routine follow-up visit.

Rates data updated July 2026.

How much does Psychiatric Evaluation With Medical Assessment cost?

$170

Typical negotiated rate. In Illinois, July 2026.

Insurers have agreed to pay about $170 for this service. The price depends on where it is billed: about $170 from a physician practice, and about $178 from a hospital or other facility. The two figures are alternatives, not parts of one bill.

These are rates insurers have negotiated with providers, not the amount a patient is billed. What you owe depends on your plan's deductible and coinsurance. Based on rates published by 7 insurance carriers under federal price transparency rules.

Where it's billed changes the price

Billed byTypicalRange
Physician practiceA doctor's office, clinic or independent provider$170$145 to $214
FacilityA hospital or hospital-owned outpatient department$178$155 to $209

How much rates vary

Facilitymedian $178 · 10th to 90th $98 to $245Professionalmedian $170 · 10th to 90th $126 to $282
$50$100$200$500facility $178professional $170

Distribution of negotiated rates across all payers (price axis is log-scale). Each curve is scaled to its own total: facility and professional rates are different services, shown together to compare where they cluster. Need provider-level prices or 24+ months of history? Contact us.

Rates by insurance carrier

Insurance Carrier
Aetna
Setting
Facility
Modifier
Global
Typical Low
$97.72
Median
$177.83
Typical High
$239.88
Aetna
Setting
Professional
Modifier
Global
Typical Low
$123.03
Median
$165.96
Typical High
$275.42
Aetna
Setting
Professional
Modifier
25 · Same-day visit
Typical Low
$173.78
Median
$173.78
Typical High
$218.78
Ambetter
Setting
Professional
Modifier
Global
Typical Low
$131.83
Median
$173.78
Typical High
$239.88
BCBS
Setting
Facility
Modifier
Global
Typical Low
$229.09
Median
$758.58
Typical High
$758.58
BCBS
Setting
Professional
Modifier
Global
Typical Low
$154.88
Median
$223.87
Typical High
$245.47
Cigna
Setting
Facility
Modifier
Global
Typical Low
$186.21
Median
$186.21
Typical High
$275.42
Cigna
Setting
Professional
Modifier
Global
Typical Low
$75.86
Median
$190.55
Typical High
$302.00
Hally Health
Setting
Professional
Modifier
Global
Typical Low
$154.88
Median
$234.42
Typical High
$354.81
Molina
Setting
Professional
Modifier
Global
Typical Low
$32.36
Median
$33.11
Typical High
$239.88
United
Setting
Facility
Modifier
Global
Typical Low
$83.18
Median
$169.82
Typical High
$478.63
United
Setting
Professional
Modifier
Global
Typical Low
$102.33
Median
$177.83
Typical High
$302.00

Where Illinois sits

The same service costs 1.5 times more in North Dakota than in Delaware. Every bar is a state, most expensive first. Touch or drag across it to read any state, then open that state for its carriers and full range.

Illinois· 8th of 51

$170

ND $219DE $145

Median negotiated rate in each state, from every insurer that publishes one. States where no insurer publishes a rate for this service are not shown.