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#102 of 11K

90791

Psychiatric diagnostic evaluation

Psychiatric diagnostic evaluation is the #102 most-billed Medicaid procedure code, with $1.94B in payments across 16.1M claims from 2018–2024. The national median cost per claim is $99.21.

Total Paid

$1.94B

0.18% of all spending

Total Claims

16.1M

Providers

22K

Avg Cost/Claim

$120

National Cost Distribution

How much do providers bill per claim for 90791? Based on 20K providers billing this code nationally.

Median

$99.21

Average

$105.02

Std Dev

$76.39

Max

$4,511.66

Percentile Distribution (Cost per Claim)

p10
$35.93
p25
$70.16
Median
$99.21
p75
$126.49
p90
$164.28
p95
$208.60
p99
$333.27

50% of providers bill between $70.16 and $126.49 per claim for this code.

90% bill between $35.93 and $164.28.

Top 1% bill above $333.27.

About This Procedure

HCPCS code 90791 (Psychiatric diagnostic evaluation) was billed by 22K providers across 16.1M claims, totaling $1.94B in Medicaid payments from 2018–2024. This code was used for 14.1M unique beneficiaries.

Risk Assessment

Billing Statistics

Median Cost/Claim

$99.21

Providers Billing

20K

National Spending

$1.94B

Avg/Median Ratio

1.06×

Normal distribution

Top Providers Billing This Code

Ranked by total Medicaid payments for 90791

#ProviderTotal Paid
1Sate Of Alabama Dept Of Finance

Montgomery, AL · Public Health or Welfare

$40.5M
2Alabama Department Of Mental Health And Mental Retardation

Montgomery, AL · Community/Behavioral Health

$21.2M
3University Of Rochester

Rochester, NY · General Acute Care Hospital

$20.2M
4Nationwide Children's Hospital

Columbus, OH · General Acute Care Hospital

$19.5M
51437197985$16.2M
6New York City Health And Hospitals Corporation

New York, NY · Internal Medicine

$15.8M
7New York Psychotherapy And Counseling Center

Jamaica, NY · Community/Behavioral Health

$13.2M
8Richmond Medical Center

Staten Island, NY · Psychiatric Unit

$13.2M
91972523348$13.1M
101174129563$12.4M
11Valley Behavioral Health Incorporated

Salt Lake City, UT · Psychiatry & Neurology Psychiatry

$12.3M
12Bronxcare Health System

Bronx, NY · General Acute Care Hospital

$10.9M
131508815333$10.9M
14Bowen Health Inc

Warsaw, IN · Psychiatric Hospital

$10.7M
15Centerstone Of Tennessee Inc.

Nashville, TN · Clinic/Center Mental Health (Including Community Mental Health Center)

$10.0M
16New York City Health And Hospitals Corporation

Brooklyn, NY · Internal Medicine

$9.6M
17Beth Israel Medical Center

Brooklyn, NY · Psychiatric Unit

$9.6M
18The Brookdale Hospital Medical Center

Brooklyn, NY · General Acute Care Hospital

$9.4M
19St Lukes Roosevelt Hospital Center

New York, NY · Case Management

$8.9M
20Community Mental Health For Central Michigan

Mt Pleasant, MI · Psychiatry & Neurology Psychiatry

$8.5M

Showing top 20 of 22K providers billing this code