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#161 of 11K

90792

Psychiatric diagnostic evaluation with medical services

Psychiatric diagnostic evaluation with medical services is the #161 most-billed Medicaid procedure code, with $1.09B in payments across 8.4M claims from 2018–2024. The national median cost per claim is $108.91. Costs vary widely — the 90th percentile is $233.36 per claim, 2.1× the median.

Total Paid

$1.09B

0.10% of all spending

Total Claims

8.4M

Providers

10K

Avg Cost/Claim

$130

National Cost Distribution

How much do providers bill per claim for 90792? Based on 10K providers billing this code nationally.

Median

$108.91

Average

$127.26

Std Dev

$104.05

Max

$2,255.04

Percentile Distribution (Cost per Claim)

p10
$26.78
p25
$66.42
Median
$108.91
p75
$157.35
p90
$233.36
p95
$325.00
p99
$486.30

50% of providers bill between $66.42 and $157.35 per claim for this code.

90% bill between $26.78 and $233.36.

Top 1% bill above $486.30.

About This Procedure

HCPCS code 90792 (Psychiatric diagnostic evaluation with medical services) was billed by 10K providers across 8.4M claims, totaling $1.09B in Medicaid payments from 2018–2024. This code was used for 7.5M unique beneficiaries.

Risk Assessment

Billing Statistics

Median Cost/Claim

$108.91

Providers Billing

10K

National Spending

$1.09B

Avg/Median Ratio

1.17×

Normal distribution

Top Providers Billing This Code

Ranked by total Medicaid payments for 90792

#ProviderTotal Paid
11447206420$14.5M
21578641924$8.8M
3Team Mental Health Services Inc.

Detroit, MI · Radiology, Diagnostic Radiology

$7.8M
4Macomb County Community Mental Health

Clinton Twp, MI · Clinic/Center Mental Health (Including Community Mental Health Center)

$7.8M
51649217761$7.0M
6Upmc Presbyterian Shadyside

Pittsburgh, PA · Clinic/Center

$6.6M
71831338961$6.1M
81609300854$6.0M
9Community Mental Health For Central Michigan

Mt Pleasant, MI · Psychiatry & Neurology Psychiatry

$4.4M
10Lsu Health Sciences Center Shreveport Faculty Group Practice

Shreveport, LA · Oral & Maxillofacial Surgery

$4.4M
111013476787$4.4M
12Easterseals Morc Health Care, Inc.

Auburn Hills, MI · Psychiatry & Neurology, Psychiatry

$4.1M
13Bowen Health Inc

Warsaw, IN · Psychiatric Hospital

$4.0M
14Community Mental Health Authority Of Clinton Eaton Ingham Counties

Lansing, MI · Clinic/Center Mental Health (Including Community Mental Health Center)

$3.9M
15County Of Kern

Bakersfield, CA · Clinic/Center, Adult Mental Health

$3.9M
16County Of San Bernardino

San Bernardino, CA · Clinic/Center Rehabilitation Substance Use Disorder

$3.7M
171356397228$3.7M
181508814625$3.6M
19Genesee Health System

Flint, MI · Community/Behavioral Health

$3.6M
201760596480$3.5M

Showing top 20 of 10K providers billing this code