How much insurance pays for 90791 (initial evaluation)
Major insurers typically reimburse $97 to $133 for CPT 90791 (initial evaluation). Aetna $129, Anthem BCBS $133, Cigna $97, UnitedHealthcare $131, based on contracted rates published in CMS Transparency in Coverage files. Rates vary widely by state. Updated July 2026.
CPT 90791 is the psychiatric diagnostic evaluation, the intake session. It is billed once per new client episode and usually reimburses above a routine therapy session.
- Reimbursement rates retrieved from CMS transparency data
- Updated July 2026
| Payer | Typical rate | Typical range |
|---|---|---|
| Aetna | $129 | $129–$146 |
| Anthem BCBS | $133 | $133–$156 |
| Cigna | $97 | $97–$114 |
| UnitedHealthcare | $131 | $131–$149 |
| State | Aetna | Anthem BCBS | Cigna | UnitedHealthcare |
|---|---|---|---|---|
| North Dakota | $160 | n/a | $60 | $158 |
| Wyoming | $140 | n/a | $94 | $159 |
| Connecticut | $141 | $127 | $108 | $157 |
| Massachusetts | n/a | n/a | $104 | $157 |
| Montana | $144 | n/a | n/a | $153 |
Explore more rates
90791 rates by state
- Alabama
- Arizona
- Arkansas
- California
- Colorado
- Connecticut
- Delaware
- District of Columbia
- Florida
- Georgia
- Hawaii
- Idaho
- Illinois
- Indiana
- Iowa
- Kansas
- Kentucky
- Louisiana
- Maine
- Maryland
- Massachusetts
- Michigan
- Minnesota
- Mississippi
- Missouri
- Montana
- Nebraska
- Nevada
- New Hampshire
- New Jersey
- New Mexico
- New York
- North Carolina
- North Dakota
- Ohio
- Oklahoma
- Oregon
- Pennsylvania
- Rhode Island
- South Carolina
- South Dakota
- Tennessee
- Texas
- Utah
- Vermont
- Virginia
- Washington
- West Virginia
- Wisconsin
- Wyoming
About this data
From CMS Transparency in Coverage files, which insurers must publish. This page reflects published contracted rates for CPT 90791 across 50 states. Each figure is the typical contracted rate for master's-level clinicians (LCSW, LMHC, LMFT): a guide, not a quote, and credentialing never guarantees panel acceptance. Last synced July 2026.
Common questions
- What is the average reimbursement for CPT 90791?
- Across Aetna, Anthem BCBS, Cigna, and UnitedHealthcare, the typical national rate for 90791 (initial evaluation) runs from $97 to $133 per session, based on CMS Transparency in Coverage data. State-level rates can sit well above or below that.
- Does 90791 pay differently by state?
- Yes, the same payer's contracted 90791 rate can differ by 30% or more between states. The highest-paying states are listed above; for your own state and license, use the calculator or your state's rate guide.
- How do I start billing these codes in network?
- You need to be credentialed with each payer first; your own contract then sets your exact rates, and it applies from the day you're approved. Payer reviews run 60 to 120 days and only start once a clean application is filed, so filing sooner is the fastest route to billing in network. We prepare and file each application for a one-time $99 per payer and handle the follow-ups from there. Start with paneled.ai.
Rates like these start with getting on the panels.
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