What does Centene pay for CPT 90791 in Los Angeles-Long Beach-Anaheim, CA?

The local peer median for CPT 90791 under Centene in Los Angeles-Long Beach-Anaheim, CA is $450.52, based on 2009 indexed providers. Modeled from published rates, not guaranteed.

What is the top of the local market (P90) for CPT 90791 under Centene in Los Angeles-Long Beach-Anaheim, CA?

The P90, the top of the local market and Reddenda's target rate, is $767.

How does Centene's rate for CPT 90791 compare to Medicare?

The Centene local median of $450.52 is 260% of Medicare's national non-facility rate of $173.35 for CPT 90791.

Reddenda · Rate Intelligence · Los Angeles-Long Beach-Anaheim, CA

90791 under Centene in Los Angeles-Long Beach-Anaheim, CA

Name: Centene rates for CPT 90791 in Los Angeles-Long Beach-Anaheim, CA
Creator: Reddenda

Psychiatric diagnostic evaluation · Local peer median $450.52 · High confidence

$450.52 local peer median. In the Los Angeles-Long Beach-Anaheim, CA market, Centene pays a local peer median of $450.52 for CPT 90791 (Psychiatric diagnostic evaluation), based on 2009 providers in Reddenda's index of Centene's own published in-network rates. The top of the local market, the P90 target, is $767, 70% above the median. A provider billed below the local median is being paid less than peers holding the identical Centene contract in Los Angeles-Long Beach-Anaheim, CA for the identical code. Modeled from published rates, not guaranteed.

Local distribution · 2009 providers · 2010 rate records

P10

$112.50

P25

$152.85

Median

$450.52

P75

$767

P90 (target)

$767

P10$112.50

P25$152.85

Median (P50)$450.52

P75$767

P90 target$767

Peer basis: local peer distribution: same CPT, same payer file, same metro (CBSA) Benchmark: local peer median; never a national average Range: $60 – $767

The local peer median for CPT 90791 under Centene in Los Angeles-Long Beach-Anaheim, CA is $450.52, drawn from 2009 distinct providers.Source: the federal Transparency in Coverage Rule (45 CFR §147.212), which compels Centene to publish this rate
The bottom of the local market (P10) is $112.50 and the top (P90) is $767; the median-to-P90 spread is $316.48.Source: the federal Transparency in Coverage Rule (45 CFR §147.212), which compels Centene to publish this rate
The lowest published rate in this market is $60; the highest is $767.Source: the federal Transparency in Coverage Rule (45 CFR §147.212), which compels Centene to publish this rate
This benchmark is drawn from 2010 individual rate records that Centene itself published for this code in this metro.Source: the federal Transparency in Coverage Rule (45 CFR §147.212), which compels Centene to publish this rate
Medicare's national non-facility rate for CPT 90791 is $173.35, making the Centene local median 260% of Medicare.Source: Medicare Physician Fee Schedule; the federal Transparency in Coverage Rule (45 CFR §147.212), which compels Centene to publish this rate
48.7% of indexed providers cluster at the single most common rate; the remainder shows a real, scoreable spread across the local market.Source: the federal Transparency in Coverage Rule (45 CFR §147.212), which compels Centene to publish this rate
A federal No Surprises Act arbitrator may weigh up to four plan years of a provider's own contracted rate history and local market share when resolving a payment dispute over this exact code and payer.Source: 45 CFR §149.510(c)(4)(iii)(B)

2009 providers bill this code to this payer in this metro.

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This is the local market for CPT 90791 (Psychiatric diagnostic evaluation) under Centene in Los Angeles-Long Beach-Anaheim, CA. Enter your NPI to see your own contracted rate against this peer curve, per payer and per code. Free, about 15 seconds, no card and no PHI.

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Documented reimbursement opportunity, modeled from published rates and never a guaranteed outcome.

Modeled from Centene's own published in-network rates, never guaranteed and never a national average. Peer basis: same CPT, same payer file, same metro (CBSA). Federal citation for the underlying obligation: the federal Transparency in Coverage Rule (45 CFR §147.212), which compels Centene to publish this rate. Page generated 2026-08-24 12:00 UTC; the live index is queried in real time on every request.