Psychiatric Evaluation vs. Psychological Evaluation: What's the Difference?

The terms get used interchangeably. They aren’t.

A psychiatric evaluation and a psychological evaluation are two different products, conducted by two different kinds of clinicians, optimized for two different questions. Knowing which one you need saves money, time, and the frustration of getting the wrong answer.

Who Conducts Each One

Psychiatric evaluations are conducted by:

• Psychiatrists — medical doctors (MD or DO) who completed a residency in psychiatry
• Psychiatric nurse practitioners (PMHNP) — advanced practice registered nurses with psychiatric specialty training
• Physician assistants (PA) with psychiatric training, in some practices

These clinicians can prescribe medication. That’s the central feature of their scope.

Psychological evaluations are conducted by:

• Licensed psychologists (PhD or PsyD) — doctoral-level clinicians trained in psychotherapy, psychological testing, and clinical assessment
• Other licensed mental health clinicians (LCSW, LPC, LMFT) — for specific instruments where their licensure and training qualify them (the PAI and MMPI, for instance, are B-level Pearson/PAR qualifications that licensed master’s-level clinicians can administer with appropriate training)

These clinicians cannot prescribe medication in Colorado. Their scope is assessment, diagnosis, and therapy.

What Each One Includes

A standard psychiatric evaluation runs 45 to 90 minutes and includes:

• Clinical interview (history, symptoms, prior treatment)
• Medication review
• Screening questionnaires (PHQ-9 for depression, GAD-7 for anxiety, etc.)
• Discussion of treatment options — usually centered on medication, sometimes with referrals for therapy
• A short clinical note in the medical record

A standard psychological evaluation runs anywhere from 3 to 10+ hours of contact time and includes:

• Extended clinical interview (usually 60 to 90 minutes by itself)
• Collateral information when relevant (school records, prior reports, family input)
• Administration of validated standardized instruments — examples include the PAI or MMPI-3 for personality, the WAIS-5 for cognitive ability, the DIVA-5 and CAARS for ADHD, the ADOS-2 for autism
• Scoring and interpretation by the clinician
• A 10 to 20 page written report summarizing findings, diagnoses, and recommendations
• A feedback session to walk through the report

The written report is the central deliverable of a psychological evaluation. It’s the thing schools, employers, surgeons, attorneys, and treating providers actually need.

Which Question Each One Answers

Psychiatric evaluations are good at:

• Do I need medication for what I’m experiencing?
• Is the medication I’m on the right one?
• Are my symptoms primarily biological?

Psychological evaluations are good at:

• Do I actually have ADHD, or is this anxiety with executive function problems?
• Two providers have given me different diagnoses — which is right?
• My child needs accommodation documentation for school.
• Is this BPD or bipolar disorder?
• I’m being cleared for bariatric surgery / a security clearance / a custody evaluation.
• Why has therapy not worked, and what would?

If your question is “what’s actually going on,” start with a psychological evaluation. If your question is “what should I take for it,” start with a psychiatric evaluation.

Cost and Time

Psychiatric evaluation — typically $300 to $600 private pay for an initial intake; often covered by insurance. Returning visits run $150 to $300 for medication management. Wait times vary — a few weeks to a few months for new patients in Denver.

Psychological evaluation — typically $900 (training clinic) to $5,000+ (boutique) in Denver, with most private practices in the $1,500 to $3,000 range. FRTC’s pricing sits at $750 to $2,500 depending on the battery, with most adult evaluations between $1,500 and $2,100. Insurance coverage is variable — many plans cover psychological testing for established mental health conditions but exclude ADHD or learning disorders. See does insurance cover psychological testing for the specifics. Wait times in Denver range from 2 weeks (smaller practices) to 6 months (the busiest ones).

When You Need Both

For many people, the right sequence is psychological evaluation first, then psychiatric consultation if medication makes sense.

The reason: medication decisions are downstream of diagnosis. If a psychiatrist sees you for 45 minutes and prescribes a stimulant on the assumption that you have ADHD, but a full evaluation would have shown the real picture is anxiety with executive function symptoms, the medication may not help — or may make things worse. A clean diagnostic picture from a psychological evaluation makes a subsequent psychiatric consultation much more focused and useful.

There are exceptions. If you’re in crisis, if you’ve already had a clear diagnosis from prior providers, or if your question is straightforwardly “I’m depressed, I want to try an SSRI” — go directly to psychiatry.

A Note on Insurance Wording

Insurance plans often use the terms inconsistently. You may see “psychological testing,” “psychiatric evaluation,” “diagnostic evaluation,” and “behavioral health assessment” used to mean different things depending on the document. When in doubt, the CPT codes are the unambiguous reference point:

• 90791 / 90792 — psychiatric diagnostic evaluation (with and without medical services)
• 96130 / 96131 / 96132 / 96133 / 96136 / 96137 — psychological and neuropsychological testing services

If you’re trying to find out what your plan covers, ask about the codes, not the labels.

Getting Either One at FRTC

FRTC offers psychological evaluations — personality testing and diagnostic clarification interviews now, with full ADHD, cognitive, and pre-treatment readiness assessments launching August 2026. We don’t provide psychiatric evaluations in-house, but we work closely with psychiatrists across the Denver metro and will refer when medication is the right next step.

Start with a free 15-minute consultation to talk through which kind of evaluation actually fits the question you’re asking.