90791: Psychiatric diagnostic evaluation
90791 is the intake. It covers the first full diagnostic evaluation of a new client: history, mental status, risk, and a working diagnosis with a treatment plan. There is no medical service inside it, which is what separates it from 90792, the version prescribers use.
- Kind
- CPT code
- Family
- intake
- Time
- One unit per evaluation; no time threshold
- Who bills
- Therapists, Psychologists, Associates
- Telehealth
- Eligible
- Add-on
- Stands alone
When to use it
Use 90791 for the first visit with a new child or teen, or when a client returns after a long gap and needs a fresh evaluation. Most payers allow one 90791 per clinician per episode; a second one needs a clinical reason in the note. Some plans allow the evaluation to run across two dates when the parent interview and the child interview are separate; check the payer.
When not to
Do not bill 90791 for a routine follow-up session, for a session that was mostly therapy, or for the parent-only history call before you have met the child (that is usually part of the same 90791, not its own). Prescribers who include a medical assessment bill 90792 instead.
With children and families
With children the evaluation is rarely one conversation. You will speak with the parent, with the child, and often with both, and you may gather school reports and rating scales. Document who was interviewed and when. If the parent interview and the child interview happen on different days, note the payer's rule on split evaluations. The identified patient is the child, even when the parent does most of the talking.
Questions about 90791
- Can I bill 90791 and a therapy code on the same day?
- Almost never for the same clinician. If a crisis emerges you may add 90839 in some plans, but the routine answer is no.
- How long does a 90791 take?
- It is not timed. Most child intakes run 60 to 90 minutes across parent and child conversations.
- Can an associate bill 90791?
- Where the payer credentials associates, yes; otherwise it is billed under the supervisor per the payer contract. Emora handles which.
- What is the difference between 90791 and 90792?
- 90792 includes medical services (medication assessment) and is billed by prescribers such as PMHNPs.
Related
| Code | What it is | Time | Who bills | Telehealth |
|---|---|---|---|---|
| 90832 | Psychotherapy, 30 minutes | 16 to 37 min | Therapists, Psychologists, Associates | Yes |
| 90834 | Psychotherapy, 45 minutes | 38 to 52 min | Therapists, Psychologists, Associates | Yes |
| 90837 | Psychotherapy, 60 minutes | 60 min | Therapists, Psychologists, Associates | Yes |
| 90792 | Psychiatric diagnostic evaluation with medical services | One unit per evaluation; no time threshold | Nurse practitioners | Yes |
General information for licensed clinicians, not billing advice. Insurers reimburse each code differently and payer contracts control; Emora handles the billing.
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