90791 vs 90792: Which Psychiatric Diagnostic Evaluation Code to Bill

90791 is a psychiatric diagnostic evaluation without medical services, billed by therapists, counselors, social workers, psychologists and prescribers. 90792 is the same evaluation with medical services added (such as a medication review, physical screening or ordering labs), and only prescribers such as psychiatrists and PMHNPs bill it. Neither code is time-based, and neither is normally billed on the same day as psychotherapy or an E/M by the same provider.

The intake visit sets up every claim that follows it, so getting it right matters: the diagnosis, the treatment plan and the authorization for later visits often depend on it.

Side by side

	90791	90792
What it is	Psychiatric diagnostic evaluation	Psychiatric diagnostic evaluation with medical services
Who bills it	Therapists, counselors, social workers, psychologists, and prescribers	Prescribers only: psychiatrists, PMHNPs, other physicians and NPs
Medical services included	No	Yes: medication review, physical or neurological exam elements, labs or other medical workup
Time requirement	None in CPT	None in CPT
Typical use	Therapy intake	Psychiatry or medication-management intake

What the evaluation note should include

For both codes:

• Reason for referral and presenting problem
• History of the present illness and past psychiatric history
• Mental status examination
• Relevant medical, family, social and substance use history
• Risk assessment
• Diagnosis and a treatment plan or recommendations

For 90792, add the medical elements that make it different: review of current medications and side effects, relevant physical or neurological findings, labs ordered or reviewed, and the prescribing plan.

Codes that do not go together

• 90791 or 90792 with 90832, 90834 or 90837 on the same day by the same provider. Therapy during the intake is part of the evaluation.
• 90792 with an E/M code on the same day. 90792 already includes the medical evaluation.
• 90791 and 90792 together. Bill one evaluation per visit.

90785 (interactive complexity) can be added to either evaluation when a third party, such as a parent, guardian or interpreter, makes communication harder, and the note says why.

Evaluations over more than one visit

Some evaluations take more than one session, for example with children, where parents and the child are seen separately. Payers handle this differently: some allow 90791 on more than one date, others want one evaluation code only. Check the payer’s policy before billing a second evaluation.

Common intake denials

Denial	Usual cause	Fix
Frequency limit	Payer allows one evaluation per period, and one was already billed (sometimes by another provider)	Check history with the payer; appeal with the reason a new evaluation was needed
Provider type	90792 billed by a non-prescriber	Bill 90791
Same-day conflict	Evaluation billed with psychotherapy or E/M	Bill the evaluation only
Out-of-network	Clinician not credentialed with the behavioral health network	Fix the credentialing, then resubmit

When the evaluation leads to formal psychological testing, testing is billed with its own codes. See psychological testing codes.

After the intake

Follow-up visits are billed differently: therapists bill psychotherapy codes by time (see 90837 vs 90834 vs 90832), and prescribers usually bill an E/M code, with a psychotherapy add-on when therapy is provided (see billing 99214 with 90833).

Codes and payer rules change. We check current CPT guidance and each payer’s policy before submission. Our psychiatry billing and therapist billing teams code intakes and follow-ups from your notes.

Frequently asked questions