The CPT coding system, maintained by the American Medical Association (AMA), is essential for accurate healthcare billing and reimbursement. Among these codes, CPT 90792 is vital for mental health professionals performing psychiatric evaluations. Understanding the specifics of this code helps providers ensure proper documentation, streamline billing, and receive appropriate reimbursement.
CPT code 90792 is critical in mental health billing, used primarily for psychiatric diagnostic evaluation with medical services. Accurate coding ensures your practice receives proper reimbursement while remaining compliant with insurance guidelines.
In this guide, we cover the CPT 90792 description, documentation requirements, and reimbursement. And practical tips for billing mental health services in 2025.
CPT code 90792 is defined as a psychiatric diagnostic evaluation with medical services. It is often billed by psychiatrists and other qualified healthcare providers when performing a comprehensive assessment that includes:
This code differs from CPT 90791, which is a psychiatric diagnostic evaluation without medical services.
CPT 90792 covers a psychiatric diagnostic evaluation with medical services, combining a detailed mental health assessment with medical decision-making. Accurate billing requires documenting a comprehensive patient history, mental status examination, and any medical evaluation performed.
Proper documentation supports the code’s use and safeguards your practice’s financial health.
Accurate documentation is key to justify time and services billed under CPT 90792.
Reimbursement varies by:
On average, reimbursement for CPT code 90792 ranges from $150 to $250.
Tip: Always verify with the patient’s insurance before billing to avoid surprises.
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Modifiers may be required depending on the service scenario:
Correct modifier use prevents claim denials and ensures accurate reimbursement.
CPT code 90792 is essential for billing comprehensive psychiatric evaluations with medical services. Accurate documentation, understanding modifiers, and proper reimbursement practices are vital for your practice’s financial health.
Cures Medical Billing Services ensures your psychiatric billing is accurate, compliant, and fully optimized. Helping you focus on patient care while maximizing revenue.
Yes, if the evaluation meets the code criteria and the provider documents both psychiatric and medical services.
Yes, G30.1 (Alzheimer’s disease with behavioral disturbance) can be billed with CPT 90792 when psychiatric evaluation and medical management are performed.
Add-on codes are usually psychotherapy codes (e.g., 90833, 90836, 90838) billed when therapy is performed alongside the psychiatric evaluation.
Generally, once per evaluation unless there is a new psychiatric concern or significant change in patient status.
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