CPT 90785 Fee Schedule
Healthcare providers use this code to document and receive reimbursement for visits that address moderate-level medical decision-making, often including multiple diagnoses or prescription management.
| Key Fact | Detail |
|---|---|
| Service Type | • Medicine Services and Procedures • Psychiatry Services and Procedures |
| Common Place of Service | • 11 - Office • None • 10 - Telehealth in Patient's Home |
| Common Modifiers | • None • 95 - Telemedicine - audio and video • GT - Via interactive audio and video telecommunication systems |
| Complexity Level | Low |
National average reimbursement for CPT 90785 by major payers:
$15.55
$13.22
$15.33
$23.75
| Payer | Code | Rate | NPI | Tax ID | State | Specialty |
|---|---|---|---|---|---|---|
Select a payer to view fee schedule data Choose a payer from the options above to see rates for CPT 90785 | ||||||
United | 90785 | $11.72 | 1407324619 - EILEEN HUGHES | 592292041 - ST VINCENTS AMBULATORY CARE INC | FL | Clinical Social Worker (1041C0700X) |
United | 90785 | $12.85 | 1861680936 - CAROLYN WILSON | 852938829 | FL | Clinical Social Worker (1041C0700X) |
United | 90785 | $11.18 | 1558928853 - VERONICA-JO PRISCO | 471739920 - (FL) CENTRAL FLORIDA DETOX LLC | FL | Clinical Social Worker (1041C0700X) |
United | 90785 | $13.18 | 1043834344 - PAMELA QUIROZ | 854252623 | FL | Clinical Social Worker (1041C0700X) |
United | 90785 | $11.18 | 1649323189 - BARBARA DAIRE | 592092717 - (FL) SUNCOAST CENTER INC | FL | Clinical Social Worker (1041C0700X) |
United | 90785 | $10.61 | 1841578747 - KRISTIN MILLER | 832977171 | FL | Clinical Social Worker (1041C0700X) |
United | 90785 | $11.18 | 1548330939 - JOHN MANN | 844320838 - (FL) GULF COAST THERAPY CENTER | FL | Clinical Social Worker (1041C0700X) |
United | 90785 | $14.90 | 1457355273 - JANICE HERRON | 473114126 - (FL) VILLAR NEUROPSYCHOLOGY, LLC | FL | Family Psychologist (103TF0000X) |
United | 90785 | $11.73 | 1780469171 - LISA SAVARD | 201966531 - (FL) THE CHRYSALIS CENTER, INC. | FL | Clinical Social Worker (1041C0700X) |
United | 90785 | $17.71 | 1811215940 - HELEN ZIMNIEWICZ | 383876436 - (FL) THE VILLAGES HEALTH SYSTEM LLC | FL | Clinical Social Worker (1041C0700X) |
United | 90785 | $12.67 | 1609365519 - REFRESH IN-HOME COUNSELING LLC, IN HOME COUNSELING | 825351068 | AR | Clinical Social Worker (1041C0700X) |
United | 90785 | $11.18 | 1679337653 - ROMEO BALLAYAN | 1053059360 - (TX) GENEVIEVE MARTINEZ | FL | Clinical Social Worker (1041C0700X) |
United | 90785 | $13.18 | 1780381756 - HILLAREE MERCK | 854252623 | FL | Clinical Social Worker (1041C0700X) |
United | 90785 | $11.73 | 1467617530 - TAMARA IRONS | 43774404 - CENTER OF REVITALIZING PSYCHIATR | NV | Clinical Social Worker (1041C0700X) |
United | 90785 | $11.18 | 1417342866 - SABRINA GONZALEZ | 464975708 - (NM) ELEVATION COUNSELING LLC | FL | Clinical Social Worker (1041C0700X) |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
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CPT 90785 vs. Other Psychiatry Services and Procedures Codes
The CPT 90785 code is part of the Medicine Services and Procedures services used for Psychiatry Services and Procedures. It represents a moderate-complexity encounter and is one of several codes that vary based on time spent, level of medical decision-making, and documentation requirements.
The CPT 90785 code involves more provider time and moderate medical decision-making, unlike lower-level codes that require less time and simpler assessments. It typically includes multiple diagnoses, medication management, or test interpretation, leading to higher reimbursement and more detailed documentation requirements.
| Code | Complexity | Description |
|---|---|---|
| 90785-CPT | Low | Individual Pschophysiological Therapy Incorporatin G Biofeedback Training By And Modality (Face To Fa Ce W/Pt) (Eg Insight Oriented, Behavior Modifying Or Supportive Psychotherapy) Approx 20-30 Minut |
| 90791-CPT | Low | Psychiatric Diagnostic Evaluation (With No Medical Services); Medicaid Level Of Care 4, As Defined By Each State; Nurse Pracitioner Rendering Service In Collaborat |
| 90832-CPT | Low | Psychotherapy, 30 Minutes With Patient; Medicaid Level Of Care 7, As Defined By Each State |
| 90837-CPT | Low | Psychotherapy 60 Minutes Member Of High Risk Population-Use W Immunizations Via Interactive Audio And Video Telecommunication |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 90785. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 90785 fee schedule helps patients estimate costs and providers optimize billing for accurate reimbursements.
Factors that affect fee schedules
Medicare & Medicaid Rates
Government-set reimbursement amounts
Private Insurance Rates
Negotiated rates between providers and insurance companies
Geographic Location
Costs may be higher in urban areas.
Provider Type
Hospital providers may have different rates than private practice.
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