CPT 90791 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 | Moderate |
National average reimbursement for CPT 90791 by major payers:
$184.47
$160.15
$164.22
$222.25
| 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 90791 | ||||||
United | 90791 | $132.89 | 1447243241 - MEDEIA GARTEL | 363305449 - (IL) MOUNT SINAI COMMUNITY FOUNDATION | IL | Psychiatry Physician (2084P0800X) |
United | 90791 | $150.00 | 1366641714 - KHATIJA VAID | 460787784 | IL | Psychiatry Physician (2084P0800X) |
United | 90791 | $130.00 | 1144476136 - STEVE PASCHOS | 882977235 | IL | Psychiatry Physician (2084P0800X) |
United | 90791 | $191.80 | 1003049966 - GIRISHKUMAR DHORAJIA | 362169147 - ADVOCATE HEALTH AND HOSPITALS CORPORATION | IL | Psychiatry Physician (2084P0800X) |
United | 90791 | $174.86 | 1518078732 - RAD GHARAVI | 364382886 - (IL) RAD GHARAVI MD PC | FL | Psychiatry Physician (2084P0800X) |
United | 90791 | $159.00 | 1760923916 - LUKE PETRY | 376000511 - THE BOARD OF TRUSTEES OF THE UNIVERSITY OF ILLINOIS | IL | Psychiatry Physician (2084P0800X) |
United | 90791 | $131.14 | 1952521791 - PHILIP WOERNER | 370923523 - (IL) SCHUYLER COUNTY MENTAL HEALTH ASSOCIATION | IL | Psychiatry Physician (2084P0800X) |
United | 90791 | $533.44 | 1760657050 - HYUNGJIN CHO | 43466314 - MASS GENERAL BRIGHAM INCORPORATED | MA | Internal Medicine Physician (207R00000X) |
United | 90791 | $137.69 | 1336292358 - CINDY FUERST | 824052406 - (IL) MAUDLIN ASSOCIATES LLC | IL | Clinical Social Worker (1041C0700X) |
United | 90791 | $179.77 | 1477862753 - MARSHA BROWN | 832675429 | FL | Psychologist (103T00000X) |
United | 90791 | $205.46 | 1427493022 - KIARA PERKINS | 362169147 - ADVOCATE HEALTH AND HOSPITALS CORPORATION | IL | Speech-Language Pathologist (235Z00000X) |
United | 90791 | $137.69 | 1760907737 - MYRIAM AYALA | 843441145 - (FL) INCLUSION ONLINE THERAPY CORP | FL | Clinical Social Worker (1041C0700X) |
United | 90791 | $124.58 | 1477887529 - ALISON HOLT | 882482047 | NY | Mental Health Counselor (101YM0800X) |
United | 90791 | $141.19 | 1003316225 - TIFFANY GLEASON | 871268650 - (OK) STEPS TO HEALING AND RECOVERY COUNSELING LLC | OK | Clinical Social Worker (1041C0700X) |
United | 90791 | $131.14 | 1003399676 - MIREILLE TAIME | 920986068 | 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 90791 vs. Other Psychiatry Services and Procedures Codes
The CPT 90791 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 90791 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 | 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 | Low | Psychiatric Diagnostic Evaluation (With No Medical Services); Medicaid Level Of Care 4, As Defined By Each State; Nurse Pracitioner Rendering Service In Collaborat |
| 90792 | Moderate | Psychiatric Diagnostic Evaluation (With No Medical Servcies) Medicaid Level Of Care 4, As Defined By Each State Nurse Pracitioner Rendering Service In Collaborati |
| 90832 | Low | Psychotherapy, 30 Minutes With Patient; Medicaid Level Of Care 7, As Defined By Each State |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 90791. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 90791 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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