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See a sample rate comparisonCPT 90791 Fee Schedule
Last Verified: October 2026
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.
Mental Health Evaluation, An Assessment By A Mental Health Professional Of A Persons Mental Health Status. This Is Conducted Through An Interview Exam Or Nonverbal Methods. The Mental Health Professional May Communicate With Family Or Other People.
| Key Fact | Detail |
|---|---|
| Service Type | Medicine Services and Procedures Psychiatry Services and Procedures |
| Common Place of Service | 11 - Office 10 - Telehealth in Patient's Home |
| Common Modifiers | 95 - Telemedicine - audio and video GT - Via interactive audio and video telecommunication systems |
| Complexity Level | Low |
| ASAM Level | Level 1 - Outpatient Services |
| Care Type | Treatment |
| Setting | Outpatient |
| Medicare Fee Schedule | $173.35 national non-facility rate (2026) · View Medicare rates for 90791 |
| Medicaid Fee Schedule | $144.15 median of the 8 states in the free preview · View Medicaid rates for 90791 |
National average reimbursement for CPT 90791 by major payers:
$184.47
$160.15
$164.22
$205.36
Compare published rates across providers.
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CPT 90791
5 of 25 sample ratesHigher to lower in this preview
Sung Anderson
Atrius Health, Inc.
$322.48Published rateAnn Martin
Ashley Mcginn
$166.11Published rateMyriam Ayala
Inclusion Online Therapy Corp
$137.69Published rateSummer Brown
Shaunte' Johnson
$124.58Published rateTeoletta West
$110.30Published rate
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Payer Contract Negotiation
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See a sample payer proposalCPT 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-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 | Mental Health Evaluation, An Assessment By A Mental Health Professional Of A Persons Mental Health Status. This Is Conducted Through An Interview Exam Or Nonverbal Methods. The Mental Health Professional May Communicate With Family Or Other People. |
| 90792-CPT | Moderate | Mental Health Eval W/Services, An Assessment By A Psychiatrist Of A Persons Mental Health Status Conducted Through An Interview Exam Or Nonverbal Methods. It Includes Additional Medical Services Such As Pharmacy Or Other Diagnostic Evaluation. |
| 90832-CPT | Low | Psychotherapy Session 30 Mins, Psychotherapy Session With Psychiatrist Psychologist Or Other Mental Health Professional; 30 Minutes. |
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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Frequently Asked Questions
CPT code 90791 is used by healthcare providers for psychiatric diagnostic evaluations without medical services, often for Medicaid Level of Care 4, and involves moderate-level medical decision-making.
Factors affecting CPT 90791 fee schedules include government-set Medicare & Medicaid rates, privately negotiated rates between providers and insurance companies, geographic location (costs may be higher in urban areas), and provider type (e.g., hospital vs. private practice). For specific fee schedule information tailored to your location and insurance, you can use Payerprice's fee schedule lookup tool to search with the CPT code and your specific location.