CPT 90792 Fee Schedule
Last Updated: August 2025
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 Provided in Patient’s Home |
| Common Modifiers | • None • 95 - Synchronous telemedicine service via real-time audio and video telecommunications • GT - Via interactive audio and video telecommunication systems |
| Complexity Level | Moderate |
National average reimbursement for CPT 90792 by major payers:
$210.44
$173.44
$183.80
$269.77
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Related Codes
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 90792. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 90792 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.
CPT 90792 vs. Other Psychiatry Services and Procedures Codes
The CPT 90792 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 90792 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.
| CPT Code | Complexity Level | Description |
|---|---|---|
| 90791 | Moderate | 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 |
| 90839 | Moderate | Psychotherapy For Crisis, First 60 Min Nurse Pracitioner Rendering Service In Collaborati |
See what providers are getting paid in 2025 for 90792:
CPT 90792 Fee Schedule & Reimbursement Rates
The CPT 90792 fee schedule varies by payer type. Below are Medicare rates for 2025 and average in-network rates by state across major payers:
| Code | Medicare Rate | Avg. Cigna National Rate | More Info |
|---|---|---|---|
| 90791 | $172.10 | $222.25 | |
| 90792 | $193.73 | $269.77 | |
| 90832 | $78.23 | $103.84 | |
| 90839 | $146.47 | $210.07 | |
| 90845 | $97.87 | $135.45 | |
| 90846 | $97.53 | $131.32 |
Reimbursement rates depend on provider contracts, region, and payer. Always verify rates with your insurance provider or medical billing department.
What is price transparency?
The Price Transparency Rule is a federal law that took effect in July 2022, requiring all commercial payers to publicly disclose their prices through machine-readable files (MRFs). In short, this regulation mandates that insurance companies make healthcare costs transparent to the public.
Our data comes directly from these insurer-posted MRFs, ensuring compliance with the Price Transparency Rule. While PayerPrice is working toward a future where providers and payers collaborate for 100% upfront price certainty, it's important to acknowledge that data limitations and occasional errors may exist.
Healthcare Price Transparency Rule
cms.govConsumer Guide To Healthcare Prices
aha.orgGlossary of Healthcare Terms
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