90792 CPT Code: Psychiatric Diagnostic Evaluation Guide

The 90792 CPT code reports a psychiatric diagnostic evaluation that includes medical services — the intake performed by a prescriber who can also examine the patient, order tests, and prescribe or evaluate medication. It is the medical sibling of 90791: same diagnostic interview, plus the medical component only a physician, psychiatric nurse practitioner, or similarly licensed prescriber can provide. Choosing between the two comes down to who performed the evaluation and what it included.

What is the 90792 CPT code? 90792 is the Current Procedural Terminology code for a psychiatric diagnostic evaluation that includes medical services — a diagnostic assessment combined with a medical examination, ordering of tests, and prescribing or review of medication.

Undeny's Take

The single most common 90792 error is a credentialing mismatch: a clinician who cannot furnish medical services bills 90792 instead of 90791, and the payer claws it back. 90792 is reserved for prescribers — the code's value reflects the medical examination and prescribing that come with it. The second error is repetition: 90792 is an intake code, generally billed once at the start of an episode, and re-billing it for an ongoing patient draws a frequency denial. Match the code to the credential and bill it once per episode, and it is one of the cleaner psychiatric codes to collect on.

What 90792 Covers

90792 covers a complete psychiatric diagnostic evaluation — history, mental status, and a diagnostic formulation — combined with medical services: a physical or medical examination as indicated, ordering and interpretation of diagnostic studies, and prescribing or evaluating medication. The diagnostic interview itself mirrors 90791; the medical component is what distinguishes 90792.

Who Can Bill 90792 and How Often

Because it includes medical services, 90792 is reported by prescribers — psychiatrists, psychiatric nurse practitioners, and other licensed providers permitted to furnish those services — while non-medical clinicians use 90791. It is an evaluation code, typically reported once at the outset of an episode of care; a new episode or a significant change can justify another, but routine repetition does not. It is a single untimed unit, not a timed service. Reimbursement follows each payer's fee schedule on the Physician Fee Schedule — check your contracted rate or the CPT estimator for a working figure.

Modifiers for 90792

• 95 — synchronous audio-video telehealth delivery, with the matching place of service.
• GT — some payers still require this telehealth indicator instead of 95.
• Some Medicaid programs require discipline or program modifiers on behavioral-health claims.

Common 90792 Denials

• Billed by a clinician not credentialed to furnish medical services (90791 was correct).
• Repeated for an established patient, triggering a frequency edit.
• Billed on the same day as a psychotherapy or E/M service the payer bundles.
• Telehealth modifier or place-of-service mismatch.

Related Intake Codes

90792 is the medical intake code; 90791 is its non-medical counterpart, and 90837 is the 60-minute therapy that often follows the evaluation. For a new-patient medical E/M intake, see 99205. Browse the full set under CPT codes.

Frequently Asked Questions

What is the difference between 90791 and 90792?

Both report a psychiatric diagnostic evaluation, but 90792 includes medical services — a medical examination, test ordering, and prescribing — and is billed by prescribers, while 90791 is the diagnostic interview without medical services, used by non-medical clinicians.

Who can bill 90792?

90792 is reported by providers who can furnish medical services: psychiatrists, psychiatric nurse practitioners, and other licensed prescribers. Clinicians who cannot prescribe or perform the medical component bill 90791 instead.

How often can 90792 be billed?

90792 is an intake evaluation code, generally billed once at the start of an episode of care. A new episode or a significant change in the patient's condition can justify another, but routine repetition for an established patient triggers a frequency denial.

Is 90792 a timed code?

No. 90792 is reported as a single untimed unit for the diagnostic evaluation, regardless of session length. It is not billed in timed increments the way the psychotherapy codes are.

Informational only — not legal, medical, or billing advice. Always verify against current CPT guidance and your payer policy.

Estimate 90792 reimbursement

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