cpt 90791, cpt code 90791, 90791 cpt code

CPT Code 90791 | Psychiatric Diagnostic Evaluation

CPT 90791 describes a psychiatric diagnostic evaluation. This procedure involves a comprehensive assessment of a patient’s mental health, including gathering information about their current and past behavior concerns and medical, family, and social history.

What Is CPT Code 90791?

CPT 90791 describes a psychiatric diagnostic evaluation. This procedure involves a comprehensive assessment of a patient’s mental health.

This evaluation is conducted by a healthcare provider and is designed to gather as much information as possible about the patient’s current and past behavior concerns, as well as their past medical, family, and social history.

Description

The CPT book describes CPT code 90791 as: “Psychiatric diagnostic evaluation.”

Procedure

The provider will conduct a thorough diagnostic evaluation to gather as much information as possible about the patient’s current and past behavior concerns and their medical, family, and social history.

This evaluation may include various diagnostic tests to arrive at a diagnosis.

CPT code 90791 is applicable for both new patients and those who are undergoing a re-evaluation. The provider must comprehensively understand the patient’s history and current concerns to provide the most effective care.

How To Use CPT 90791

CPT code 90791 should only be used once daily, regardless of the number of sessions or the time the provider spends with the patient on the same day.

This means that if a provider performs a diagnostic evaluation on a patient multiple times in one day or if the evaluation extends over a period of time that exceeds one day, only one instance of CPT code 90791 should be reported.

This rule applies regardless of the duration or intensity of the evaluation and is intended to ensure that CPT 90791 is used accurately and appropriately.

Similar Posts

2 Comments

  1. I am curious – some practices that I know about see the parents of the child client first and then the child alone and then the child with the family. All was part of the evaluation. Would the practice bill 90791 for each session in this case? How can they see the parents alone if 90791 is supposed to have the child present?

    1. Hi Marian,

      The guidelines now allow charging on consecutive days when a lengthy evaluation is medically required. Because an assessment of a child requires that both the child and the parents be seen together and independently, for institutionalized patients, Medicare will only cover one 90791 annually unless medical necessity can be proven for others.

Leave a Reply

Your email address will not be published. Required fields are marked *