Assessment & Evaluation

90791 — Psychiatric Diagnostic Evaluation

An integrated biopsychosocial assessment including history, mental status exam, and diagnosis. This is a non-medical diagnostic evaluation performed without medical services (no E/M component). Used for initial intake assessments by therapists, counselors, psychologists, and social workers.

Time Requirements

Typically 45-90 minutes. No strict time floor, but documentation must support the complexity billed.

Modifiers

CodeDescription
95Synchronous telemedicine service rendered via real-time audio/video.
GTVia interactive audio and video telecommunications systems (legacy; 95 is preferred).

When to Use

  • Initial intake evaluation for a new client
  • Comprehensive re-evaluation when diagnosis is being reconsidered
  • Court-ordered or forensic psychiatric evaluation
  • When establishing a new treatment plan based on a full diagnostic workup

When Not to Use

  • Routine follow-up therapy sessions — use 90834 or 90837 instead
  • When only providing medication management — use E/M codes
  • Brief screenings or questionnaire administration alone
  • When the evaluation is primarily medical in nature — use 90792

Common Denial Reasons

  • Billed more than once per provider per client without documentation of medical necessity for re-evaluation
  • Documentation does not support a full diagnostic evaluation (missing history, MSE, or diagnostic formulation)
  • Billed on the same date as a therapy code without modifier 25 or adequate documentation
  • Missing or invalid diagnosis code on the claim

Payer Notes

Most payers allow one 90791 per client per provider. Some Medicaid programs allow a second if there is a significant change in clinical presentation. Pre-authorization is rarely required but check payer-specific policies.

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