Is 90791 a time based code?

The Centers for Medicare Services have specific requirements that require CPT Code 90791 to be at least 16 minutes and not more than 90 minutes in the designated session time, with 60-minutes being the typical standard.

Is 90792 time based?

CPT Code 90792 Time Length Providers require at minimum 60 minutes up to 120 minutes of time to render an exhaustive diagnostic interview and examination of their mental health clients in order to code procedure code 90792.

How many minutes is 90791?

20 to 90 minutes
CPT Code 90791 Reimbursement Rates — Psychiatric diagnostic interview performed by a licensed mental health provider for 20 to 90 minutes in length.

What is procedure code 90791?

The 90791 code is used for psychiatric diagnostic evaluations without medical services. It was created in 2013, along with 90792, to replace the former psychiatric diagnostic evaluation codes 90801 and 90802.

Is 90791 An E&M code?

The diagnostic evaluation (CPT code 90791) is a biopsychosocial assessment. The diagnostic evaluation with medical services (CPT code 90792) is a biopsychosocial and medical assessment. Both of these evaluations may include discussion with family or other sources in addition to the patient.

How many times can 90791 be billed BCBS?

Codes 90791, 90792 may be reported once per day and not on the same day as an evaluation and management service performed by the same individual for the same patient.

How many times can I make a 90791 call?

Typically Medicare and Medicaid plans allow 90791 once per client per provider per year. Other plans will allow as frequently as once per 6 months. Our mental health insurance billing service, TheraThink, calls to verify on your behalf to find out.

What is the time frame for CPT 90791?

CPT Code 90791 Time Frame The Centers for Medicare Services (CMS.gov) requires CPT code 90791 to be 16 minutes in length at minimum and 90 minutes of length at maximum before using an add-on CPT code to designate session time.

Does 90791 pay more per session than 90834 or 90837?

Yes! 90791 almost always pays more per session than 90834 or 90837. The exact payment depends on the credentialing of the provider rendering services and the insurance plan. In our experience, 90791 is typically allowed at +35-75% of the 90834 reimbursement rate and +10-50% of the 90837 reimbursement rate.

What are the regulations governing the use of code 90791?

Part of the regulations governing the use of code 90791 are related to what the session must include. According to Medicare, each session billed with code 90791 must include the following (or have the following characteristics): Elicitation of a complete medical and psychiatric history