From the Guidelines
The CPT code for a psychiatric evaluation is 90791 for a diagnostic evaluation without medical services, or 90792 for a diagnostic evaluation with medical services. These codes are used when a mental health professional conducts a comprehensive assessment of a patient's mental, emotional, and behavioral health. The difference between the two codes depends on whether the provider includes medical components such as prescribing medications or addressing physical health concerns during the evaluation. Typically, psychiatrists and psychiatric nurse practitioners use 90792 since they can prescribe medications, while psychologists and therapists use 90791 1. The evaluation usually involves collecting the patient's history, assessing symptoms, determining a diagnosis, and developing a treatment plan.
Some key points to consider when using these codes include:
- The use of modifier "95" to indicate that services were provided using telemedicine technology 1
- The requirement for an interactive audio and video telecommunications system that permits real-time communication between the beneficiary and the provider 1
- The list of CPT codes that can be used with the telehealth modifier, including 90791 and 90792 1
- The importance of checking with insurance companies to determine coverage and medical necessity for these evaluations.
It's also worth noting that the American Academy of Pediatrics provides guidance on CPT codes for developmental screening and evaluation, but these codes are not directly applicable to psychiatric evaluations 1. However, the principles of using CPT codes to document and bill for services remain the same.
In terms of morbidity, mortality, and quality of life, accurate diagnosis and treatment of psychiatric conditions are crucial for improving patient outcomes. The use of CPT codes 90791 and 90792 can help ensure that patients receive comprehensive and appropriate care for their mental health needs.
From the Research
Psychiatric Evaluation CPT Code
- There are no research papers to assist in answering this question, as the provided studies focus on the efficacy of psychotherapies and pharmacotherapies for mental disorders, evaluation of evidence grades in psychiatry and psychotherapy guidelines, and next-generation cognitive-behavioral therapy for depression, but do not mention CPT codes for psychiatric evaluations 2, 3, 4, 5, 6.
Relevant Information
- The studies provided discuss various topics related to psychiatry and psychotherapy, including the efficacy of treatments, evaluation of evidence grades, and next-generation cognitive-behavioral therapy 2, 3, 4, 5, 6.
- However, none of the studies mention CPT codes or provide information on how to code a psychiatric evaluation.