Billing Reference
CPT code 90791: the therapy intake evaluation
CPT code 90791 is the psychiatric diagnostic evaluation without medical services: the intake assessment most therapists bill for a new client. Medicare covers it once at the outset of an illness or suspected illness, it is reportable once per day, and it may span more than one visit when the record supports why. Unlike the individual psychotherapy codes, it carries no minute band in the CMS billing guidance behind this page. Once the intake is done, ongoing sessions move to the time-based codes 90832, 90834, and 90837.
Part of CPT Codes for Therapists, the plain-English lookup verified against public CMS billing guidance.
What CPT code 90791 covers
Psychiatric diagnostic evaluation. The intake assessment, without medical services. The first-visit evaluation most therapists bill for a new client.
Every new client starts here. 90791 covers the diagnostic interview and assessment work of a first visit, before ongoing psychotherapy begins. It is the evaluation code for clinicians who do not provide medical services; when a medical assessment is part of the evaluation, prescribers use 90792 or an evaluation and management code instead.
Two things make 90791 different from the session codes that follow it. First, it is not time-banded: the CMS billing articles this page is verified against set no minute bracket for the evaluation. Second, it is a coverage event rather than a recurring service: Medicare covers it once at the outset of an illness, with specific situations that support a new evaluation later.
The evaluation also does not have to fit inside a single appointment. CMS guidance allows 90791 to span more than one visit when clinically necessary, and notes that certain patients, especially children, may require more than one visit. What matters is that the record supports why the evaluation took the extra time.
The Rules
Time rule and documentation for 90791
Paraphrased from public CMS billing guidance, with the source documents linked below the notes.
- May span more than one visit when clinically necessary; the record must support why.
- CMS notes that certain patients, especially children, may require more than one visit to complete the evaluation.
- Reportable once per day. Not reportable on the same day as an evaluation and management service performed by the same clinician for the same patient.
- Medicare covers the diagnostic evaluation once at the outset of an illness or suspected illness. It may be covered again for a new episode of illness after a hiatus, or on admission or readmission to inpatient status due to complications of the underlying condition.
- Never billed alongside the crisis psychotherapy codes 90839 or 90840.
The Boundaries
90791 next to its neighboring codes
90791 vs 90792: whether medical services are included
The split is medical services. 90791 is the diagnostic evaluation without them, which is why it is the intake code for therapists. When a medical assessment is performed, CMS notes that a physician or other qualified practitioner uses 90792 or an evaluation and management code instead.
After the intake: 90832, 90834, and 90837
Ongoing individual sessions follow documented psychotherapy time instead: 16 to 37 minutes bills 90832, 38 to 52 minutes bills 90834, and 53 minutes or more bills 90837. Document start and stop times or the total time for every session.
90791 and the crisis codes never mix
CMS guidance draws a hard line here: the crisis psychotherapy codes 90839 and 90840 are never billed alongside 90791 or 90792.
Common Questions
Questions therapists ask about 90791
Does Medicare cover 90791 more than once?
Medicare covers the diagnostic evaluation once at the outset of an illness or suspected illness. Per CMS guidance it may be covered again for a new episode of illness after a hiatus, or on admission or readmission to inpatient status due to complications of the underlying condition. Outside those situations, once at the outset is the coverage rule.
Can the intake evaluation take more than one session?
Yes. CMS guidance allows the evaluation to span more than one visit when clinically necessary, and notes that certain patients, especially children, may require more than one visit. The record must support why the evaluation needed the additional time.
Can I bill 90791 on the same day as another service?
90791 is reportable once per day, and not on the same day as an evaluation and management service performed by the same clinician for the same patient. It is also never billed alongside the crisis psychotherapy codes 90839 and 90840.
How many minutes does 90791 require?
The CMS billing articles this page is verified against do not attach a minute band to 90791 the way they do for the individual psychotherapy codes. Check the current CPT code set and your payer contracts for any time expectations, and document the evaluation work either way.
What do I bill after the intake?
Ongoing individual psychotherapy is billed by documented session time: 90832 for 16 to 37 minutes, 90834 for 38 to 52 minutes, and 90837 for 53 minutes or more. Couples and family work uses 90847 or 90846 depending on whether the identified client is in the room.
Why are there no reimbursement rates on this page?
Reimbursement varies by payer, locality, and year, so a single national number would be wrong for most readers. Check your payer contracts for your actual rates, or the CMS Physician Fee Schedule lookup tool for Medicare amounts in your locality.
Keep Going
Related codes and tools
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This is an informational tool, not billing, legal, or clinical advice. You are responsible for selecting the correct codes for your services and for verifying coverage, code definitions, and documentation requirements against your payer contracts and the current code set.
CPT is a registered trademark of the American Medical Association. This page does not reproduce the CPT code set or its official descriptors. Every description here is a plain-English summary written by Reframe Practice and checked against the CMS public billing documents linked above.