CPT code 90785: Interactive complexity, communication factors2026 Medicare rate & RVUs

Medicare pays $14.70 for 90785 nationally in the office and $11.69 in a hospital or facility. Local office rates run $14.18–$20.45.

Medicare allowed amount for participating (non-QP) physicians, before deductible, coinsurance and claim adjustments. Not a patient’s bill or a hospital charge.

What 90785 covers

Code 90785 captures added communication work during a psychiatric service, not a separate evaluation or a longer psychotherapy session. Examples include using play equipment to communicate with a young child, working through an interpreter, coordinating with a third party whose involvement complicates the exchange, or addressing a disclosure that requires mandated reporting. Psychiatrists, psychologists, clinical social workers, and other qualified mental health clinicians may encounter these circumstances in office or facility settings.

Report 90785 only with an eligible primary psychiatric service, such as a psychiatric diagnostic evaluation or psychotherapy; it is not billed by itself. The record should identify the communication factor and explain how it affected delivery of the primary service. CMS classifies it as an add-on paid within the primary procedure’s global period, so submit it with that procedure rather than as a standalone service.

This summary was written with AI assistance from CMS physician fee schedule data and checked against the CMS billing rules shown here. Rates on this page come directly from CMS files.

Where 90785 pays more and less

The same RVUs, adjusted for each area’s costs. Open a locality for its calculation, history and nearby areas.

109 of 109 payment localities

90785 rates by state

Office rate range in each state. Select a state to see its payment localities.

How the 90785 rate is calculated

Each of 90785’s three RVUs is multiplied by a geographic index (GPCI) for the payment locality, added up, and multiplied by the conversion factor. Drag the indexes or enter a ZIP to see what moves the rate.

Payment rules and modifiers for 90785

The CMS indicators that decide how 90785 is paid alongside other services.

90785 compared with similar codes

How to choose

90791Psychiatric evaluationWithout medical services

90791 is the psychiatric diagnostic evaluation itself. Add 90785 only when a qualifying communication factor complicates that evaluation.

90792Psychiatric evaluationWith medical services

90792 describes a psychiatric diagnostic evaluation that includes medical services. Code 90785 may be added when communication factors complicate that evaluation; it does not replace 90792.

90837Psychotherapy60 minutes, no E/M

90837 reports an individual psychotherapy service. Code 90785 is an add-on for qualifying interactive complexity during the psychotherapy, not a substitute for the psychotherapy code.

Codes related to 90785

Related codes aren’t interchangeable: bill the code that matches the service performed.

Where these rates come from

FeeBase calculates base physician payments from CMS work, practice-expense and malpractice RVUs, adjusted by each locality’s geographic indexes and the conversion factor. Services without a published rate are labeled, never given a made-up amount. Amounts are Medicare allowed amounts before claim adjustments: not a patient’s bill or a commercial rate.

CMS RVU26D · effective Oct 1, 2026 through the day before Jan 1, 2027

Open CMS sourceHow we calculate rates