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

Report interactive complexity when communication barriers or other specified factors complicate a psychiatric evaluation or psychotherapy service.

CMS RVU26DEffective Oct 1, 2026One payment locality414.3K Medicare services in 2024

In Napa, CA, Medicare pays $16.56 for 90785 in the office and $12.60 when it’s performed in a hospital or facility.

$16.56Office (non-facility)
$12.60Hospital or facility
+12.7%vs the national office rate ($14.70)

Check a contract rate as a % of Medicare · 90785 nationwide

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

We’ll open 90785 for the payment locality that covers the ZIP.

On this page 11 sections
  1. Rate in Napa, CA
  2. What 90785 covers
  3. Compared with other areas
  4. Rate map
  5. How it’s calculated
  6. Payment rules
  7. Related codes
  8. Rate history
  9. Where it applies
  10. Billing questions
  11. Sources

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.

Billing guides for 90785: Psychotherapy CPT codes · Mental health billing

How Napa, CA compares for 90785

Across 109 of 109 payment localities, the office rate for 90785 runs from $14.18 in Arkansas to $20.45 in Alaska. Napa, CA pays $16.56. The RVUs are the same everywhere; the geographic indexes change the dollars.

90785 in Napa, CA vs other payment areas
  1. Napa, CA · this page$16.56
  2. Bakersfield, CA · California$15.26−$1.30
  3. Chico, CA · California$15.24−$1.32
  4. El Centro, CA · California$15.24−$1.32
  5. Fresno, CA · California$15.24−$1.32
  6. Hanford, CA · California$15.24−$1.32
  7. Los Angeles, CA · California$15.82−$0.74

Other areas in California first, then benchmark localities. Bars start at $0.

Every other payment area

90785 in every other Medicare payment locality
Payment localityOfficeFacility
Madera, CACalifornia$15.24$11.94
Merced, CACalifornia$15.24$11.94
Modesto, CACalifornia$15.24$11.94
Oxnard, CACalifornia$15.67$12.12
Redding, CACalifornia$15.24$11.94
Rest of CaliforniaCalifornia$15.24$11.94
Riverside, CACalifornia$15.25$11.95
Sacramento, CACalifornia$15.69$12.20

90785 rates by state

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

Explore a state

Local rates. Clear comparisons.

Hover or focus a tile to see its rate range. Select it to open the state’s fee schedule.

$14.18

$20.45

Color shows the midpoint of each state’s locality range.

View every state and territory as a table
90785 office rate range by state
State / territoryOffice rate rangeLocalities
AK$20.451
AL$14.241
AR$14.181
AZ$14.581
CA$15.24–$17.5329
CO$15.061
CT$15.201
DC$15.951
DE$14.711
FL$14.53–$14.853
GA$14.30–$14.792
GU$15.201
HI$15.201
IA$14.381
ID$14.401
IL$14.38–$14.874
IN$14.431
KS$14.341
KY$14.291
LA$14.27–$14.482
MA$15.07–$15.862
MD$14.85–$15.953
ME$14.40–$14.662
MI$14.38–$14.572
MN$14.801
MO$14.19–$14.523
MS$14.191
MT$14.701
NC$14.451
ND$14.701
NE$14.411
NH$14.851
NJ$15.48–$15.982
NM$14.391
NV$14.701
NY$14.51–$16.105
OH$14.381
OK$14.301
OR$14.68–$15.282
PA$14.40–$15.052
PR$14.741
RI$15.031
SC$14.421
SD$14.701
TN$14.361
TX$14.37–$14.938
UT$14.481
VA$14.63–$15.952
VI$14.741
VT$14.661
WA$15.03–$16.082
WI$14.541
WV$14.221
WY$14.701

See 90785 in every payment locality

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.

How the rate is built · 90785

RVUs × geographic indexes × conversion factor

Office or facility?

Work0.33

0.33 RVUs× 1.000 GPCI

Practice expense0.11

0.11 RVUs× 1.000 GPCI

Malpractice0.00

0.00 RVUs× 1.000 GPCI

Adjusted RVUs

0.4400

Conversion factor

$33.4009

Medicare rate

$14.70

Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.

The exact Napa, CA inputs and CMS source lines

PPRRVU2026_Oct_nonQPP.csv

11,526

Code
90785
Physician work
0.33
Practice expense
0.11
Malpractice
0.00

GPCI2026.csv

17

Locality
Napa, CA
Physician work
1.063
Practice expense
1.318
Malpractice
0.508
Office calculation for 90785 in Napa, CA
ComponentRVULocality factorAdjusted
Physician work0.33× 1.0630.3508
Practice expense0.11× 1.3180.1450
Malpractice0.00× 0.5080.0000
Total RVUs0.4958
Conversion factor× 33.4009

Office rate, Napa, CA$16.56

Office: (0.33 × 1.063 + 0.11 × 1.318 + 0 × 0.508) × $33.4009 = $16.56

Facility: (0.33 × 1.063 + 0.02 × 1.318 + 0 × 0.508) × $33.4009 = $12.60

Open 90785 in the RVU calculator

Payment rules and modifiers for 90785

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

CMS payment indicators · 90785

Interactive complexity, communication factors

RuleCMS valueWhat it means
Global periodZZZAdd-on code: falls within the primary procedure’s global period.
Multiple procedures0No multiple-procedure reduction.
Bilateral (modifier 50)0The 150% bilateral adjustment doesn’t apply.
Assistant at surgery (80/81/82/AS)9The concept doesn’t apply.
Co-surgeons (62)0Not permitted.
Team surgery (66)0Not permitted.
Professional/technical0Physician service: no professional/technical split.

How 90785 has changed in Napa, CA

90785 · Office / nonfacility

$16.56

Effective 2026-10-01

The base rate is $0.86 higher than on 2025-10-01, moving from $15.70 to $16.56 (5.5%).

It is unchanged from the immediately preceding available release, effective 2026-07-01.

Base rate by release · bars start at $0 · select a bar to compare

One bar per available release, ordered by effective date. Missing rates remain gaps. These comparisons hold the code, setting and locality identifiers constant; they do not isolate which policy or input caused a change.

What changed, release by release
  1. January 1, 2026

    RVU26A

    $15.70changed to$16.56

    • Conversion factor 32.3465 changed to 33.4009
    • Practice expense RVU 0.10 changed to 0.11
    • Malpractice RVU 0.01 changed to 0.00
    • Work GPCI 1.058 changed to 1.063
    • Practice expense GPCI 1.310 changed to 1.318
    • Malpractice GPCI 0.521 changed to 0.508

    Held through RVU26B, RVU26C, RVU26D.

  2. January 1, 2025

    RVU25A

    $16.16changed to$15.70

    • Conversion factor 33.2875 changed to 32.3465

    Held through RVU25B, RVU25C, RVU25D.

  3. March 9, 2024

    RVU24AR

    $15.89changed to$16.16

    • Conversion factor 32.7442 changed to 33.2875

    Held through RVU24B, RVU24C, RVU24D.

  4. January 1, 2024

    RVU24A

    $16.21changed to$15.89

    • Conversion factor 33.8872 changed to 32.7442
    • Work GPCI 1.051 changed to 1.058
    • Practice expense GPCI 1.265 changed to 1.310
    • Malpractice GPCI 0.513 changed to 0.521
  5. January 1, 2023

    RVU23A

    $15.90changed to$16.21

    • Conversion factor 34.6062 changed to 33.8872
    • Practice expense RVU 0.09 changed to 0.10
    • Work GPCI 1.044 changed to 1.051
    • Practice expense GPCI 1.220 changed to 1.265
    • Malpractice GPCI 0.504 changed to 0.513

    Held through RVU23B, RVU23C, RVU23D.

  6. January 1, 2022

    RVU22A

    $16.03changed to$15.90

    • Conversion factor 34.8931 changed to 34.6062

    Held through RVU22B, RVU22C, RVU22D.

  7. January 1, 2021

    RVU21A

    $16.69changed to$16.03

    • Conversion factor 36.0896 changed to 34.8931
    • Work GPCI 1.049 changed to 1.044
    • Practice expense GPCI 1.238 changed to 1.220
    • Malpractice GPCI 0.496 changed to 0.504

    Held through RVU21B, RVU21C, RVU21D.

  8. January 1, 2020

    RVU20A

    $16.33changed to$16.69

    • Conversion factor 36.0391 changed to 36.0896
    • Practice expense RVU 0.08 changed to 0.09
    • Work GPCI 1.055 changed to 1.049
    • Practice expense GPCI 1.256 changed to 1.238
    • Malpractice GPCI 0.458 changed to 0.496

    Held through RVU20B, RVU20C, RVU20D.

  9. January 1, 2019

    RVU19A

    $15.86changed to$16.33

    • Conversion factor 35.9996 changed to 36.0391
    • Practice expense RVU 0.07 changed to 0.08

    Held through RVU19B, RVU19C, RVU19D.

  10. January 1, 2018

    RVU18AR1

    $14.97changed to$15.86

    • Conversion factor 35.8887 changed to 35.9996
    • Practice expense RVU 0.05 changed to 0.07
    • Work GPCI 1.057 changed to 1.055
    • Practice expense GPCI 1.271 changed to 1.256
    • Malpractice GPCI 0.477 changed to 0.458

    Held through RVU18B, RVU18C, RVU18D.

  11. January 1, 2017

    RVU17A

    No ratechanged to$14.97

    Held through RVU17B, RVU17C, RVU17D.

  12. January 1, 2013

    RVU13AR

    Earliest loaded release: No rate

    Held through RVU13B, RVU13C, RVU13D, RVU14A, RVU14B, RVU14C, RVU14D, RVU15A, RVU15B, RVU15C, RVU15D, RVU16A, RVU16B, RVU16C, RVU16D.

Rates in every CMS release
Effective fromOfficeFacilityCMS release
2026-10-01$16.56$12.60RVU26D
2026-07-01$16.56$12.60RVU26C
2026-04-01$16.56$12.60RVU26B
2026-01-01$16.56$12.60RVU26A
2025-10-01$15.70$13.16RVU25D
2025-07-01$15.70$13.16RVU25C
2025-04-01$15.70$13.16RVU25B
2025-01-01$15.70$13.16RVU25A
2024-10-01$16.16$13.98RVU24D
2024-07-01$16.16$13.98RVU24C
2024-04-01$16.16$13.98RVU24B
2024-03-09$16.16$13.98RVU24AR
2024-01-01$15.89$13.75RVU24A
2023-10-01$16.21$14.07RVU23D
2023-07-01$16.21$14.07RVU23C
2023-04-01$16.21$14.07RVU23B
2023-01-01$16.21$14.07RVU23A
2022-10-01$15.90$13.79RVU22D
2022-07-01$15.90$13.79RVU22C
2022-04-01$15.90$13.79RVU22B
2022-01-01$15.90$13.79RVU22A
2021-10-01$16.03$13.90RVU21D
2021-07-01$16.03$13.90RVU21C
2021-04-01$16.03$13.90RVU21B
2021-01-01$16.03$13.90RVU21A
2020-10-01$16.69$14.91RVU20D
2020-07-01$16.69$14.91RVU20C
2020-04-01$16.69$14.91RVU20B
2020-01-01$16.69$14.91RVU20A
2019-10-01$16.33$14.98RVU19D
2019-07-01$16.33$14.98RVU19C
2019-04-01$16.33$14.98RVU19B
2019-01-01$16.33$14.98RVU19A
2018-10-01$15.86$14.96RVU18D
2018-07-01$15.86$14.96RVU18C
2018-04-01$15.86$14.96RVU18B
2018-01-01$15.86$14.96RVU18AR1
2017-10-01$14.97$14.97RVU17D
2017-07-01$14.97$14.97RVU17C
2017-04-01$14.97$14.97RVU17B
2017-01-01$14.97$14.97RVU17A
2016-10-01Rate data unavailableRate data unavailableRVU16D
2016-07-01Rate data unavailableRate data unavailableRVU16C
2016-04-01Rate data unavailableRate data unavailableRVU16B
2016-01-01Rate data unavailableRate data unavailableRVU16A
2015-10-01Rate data unavailableRate data unavailableRVU15D
2015-07-01Rate data unavailableRate data unavailableRVU15C
2015-04-01Rate data unavailableRate data unavailableRVU15B
2015-01-01Rate data unavailableRate data unavailableRVU15A
2014-10-01Rate data unavailableRate data unavailableRVU14D
2014-07-01Rate data unavailableRate data unavailableRVU14C
2014-04-01Rate data unavailableRate data unavailableRVU14B
2014-01-01Rate data unavailableRate data unavailableRVU14A
2013-10-01Rate data unavailableRate data unavailableRVU13D
2013-07-01Rate data unavailableRate data unavailableRVU13C
2013-04-01Rate data unavailableRate data unavailableRVU13B
2013-01-01Rate data unavailableRate data unavailableRVU13AR

Price 90785 for an earlier date of service

Where the Napa, CA rate applies

Napa, CA is a Medicare payment area, not a city. Our Census mapping connects it to 11 cities and communities in California. Some span more than one payment area; confirm with the service ZIP.

  • Napa
  • American Canyon
  • Angwin
  • Calistoga
  • Deer Park
  • Moskowite Corner
  • Oakville
  • Rutherford

Browse all communities in California

90785 billing questions

When should 90785 be added to a psychiatric service?

Use it when a specific communication factor complicates delivery of the primary psychiatric service, such as interpreter use or communication through play equipment. The record should explain the factor and its effect on the encounter.

Can 90785 be billed by itself?

No. It is an add-on code and must be reported with an eligible primary psychiatric procedure, such as 90791, 90792, or a psychotherapy service.

Does a difficult or lengthy session alone support 90785?

No. Session difficulty or length alone does not establish interactive complexity; document the specific communication circumstance that complicated the service.

Is interpreter use an example of interactive complexity?

It can be when an interpreter is needed to overcome a communication barrier during the psychiatric service. Document the interpreter’s role in facilitating the clinical exchange.

How does CMS treat payment for 90785?

CMS treats 90785 as an add-on paid within the primary procedure’s global period. Submit it with the primary service.

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

Show the CMS file lines behind this rate
RVUs for 90785PPRRVU2026_Oct_nonQPP.csv, line 11,526 (RVU26D)
Geographic factors for Napa, CAGPCI2026.csv, line 17 (RVU26D)

Open CMS sourceHow we calculate rates

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