CPT code 90791: Psychiatric evaluation, without medical services2026 Medicare rate & RVUs in Utah

Psychiatric diagnostic assessment of symptoms, history, and mental status, reported when a clinician evaluates a behavioral health concern without furnishing medical services.

CMS RVU26DEffective Oct 1, 2026One payment locality743K Medicare services in 2024

In Utah, Medicare pays $170.62 for 90791 in the office and $136.71 when it’s performed in a hospital or facility.

$170.62Office (non-facility)
$136.71Hospital or facility
−1.6%vs the national office rate ($173.35)

Check a contract rate as a % of Medicare · 90791 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 90791 for the payment locality that covers the ZIP.

On this page 11 sections
  1. Rate in Utah
  2. What 90791 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 90791 covers

A clinician uses this evaluation to assess a behavioral health concern, establish or clarify a diagnosis, and recommend treatment. The work includes psychiatric and psychosocial history, a mental status examination, and review of relevant medical history. Information may also come from family members, caregivers, or prior records. Psychologists, clinical social workers, and mental health counselors commonly perform the assessment in offices, community settings, hospitals, or by telehealth. A psychiatrist or psychiatric nurse practitioner may use this code when the evaluation includes no medical services.

Select 90791 for the diagnostic evaluation rather than a psychotherapy visit focused on treatment or 90792 when medical services are furnished as part of the evaluation. Document the presenting problem, relevant history, mental status findings, diagnostic impression, and plan. The code is not time-based: assign units for distinct, medically necessary evaluations, not for minutes or interview segments. A further evaluation on another date needs documentation supporting why additional diagnostic work was necessary. Do not separately report psychotherapy or an E/M service furnished by the same clinician as part of this evaluation. Interactive complexity may be reported when its specific requirements are met and documented.

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 90791: 90791 vs 90792 · Mental health billing

How Utah compares for 90791

Across 109 of 109 payment localities, the office rate for 90791 runs from $166.76 in Arkansas to $240.07 in Alaska. Utah pays $170.62. The RVUs are the same everywhere; the geographic indexes change the dollars.

90791 in Utah vs other payment areas
  1. Utah · this page$170.62
  2. Los Angeles, CA · California$186.51+$15.89
  3. Washington, DC area · District of Columbia$188.26+$17.64
  4. Miami, FL · Florida$176.19+$5.57
  5. Chicago, IL · Illinois$175.34+$4.72
  6. Manhattan, NY · New York$189.15+$18.53
  7. Alaska · Alaska$240.07+$69.45

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

Every other payment area

90791 in every other Medicare payment locality
Payment localityOfficeFacility
AlabamaAlabama$167.51$135.94
ArkansasArkansas$166.76$135.78
ArizonaArizona$171.88$136.92
Bakersfield, CACalifornia$179.79$140.26
Chico, CACalifornia$179.49$139.95
El Centro, CACalifornia$179.49$139.95
Fresno, CACalifornia$179.49$139.95
Hanford, CACalifornia$179.49$139.95

90791 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.

$166.76

$240.07

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

View every state and territory as a table
90791 office rate range by state
State / territoryOffice rate rangeLocalities
AK$240.071
AL$167.511
AR$166.761
AZ$171.881
CA$179.49–$206.7829
CO$177.591
CT$179.481
DC$188.261
DE$173.391
FL$171.73–$176.193
GA$168.68–$174.582
GU$179.161
HI$179.161
IA$169.171
ID$169.441
IL$169.86–$175.964
IN$169.761
KS$168.751
KY$168.361
LA$168.21–$170.822
MA$177.62–$187.152
MD$175.11–$188.263
ME$169.54–$172.702
MI$169.57–$172.252
MN$174.171
MO$167.20–$171.223
MS$167.001
MT$173.351
NC$170.131
ND$172.951
NE$169.511
NH$175.091
NJ$182.63–$188.582
NM$169.801
NV$173.281
NY$170.93–$190.535
OH$169.491
OK$168.451
OR$172.97–$180.162
PA$169.67–$177.612
PR$173.831
RI$177.181
SC$169.871
SD$172.911
TN$169.001
TX$169.31–$176.118
UT$170.621
VA$172.40–$188.262
VI$173.831
VT$172.581
WA$177.21–$189.732
WI$171.021
WV$167.821
WY$173.181

See 90791 in every payment locality

How the 90791 rate is calculated

Each of 90791’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 · 90791

RVUs × geographic indexes × conversion factor

Office or facility?

Work3.84

3.84 RVUs× 1.000 GPCI

Practice expense1.33

1.33 RVUs× 1.000 GPCI

Malpractice0.02

0.02 RVUs× 1.000 GPCI

Adjusted RVUs

5.1900

Conversion factor

$33.4009

Medicare rate

$173.35

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

The exact Utah inputs and CMS source lines

PPRRVU2026_Oct_nonQPP.csv

11,527

Code
90791
Physician work
3.84
Practice expense
1.33
Malpractice
0.02

GPCI2026.csv

104

Locality
Utah
Physician work
1.000
Practice expense
0.940
Malpractice
0.898
Office calculation for 90791 in Utah
ComponentRVULocality factorAdjusted
Physician work3.84× 1.0003.8400
Practice expense1.33× 0.9401.2502
Malpractice0.02× 0.8980.0180
Total RVUs5.1082
Conversion factor× 33.4009

Office rate, Utah$170.62

Office: (3.84 × 1 + 1.33 × 0.94 + 0.02 × 0.898) × $33.4009 = $170.62

Facility: (3.84 × 1 + 0.25 × 0.94 + 0.02 × 0.898) × $33.4009 = $136.71

Open 90791 in the RVU calculator

Payment rules and modifiers for 90791

90791 has no global surgery period, no multiple-procedure, bilateral or assistant-at-surgery adjustment, and no professional/technical split. What changes the payment is where the service happens: the place of service on the claim decides whether Medicare pays the office or the facility rate.

Place of service · 90791

Which rate does Medicare pay?

The POS code on the claim line (CMS-1500 box 24B).

POS 11 · non-facility rate · national

$173.35

Non-facility (office)
$173.35
Facility
$137.28

Higher because the practice carries its own overhead.

How 90791 has changed in Utah

90791 · Office / nonfacility

$170.62

Effective 2026-10-01

The base rate is $6.58 higher than on 2025-10-01, moving from $164.04 to $170.62 (4.0%).

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

    $164.04changed to$170.62

    • Conversion factor 32.3465 changed to 33.4009
    • Practice expense RVU 1.22 changed to 1.33
    • Malpractice RVU 0.10 changed to 0.02
    • Practice expense GPCI 0.933 changed to 0.940
    • Malpractice GPCI 0.930 changed to 0.898

    Held through RVU26B, RVU26C, RVU26D.

  2. January 1, 2025

    RVU25A

    $169.12changed to$164.04

    • Conversion factor 33.2875 changed to 32.3465
    • Practice expense RVU 1.23 changed to 1.22

    Held through RVU25B, RVU25C, RVU25D.

  3. March 9, 2024

    RVU24AR

    $166.36changed to$169.12

    • Conversion factor 32.7442 changed to 33.2875

    Held through RVU24B, RVU24C, RVU24D.

  4. January 1, 2024

    RVU24A

    $171.34changed to$166.36

    • Conversion factor 33.8872 changed to 32.7442
    • Practice expense RVU 1.22 changed to 1.23
    • Practice expense GPCI 0.926 changed to 0.933
    • Malpractice GPCI 0.865 changed to 0.930
  5. January 1, 2023

    RVU23A

    $174.69changed to$171.34

    • Conversion factor 34.6062 changed to 33.8872
    • Practice expense RVU 1.21 changed to 1.22
    • Malpractice RVU 0.12 changed to 0.10
    • Practice expense GPCI 0.919 changed to 0.926
    • Malpractice GPCI 0.799 changed to 0.865

    Held through RVU23B, RVU23C, RVU23D.

  6. January 1, 2022

    RVU22A

    $176.37changed to$174.69

    • Conversion factor 34.8931 changed to 34.6062
    • Practice expense RVU 1.20 changed to 1.21
    • Malpractice RVU 0.14 changed to 0.12

    Held through RVU22B, RVU22C, RVU22D.

  7. January 1, 2021

    RVU21A

    $142.81changed to$176.37

    • Conversion factor 36.0896 changed to 34.8931
    • Work RVU 3.00 changed to 3.84
    • Practice expense RVU 0.92 changed to 1.20
    • Malpractice RVU 0.11 changed to 0.14
    • Practice expense GPCI 0.923 changed to 0.919
    • Malpractice GPCI 0.982 changed to 0.799

    Held through RVU21B, RVU21C, RVU21D.

  8. January 1, 2020

    RVU20A

    $138.79changed to$142.81

    • Conversion factor 36.0391 changed to 36.0896
    • Practice expense RVU 0.78 changed to 0.92
    • Practice expense GPCI 0.927 changed to 0.923
    • Malpractice GPCI 1.165 changed to 0.982

    Held through RVU20B, RVU20C, RVU20D.

  9. January 1, 2019

    RVU19A

    $135.30changed to$138.79

    • Conversion factor 35.9996 changed to 36.0391
    • Practice expense RVU 0.68 changed to 0.78

    Held through RVU19B, RVU19C, RVU19D.

  10. January 1, 2018

    RVU18AR1

    $131.20changed to$135.30

    • Conversion factor 35.8887 changed to 35.9996
    • Practice expense RVU 0.57 changed to 0.68
    • Practice expense GPCI 0.925 changed to 0.927
    • Malpractice GPCI 1.167 changed to 1.165

    Held through RVU18B, RVU18C, RVU18D.

  11. January 1, 2017

    RVU17A

    $131.49changed to$131.20

    • Conversion factor 35.8043 changed to 35.8887
    • Practice expense RVU 0.59 changed to 0.57
    • Practice expense GPCI 0.922 changed to 0.925
    • Malpractice GPCI 1.169 changed to 1.167

    Held through RVU17B, RVU17C, RVU17D.

  12. January 1, 2016

    RVU16A

    $130.89changed to$131.49

    • Conversion factor 35.9335 changed to 35.8043
    • Practice expense RVU 0.57 changed to 0.59
    • Malpractice RVU 0.10 changed to 0.11

    Held through RVU16B, RVU16C, RVU16D.

  13. July 1, 2015

    RVU15C

    $130.23changed to$130.89

    • Conversion factor 35.7547 changed to 35.9335

    Held through RVU15D.

  14. January 1, 2015

    RVU15A

    $132.69changed to$130.23

    • Conversion factor 35.8228 changed to 35.7547
    • Practice expense RVU 0.63 changed to 0.57
    • Malpractice RVU 0.11 changed to 0.10
    • Practice expense GPCI 0.919 changed to 0.922
    • Malpractice GPCI 1.136 changed to 1.169

    Held through RVU15B.

  15. January 1, 2014

    RVU14A

    $146.76changed to$132.69

    • Conversion factor 34.0230 changed to 35.8228
    • Work RVU 2.80 changed to 3.00
    • Practice expense RVU 1.52 changed to 0.63
    • Practice expense GPCI 0.916 changed to 0.919
    • Malpractice GPCI 1.102 changed to 1.136

    Held through RVU14B, RVU14C, RVU14D.

  16. January 1, 2013

    RVU13AR

    Earliest loaded release: $146.76

    Held through RVU13B, RVU13C, RVU13D.

Rates in every CMS release
Effective fromOfficeFacilityCMS release
2026-10-01$170.62$136.71RVU26D
2026-07-01$170.62$136.71RVU26C
2026-04-01$170.62$136.71RVU26B
2026-01-01$170.62$136.71RVU26A
2025-10-01$164.04$141.70RVU25D
2025-07-01$164.04$141.70RVU25C
2025-04-01$164.04$141.70RVU25B
2025-01-01$164.04$141.70RVU25A
2024-10-01$169.12$146.14RVU24D
2024-07-01$169.12$146.14RVU24C
2024-04-01$169.12$146.14RVU24B
2024-03-09$169.12$146.14RVU24AR
2024-01-01$166.36$143.75RVU24A
2023-10-01$171.34$149.06RVU23D
2023-07-01$171.34$149.06RVU23C
2023-04-01$171.34$149.06RVU23B
2023-01-01$171.34$149.06RVU23A
2022-10-01$174.69$151.79RVU22D
2022-07-01$174.69$151.79RVU22C
2022-04-01$174.69$151.79RVU22B
2022-01-01$174.69$151.79RVU22A
2021-10-01$176.37$153.93RVU21D
2021-07-01$176.37$153.93RVU21C
2021-04-01$176.37$153.93RVU21B
2021-01-01$176.37$153.93RVU21A
2020-10-01$142.81$126.49RVU20D
2020-07-01$142.81$126.49RVU20C
2020-04-01$142.81$126.49RVU20B
2020-01-01$142.81$126.49RVU20A
2019-10-01$138.79$127.10RVU19D
2019-07-01$138.79$127.10RVU19C
2019-04-01$138.79$127.10RVU19B
2019-01-01$138.79$127.10RVU19A
2018-10-01$135.30$127.63RVU18D
2018-07-01$135.30$127.63RVU18C
2018-04-01$135.30$127.63RVU18B
2018-01-01$135.30$127.63RVU18AR1
2017-10-01$131.20$127.21RVU17D
2017-07-01$131.20$127.21RVU17C
2017-04-01$131.20$127.21RVU17B
2017-01-01$131.20$127.21RVU17A
2016-10-01$131.49$127.53RVU16D
2016-07-01$131.49$127.53RVU16C
2016-04-01$131.49$127.53RVU16B
2016-01-01$131.49$127.53RVU16A
2015-10-01$130.89$127.24RVU15D
2015-07-01$130.89$127.24RVU15C
2015-04-01$130.23$126.61RVU15B
2015-01-01$130.23$126.61RVU15A
2014-10-01$132.69$128.73RVU14D
2014-07-01$132.69$128.73RVU14C
2014-04-01$132.69$128.73RVU14B
2014-01-01$132.69$128.73RVU14A
2013-10-01$146.76$115.91RVU13D
2013-07-01$146.76$115.91RVU13C
2013-04-01$146.76$115.91RVU13B
2013-01-01$146.76$115.91RVU13AR

Price 90791 for an earlier date of service

Where the Utah rate applies

Utah is a Medicare payment area, not a city. Our Census mapping connects it to 334 cities and communities in Utah. Some span more than one payment area; confirm with the service ZIP.

  • Alpine
  • Alta
  • Altamont
  • Alton
  • Amalga
  • American Fork
  • Aneth
  • Annabella

Browse all communities in Utah

90791 billing questions

When should 90792 be chosen instead of 90791?

Choose 90792 when a physician or other qualified clinician furnishes medical services as part of the psychiatric diagnostic evaluation. Prescribing is not required to report 90792; reviewing a medication list alone does not establish that medical services were furnished.

Can psychotherapy be billed the same day as 90791?

Do not separately report psychotherapy performed by the same clinician as part of the diagnostic evaluation. Choose a psychotherapy code when the service is a treatment session rather than a psychiatric diagnostic evaluation.

Can 90785 be added to 90791?

Yes, when an interactive complexity factor meets the code's requirements and is documented. Examples include caregiver behavior that interferes with the evaluation or play equipment needed to overcome a patient's limited expressive language; interpreter use alone does not qualify.

Is 90791 billed by time or units?

90791 has no CPT minimum time threshold. Report a unit for a distinct diagnostic evaluation, not for each hour or interview segment.

Can 90791 be reported more than once for the same patient?

Yes, when another psychiatric diagnostic evaluation is medically necessary. Document the new diagnostic question or why additional evaluation was needed rather than treating a continuing interview as an automatic new service.

Can 90791 be furnished by telehealth?

Yes. Document the diagnostic work performed and the telehealth modality, and report the place of service appropriate to the encounter.

90791 is in these specialty bundles: Behavioral health

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 90791PPRRVU2026_Oct_nonQPP.csv, line 11,527 (RVU26D)
Geographic factors for UtahGPCI2026.csv, line 104 (RVU26D)

Open CMS sourceHow we calculate rates

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