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

In Virginia, Medicare pays $172.40 for 90791 in the office and $136.94 when it’s performed in a hospital or facility.

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.

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.

How Virginia 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. Virginia pays $172.40. The RVUs are the same everywhere; the geographic indexes change the dollars.

Every other payment area

90791 rates by state

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

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.

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.

Codes related to 90791

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

How 90791 has changed in Virginia

Price 90791 for an earlier date of service

Where the Virginia rate applies

Virginia is a Medicare payment area, not a city. Our Census mapping connects it to 628 cities and communities in Virginia. Some span more than one payment area; confirm with the service ZIP.

• Abbs Valley
• Abingdon
• Accomac
• Adwolf
• Afton
• Alberta
• Aldie
• Allison Gap

Browse all communities in Virginia

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