$179.49–$206.78
90791 is the psychiatric diagnostic evaluation itself. Add 90785 only when a qualifying communication factor complicates that evaluation.
On this page
CMS RVU26D · Effective 2026-10-01
90785 Interactive complexity Medicare reimbursement rates in California
Report interactive complexity when communication barriers or other specified factors complicate a psychiatric evaluation or psychotherapy service. Compare 90785 office and facility rates across CMS payment localities in California.
Amounts below use the non-QP conversion factor for participating physicians. These are base physician payments before claim-level adjustments, not patient costs or total hospital charges.
What does Medicare pay for 90785 in California?
California has 29 payment localities in this comparison. Use the service location to choose the applicable amount. These are the supported base rates for the 29 payment areas shown below, using the same CMS release.
Office / nonfacility
$15.24–$17.53
29 of 29 localities have a supported rate.
Lowest: Chico
Highest: San Jose-Sunnyvale-Santa Clara (Santa Clara Cnty)
A spread of $2.29 per service.
Facility setting
$11.94–$13.20
29 of 29 localities have a supported rate.
Lowest: Chico
Highest: San Jose-Sunnyvale-Santa Clara (Santa Clara Cnty)
A spread of $1.26 per service.
These are locality ranges, not averages or address-specific quotes. A facility-setting amount covers the physician service; it does not include a hospital’s separate bill. Choose a locality below to inspect its calculation, compare other payment areas, or price a percentage of Medicare.
Where 90785 pays more and less in California
29 payment localities
$15.24 to $17.53
Psychiatry
About 90785: Interactive complexity add-on for psychiatric services
Report interactive complexity when communication barriers or other specified factors complicate a psychiatric evaluation or psychotherapy service.
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.
CMS billing rules for 90785
- Global period
- Add-on code: billed only together with a primary procedure and paid within that procedure's global period.
Where the value comes from
- Work RVU0.33 · 75%
- Practice expense (office) RVU0.11 · 25%
- Malpractice RVU0.00 · 0%
414.3K
Medicare services in 2024 · #249 by national volume
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.
90785 compared with similar codes
Office rates for California, from the same CMS release.
$207.32–$240.12
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.
$172.69–$198.30
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.
Compare 90785 by payment locality
Find the payment area for your service address, then open its rate page for calculation inputs, release history and the percentage-of-Medicare tool. A city may cross payment-area boundaries; the ZIP lookup above helps resolve the location.
29 of 29 payment localities
| Payment locality | Office | Facility |
|---|---|---|
| Bakersfield | Office $15.26 | Facility $11.96 |
| Chico | Office $15.24 | Facility $11.94 |
| El Centro | Office $15.24 | Facility $11.94 |
| Fresno | Office $15.24 | Facility $11.94 |
| Hanford-Corcoran | Office $15.24 | Facility $11.94 |
| Los Angeles-Long Beach-Anaheim (Los Angeles/Orange Cnty) | Office $15.82 | Facility $12.26 |
| Madera | Office $15.24 | Facility $11.94 |
| Merced | Office $15.24 | Facility $11.94 |
| Modesto | Office $15.24 | Facility $11.94 |
| Napa | Office $16.56 | Facility $12.60 |
| Oxnard-Thousand Oaks-Ventura | Office $15.67 | Facility $12.12 |
| Redding | Office $15.24 | Facility $11.94 |
| Rest Of California | Office $15.24 | Facility $11.94 |
| Riverside-San Bernardino-Ontario | Office $15.25 | Facility $11.95 |
| Sacramento-Roseville-Folsom | Office $15.69 | Facility $12.20 |
| Salinas | Office $15.62 | Facility $12.14 |
| San Diego-Chula Vista-Carlsbad | Office $15.75 | Facility $12.15 |
| San Francisco-Oakland-Berkeley (Marin Cnty) | Office $17.25 | Facility $13.01 |
| San Francisco-Oakland-Berkeley (San Francisco/San Mateo/Alameda/Contra Costa Cnty) | Office $17.25 | Facility $13.01 |
| San Jose-Sunnyvale-Santa Clara (San Benito Cnty) | Office $17.53 | Facility $13.20 |
| San Jose-Sunnyvale-Santa Clara (Santa Clara Cnty) | Office $17.53 | Facility $13.20 |
| San Luis Obispo-Paso Robles | Office $15.39 | Facility $11.97 |
| Santa Cruz-Watsonville | Office $15.72 | Facility $12.07 |
| Santa Maria-Santa Barbara | Office $15.61 | Facility $12.11 |
| Santa Rosa-Petaluma | Office $15.86 | Facility $12.17 |
| Stockton | Office $15.24 | Facility $11.94 |
| Vallejo | Office $16.56 | Facility $12.60 |
| Visalia | Office $15.24 | Facility $11.94 |
| Yuba City | Office $15.24 | Facility $11.94 |
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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 indices and the applicable conversion factor. Unavailable or separately priced services are labeled rather than assigned a made-up amount.
Source: RVU26D. Effective 2026-10-01 through the day before 2027-01-01.
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