Billing code 90792: Psychiatric evaluationMedicare rate & RVUs in Florida
Report this service for a psychiatric diagnostic assessment that includes medical evaluation, such as assessing medication needs and developing a treatment plan.
Medicare pays $202.40–$213.11 for 90792 in the office in Florida, from Rest Of Florida to Miami. Which amount applies depends on the service address.
Medicare allowed amount for participating (non-QP) physicians, before deductible, coinsurance and claim adjustments. Not a patient’s bill or a hospital charge.
On this page 9 sections
What 90792 covers
A psychiatrist or other qualified clinician performs a psychiatric assessment that includes medical services. The work may include reviewing psychiatric and medical history, conducting a mental status examination, forming a diagnostic impression, assessing medication needs, and developing a treatment plan. It is commonly provided in an office or hospital outpatient setting for a patient who needs a diagnostic assessment, including when medication may be part of care.
Select this code when the diagnostic evaluation includes medical services, rather than an evaluation without them. Documentation should support the assessment, findings, diagnostic impression, and medical decisions, including medication-related decisions when made. CMS values the service through physician work, practice expense, and malpractice components; practice expense has separate office and facility valuations. The code represents the diagnostic evaluation, not an ongoing medication follow-up visit.
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 90792 pays more and less in Florida
The same RVUs, adjusted for each area’s costs. Open a locality for its calculation, history and nearby areas.
3 payment localities
$202.40 to $213.11
| Payment locality | Office | Facility |
|---|---|---|
| Fort Lauderdale | $207.41 | $164.10 |
| Miami | $213.11 | $168.61 |
| Rest Of Florida | $202.40 | $161.53 |
How the 90792 rate is calculated
Each of 90792’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 · 90792
RVUs × geographic indexes × conversion factor
Work4.16
4.16 RVUs× 1.000 GPCI
Practice expense1.72
1.72 RVUs× 1.000 GPCI
Malpractice0.17
0.17 RVUs× 1.000 GPCI
Adjusted RVUs
6.0500
Conversion factor
$33.4009
Medicare rate
$202.08
Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.
Payment rules and modifiers for 90792
90792 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 · 90792
Which rate does Medicare pay?
The POS code on the claim line (CMS-1500 box 24B).
POS 11 · non-facility rate · national
$202.08
- Non-facility (office)
- $202.08
- Facility
- $159.32
Higher because the practice carries its own overhead.
90792 compared with similar codes
Compare codes · National
4 codes, side by side
How to choose
- 90791Psychiatric evaluation
- Choose 90792 when medical services are part of the psychiatric diagnostic evaluation; choose 90791 when they are not.
- 90785Interactive complexity
- 90785 reports qualifying interactive complexity as an add-on; it does not replace the psychiatric diagnostic evaluation.
- 99204Office visit
- 99204 describes a new-patient office E/M service. Use 90792 when the encounter is a psychiatric diagnostic assessment that includes medical services.
90792 billing questions
How does this differ from 90791?
Use 90792 when the psychiatric diagnostic evaluation includes medical services. Use 90791 for the evaluation without medical services; do not report both for the same assessment.
Does 90792 include medication management?
It can include assessment of medication needs and related medical decisions as part of the diagnostic evaluation. It does not by itself describe a later, ongoing medication follow-up visit.
Can 90785 be reported with 90792?
Yes, when the encounter meets the requirements for interactive complexity. 90785 is an add-on, so report it with the qualifying primary service rather than alone.
Is 90792 selected by visit duration?
No. Selection turns on whether the psychiatric diagnostic evaluation includes medical services, not on a time threshold.
Can a separate E/M service be billed for the same evaluation?
The medical assessment and decisions that are part of the 90792 evaluation are represented by this service. Do not separately report an E/M service for the same work.
90792 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
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