CPT 90792
Global XXX ActivePsych diag eval w/med srvcs
CPT 90792 Billing & Documentation Guide
CPT code 90792 (Psych diag eval w/med srvcs) is classified under Psychiatry with a global period indicator of XXX. The 2026 Medicare Physician Fee Schedule assigns a work RVU of 4.16, a non-facility practice expense RVU of 1.72, and a malpractice RVU of 0.17, a total non-facility RVU of 6.05 and facility RVU of 4.77. With the current conversion factor of $33.4009, the national average non-facility reimbursement is approximately $206.61, though rates vary from $191.22 to $272.73 based on MAC locality and Geographic Practice Cost Indices (GPCIs).
When billing 90792, ensure documentation supports medical necessity and the specific components required for the code's level of service. For E/M codes, document MDM (medical decision-making) elements: problems addressed, data reviewed, and risk. For procedural codes, document the indication, technique, and any complications. Always verify NCCI edits before bundling 90792 with related codes; this code has 10 PTP bundling relationships on file (see table below).
Payment Status & Global Period
Active code (paid under MPFS)
No global period (E/M and other non-procedural services)
MUE Limit (Medically Unlikely Edits)
Submitting more than 1 units of 90792 for the same patient on the same date triggers automatic line denial unless an appropriate modifier and supporting documentation justify the higher quantity.
RVU Breakdown, CPT 90792
| Component | Non-Facility | Facility |
|---|---|---|
| Work RVU | 4.16 | 4.16 |
| Practice Expense RVU | 1.72 | 0.44 |
| Malpractice RVU | 0.17 | 0.17 |
| Total RVU | 6.05 | 4.77 |
| Conversion Factor | $33.4009 | |
2026 Medicare Reimbursement by State, CPT 90792
State-level averages across all MAC localities. Non-facility rates typically apply to office-based services; facility rates apply to hospital outpatient / inpatient.
| State | Non-Facility | Facility | Range (Non-Fac) | Localities |
|---|---|---|---|---|
| California | $214.99 | $164.4 | $207.32 - $240.12 | 29 |
| Florida | $207.64 | $164.75 | $202.4 - $213.11 | 3 |
| Georgia | $200.76 | $159.98 | $196.96 - $204.55 | 2 |
| Illinois | $205.8 | $164.49 | $200.27 - $210.69 | 4 |
| Michigan | $200.89 | $160.74 | $197.81 - $203.96 | 2 |
| North Carolina | $196.18 | $156.29 | $196.18 - $196.18 | 1 |
| New York | $217.34 | $169.65 | $197.52 - $226.69 | 5 |
| Ohio | $197.12 | $158.09 | $197.12 - $197.12 | 1 |
| Pennsylvania | $202.54 | $160.66 | $197.05 - $208.03 | 2 |
| Texas | $201.55 | $159.45 | $196.5 - $205.04 | 8 |
Source: CMS PFSRVU 2026 · Updated 2026-04-01. Full locality-level detail available for all 53 states, contact us for custom reports.
NCCI Bundling Edits, CPT 90792
Procedure-to-procedure (PTP) edits. If you bill any of these codes with 90792 on the same date of service, review the modifier indicator and payer policy before submission.
| Partner Code | Relationship | Modifier Allowed | Rationale |
|---|---|---|---|
| 0359T | Column 1 (primary), can be billed with modifier | No | CPT Manual or CMS manual coding instruction |
| 0360T | Column 1 (primary), can be billed with modifier | No | CPT Manual or CMS manual coding instruction |
| 0361T | Column 1 (primary), can be billed with modifier | No | CPT Manual or CMS manual coding instruction |
| 0362T | Column 1 (primary), can be billed with modifier | No | CPT Manual or CMS manual coding instruction |
| 0362T | Column 1 (primary), can be billed with modifier | No | CPT Manual or CMS manual coding instruction |
| 0363T | Column 1 (primary), can be billed with modifier | No | CPT Manual or CMS manual coding instruction |
| 0364T | Column 1 (primary), can be billed with modifier | No | CPT Manual or CMS manual coding instruction |
| 0365T | Column 1 (primary), can be billed with modifier | No | CPT Manual or CMS manual coding instruction |
| 0366T | Column 1 (primary), can be billed with modifier | No | CPT Manual or CMS manual coding instruction |
| 0367T | Column 1 (primary), can be billed with modifier | No | CPT Manual or CMS manual coding instruction |
Frequently Asked Questions, CPT 90792
What does CPT code 90792 mean? +
CPT code 90792 represents: Psych diag eval w/med srvcs. It's in the Psychiatry category with a global period of XXX.
What is the Medicare reimbursement for CPT 90792? +
The 2026 Medicare national average non-facility payment for CPT 90792 is $206.61. Rates range from $191.22 to $272.73 across 53 states depending on MAC locality and GPCIs.
What modifiers can I use with CPT 90792? +
Medicine section spans a wide range: therapy services use GP/GO/GN (PT/OT/SLP plans of care) and KX (above cap with documentation). Drug administration uses JW (waste) and JZ (no waste). Professional/technical split applies to some diagnostic codes.
What bundling edits apply to CPT 90792? +
This code has 10 NCCI PTP bundling relationships. See the NCCI Bundling section below for full list.
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Reviewed by the PayerReady Medical Coding Team
Verified against the CMS 2026 code set on May 31, 2026.
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