CPT 90791 Mental Health

Psychiatric Diagnostic Evaluation

What should this cost?

Medicare Pays

$150

National benchmark

Typical Range

$200–$500

What hospitals charge

Markup

Above Medicare rate

What this code means on your bill

An initial comprehensive evaluation by a mental health professional. Typically the first visit with a psychiatrist.

Commonly billed for

First visit with a psychiatrist, initial mental health evaluation

What to watch for

Upcoding

If your visit seemed straightforward but you see a high-level code, the provider may have billed for a more complex service than what was performed. Compare the code level to the time you actually spent with the doctor.

Duplicate charges

Check if this code appears more than once on the same date of service. Unless you had the same procedure performed twice (rare), a duplicate is likely a billing error.

Price check

If you're being charged more than 600 for this service, it's significantly above the typical range. Request an itemized bill and compare against the Medicare rate of $150.

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