What is the difference between CPT 90791 and 90792?

• A. 90791 = Telepsychiatry; 90792 = in-person assessment
• B. 90791 = Diagnostic imaging; 90792 = Laboratory testing
• C. 90791 = Psychiatric diagnostic evaluation without medical services; 90792 = Psychiatric diagnostic evaluation with medical services
• D. 90791 = Group psychotherapy; 90792 = Family psychotherapy

Answer: (C)

The key idea is whether medical services are included with the psychiatric evaluation. One code is used when the visit is a psychiatric diagnostic evaluation without medical services—focusing on assessing mental health symptoms, making a DSM diagnosis, and planning treatment, with no medical exam, no medical issues addressed, and no medication management tied to that encounter. The other code is used when the evaluation includes medical services—the clinician also reviews medical history in the context of mental health, may address physical health issues, orders or reviews labs or tests, and can initiate or adjust medications as part of the visit. This distinction determines which code to use: without medical services versus with medical services. The other options describe differences like telepsychiatry vs in-person, imaging or lab as the defining feature, or different psychotherapy modalities, which do not define the CPT pairing in question.