Wiki 90791

[aschaeve]

Do you know how many times an initial eval 90791 can be completed. Is it any time an extended break occurs, change in mental status etc.
If the patient is established in our Behavioral Health department where 90791 has been done in the past and goes to our Behavioral Health walk in clinic, could another 90791 be done there again?

Thanks,

Alicia, CPC

 

[cjtown]

From my understanding it is when the goals of the patient change. https://www.healthquestbilling.com/cpt-code-90791/

 

[TThivierge]

Aschave
It is given for 2 times a year per payer rules (that CPT code) but for differ mental health problems. I hope this helps you
Lady T

 

[ckeeney]

How often and under what circumstances a 90791 can be done are determined by payer rules. Some will allow every 6 months, some once a year, and some sooner under the circumstances you note but documentation may have to be submitted. We have even had 90791 denied by payers when another provider (not related to us) has completed an evaluation within the allowed time frame!