90785 Psytx complex interactive
What 90785 is
CMS fee schedule short descriptor: Psytx complex interactive.
Full CPT long descriptions are licensed by the American Medical Association and are not published on this site; the short descriptor above is the one CMS prints in its own fee schedule file. See About CPT.
Medicare payment for 90785 (CY2026)
| Work RVU | Practice expense RVU | Malpractice RVU | Total | Medicare rate | |
|---|---|---|---|---|---|
| Non-facility (office) | 0.33 | 0.11 | 0.00 | 0.44 | $14.70 |
| Facility (hospital, ASC) | 0.33 | 0.02 | 0.00 | 0.35 | $11.69 |
National rates: total RVUs x the CY2026 conversion factor of 33.4009 (non-QP), before geographic adjustment. Actual Medicare payment is 80% of the rate shown after the deductible; the patient or secondary payer owes the 20% coinsurance.
Status: Active - payable under the Physician Fee Schedule. Global period: Add-on code: global period of the primary procedure applies.
Medically Unlikely Edit (MUE)
Medicare caps 90785 at 3 units per date of service for practitioner claims (MAI 3 - date of service edit (clinical): units above the MUE may pay with documentation on appeal), rationale: Clinical: CMS Workgroup. Units above the cap are denied unless the edit's adjudication rules allow an appeal with documentation.
Billed with 90785? These codes are bundled into it
90785 is a Column 1 code in 14 active NCCI PTP edits. When one of these Column 2 codes is reported on the same date of service, it is denied as bundled - unless the edit's modifier indicator is 1 and documentation supports a distinct service with an NCCI-associated modifier.
| Column 2 code | Short description | Modifier indicator | |
|---|---|---|---|
0362T | Bhv id suprt assmt ea 15 min | 0 - no modifier bypass | Check pair |
0373T | Adapt bhv tx ea 15 min | 0 - no modifier bypass | Check pair |
36591 | Draw blood off venous device | 0 - no modifier bypass | Check pair |
36592 | Collect blood from picc | 0 - no modifier bypass | Check pair |
96164 | Hlth bhv ivntj grp 1st 30 | 0 - no modifier bypass | Check pair |
96165 | Hlth bhv ivntj grp ea addl | 0 - no modifier bypass | Check pair |
96523 | Irrig drug delivery device | 0 - no modifier bypass | Check pair |
97151 | Bhv id assmt by phys/qhp | 0 - no modifier bypass | Check pair |
97152 | Bhv id suprt assmt by 1 tech | 0 - no modifier bypass | Check pair |
97153 | Adaptive behavior tx by tech | 0 - no modifier bypass | Check pair |
97154 | Grp adapt bhv tx by tech | 0 - no modifier bypass | Check pair |
97155 | Adapt behavior tx phys/qhp | 0 - no modifier bypass | Check pair |
97156 | Fam adapt bhv tx gdn phy/qhp | 0 - no modifier bypass | Check pair |
97157 | Mult fam adapt bhv tx gdn | 0 - no modifier bypass | Check pair |
90785 is bundled into these codes
90785 appears as a Column 2 code in 19 active edits. Reported with one of these Column 1 codes on the same date of service, 90785 is the code that denies.
| Column 1 code | Short description | Modifier indicator | |
|---|---|---|---|
90839 | Psytx crisis initial 60 min | 0 | Check pair |
90840 | Psytx crisis ea addl 30 min | 0 | Check pair |
96130 | Psycl tst eval phys/qhp 1st | 0 | Check pair |
96131 | Psycl tst eval phys/qhp ea | 0 | Check pair |
96132 | Nrpsyc tst eval phys/qhp 1st | 0 | Check pair |
96133 | Nrpsyc tst eval phys/qhp ea | 0 | Check pair |
96136 | Psycl/nrpsyc tst phy/qhp 1st | 0 | Check pair |
96137 | Psycl/nrpsyc tst phy/qhp ea | 0 | Check pair |
96138 | Psycl/nrpsyc tech 1st | 0 | Check pair |
96139 | Psycl/nrpsyc tst tech ea | 0 | Check pair |
96156 | Hlth bhv assmt/reassessment | 0 | Check pair |
96158 | Hlth bhv ivntj indiv 1st 30 | 0 | Check pair |
96159 | Hlth bhv ivntj indiv ea addl | 0 | Check pair |
96167 | Hlth bhv ivntj fam 1st 30 | 0 | Check pair |
96168 | Hlth bhv ivntj fam ea addl | 0 | Check pair |
Data: CMS CY2026 Physician Fee Schedule RVU file (October release, RVU26D) and Medicare NCCI PTP practitioner edits v32.3 (2026 Q4). Verify against the official files before billing or contracting decisions.