CPT
90471 — Immunization administration, single vaccine
ACA-covered vaccines should be free, including the admin fee.
Mental health
90792 — Psychiatric diagnostic evaluation with medical services
This is an initial psychiatric evaluation that includes medical services such as medication evaluation, a physical examination component, or ordering laboratory work.
- Typical setting: Therapist's office, hospital, telehealth
- National avg charge (illustrative): $200–$400 (Medicare national non-facility rate approximately $216 in 2026)
- Most-disputed reason: Non-prescribing therapists or psychologists billing 90792 — this code is restricted to providers who can perform medical services and is not appropriate for LCSWs, LMFTs, or psychologists in most contexts.
What it means
What 90792 actually means
This is an initial psychiatric evaluation that includes medical services such as medication evaluation, a physical examination component, or ordering laboratory work. It is typically performed only by psychiatrists, psychiatric nurse practitioners, or physician assistants with prescribing authority.
Common errors with this code
What goes wrong on real bills.
Most bills that look correct still contain at least one of these issues. Up to 49% of medical bills contain errors (CFPB).
- Non-prescribing therapists or psychologists billing 90792 — this code is restricted to providers who can perform medical services and is not appropriate for LCSWs, LMFTs, or psychologists in most contexts.
- Billing 90792 repeatedly for medication management follow-up visits — it is an initial evaluation code, not a routine medication check code.
- Billing 90792 alongside an E/M code (99202–99215) on the same date for the same patient — these codes cannot be billed together per CPT guidelines.
If you see 90792 on your bill
Three steps before paying.
1. Get the itemized bill. If your statement only shows a summary, request the CPT-level itemized bill before paying. Generate the request language →
2. Cross-check against the EOB. Compare what your insurer's Explanation of Benefits says you owe versus what the hospital is asking. They disagree more often than people think. Read the bill-vs-EOB guide →
3. Run a free Bill Scan. Upload the bill (and EOB if you have it) and BillBusted will flag the most likely issues with this specific code in your specific state. Run free scan →
Related codes
Other codes in this category.
People who land on 90792 often also see these adjacent codes on the same bill.
CPT
90472 — Immunization admin; each additional vaccine
Vaccine — admin (90471) is separate from the vaccine product code.
CPT
90651 — Human papillomavirus vaccine types 6, 11, 16, 18, 31, 33, 45, 52, 58, nonavalent , IM
Vaccine — admin (90471) is separate from the vaccine product code.
CPT
90670 — Pneumococcal conjugate vaccine, 13 valent , IM
Vaccine — admin (90471) is separate from the vaccine product code.
CPT
90671 — Pneumococcal conjugate vaccine, 15 valent , IM
Vaccine — admin (90471) is separate from the vaccine product code.
CPT
90677 — Pneumococcal conjugate vaccine, 20 valent , IM
Vaccine — admin (90471) is separate from the vaccine product code.
Related BillBusted guides
Plain-English reads if you see 90792 on a bill.
90792 FAQ
Plain-English answers.
What does 90792 usually cost?
$200–$400 (Medicare national non-facility rate approximately $216 in 2026). Costs vary by region, payer contract, and whether the service was performed in a hospital outpatient department (which adds a facility fee) versus a free-standing clinic.
What's the most common billing error on 90792?
Non-prescribing therapists or psychologists billing 90792 — this code is restricted to providers who can perform medical services and is not appropriate for LCSWs, LMFTs, or psychologists in most contexts.
What should I do if I see 90792 on my bill?
Request the itemized bill and the matching EOB from your insurer. Compare the units/quantity billed against what you actually received. Run a free BillBusted scan to flag the most likely errors specific to 90792 before paying.
Don't pay 90792 blindly.
The free scan tells you in under 60 seconds whether this charge looks reasonable for your situation.