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CPT 90791 + ICD-10 F32.1: Major depressive disorder, single episode, moderate

Psychiatric diagnostic evaluation billed with Major depressive disorder, single episode, moderate — documentation requirements, denial reasons, modifiers, and reimbursement context.

CPT Code
90791
Psychiatric diagnostic evaluation
ICD-10 Code
F32.1
Major depressive disorder, single episode, moderate
Common Modifiers

Compatibility Notes

Initial evaluation where the patient presents with a first moderately severe depressive episode. The PHQ-9 score of 10-14 at intake supports the moderate specifier. This is one of the most common intake presentations in outpatient therapy. Bill 90791 for all new patient intakes.

Documentation Required

  • Comprehensive evaluation with first MDD episode documented
  • PHQ-9 in moderate range (10-14) at intake
  • Risk assessment including suicidal ideation
  • No prior depressive episodes documented (confirms single episode)
  • Treatment plan initiated

Common Denial Reasons

  • 90791 billed more than once per year by same provider
  • Prior episode documented -- use F33.1 for recurrent moderate MDD
  • Evaluation note lacks diagnostic scope

Applicable Modifiers

Reimbursement Notes

OON UCR $175-$350. Bill 90791 for all new patient intakes.

Related Billing Guides

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