CPT Code 97111: Psychiatric Diagnostic Evaluation (Adult)

CPT 97111 is a psychiatric diagnostic evaluation – a face-to-face clinical encounter with a physician or qualified healthcare professional to identify and diagnose mental, behavioral, or emotional disorders in patients aged 18+.

Assessment Includes

• Current symptoms and history (psychiatric, medical, substance use, social).
• Mental status examination.
• Risk assessment (suicide, homicide, self-neglect).
• Diagnostic formulation (DSM-5/ICD-10).
• Determination of need for further evaluation or treatment.

Key Points

• Typically 45-60 minutes.
• Billed once per episode of care (initial evaluation).
• Distinct from psychotherapy codes (90832-90838) and subsequent medication management (99212-99215).

Accurate documentation of medical necessity and time supports reimbursement.