ARTICLE

Behavioral Health

Author:
Brellium

CPT Code 90834: 45-Minute Psychotherapy Billing Guide

CPT code 90834 is one of the most frequently used codes in outpatient behavioral health billing. If you're a mental health provider, billing specialist, or practice administrator, understanding how to correctly bill 90834 can help maximize reimbursement and prevent claim denials.

In this article, we’ll cover:

  • What CPT 90834 is

  • When to use it

  • Documentation requirements

  • Reimbursement insights

  • Common billing errors

What is CPT Code 90834?

CPT 90834 refers to individual psychotherapy sessions lasting approximately 45 minutes. This code is used for outpatient mental health services provided by a licensed clinician (e.g., psychologist, licensed professional counselor, clinical social worker).

This session typically includes:

  • Therapeutic dialogue

  • Mental status examination

  • Insight-oriented, behavior-modifying, or supportive interventions

Note: This code is intended for sessions 38–52 minutes in duration. Sessions significantly shorter or longer should use 90832 (30 minutes) or 90837 (60 minutes), respectively.

When to Use CPT Code 90834

Use 90834 when:

  • The psychotherapy session lasts between 38–52 minutes.

  • The session is conducted one-on-one (not group or family therapy).

  • The focus is on treating a mental health disorder with therapeutic techniques.

This code is not appropriate for:

  • Sessions under 38 minutes (use 90832)

  • Family or couples therapy (use 90846 or 90847)

  • Sessions with medical services (use 90833 or 90836 alongside an E/M code)

Documentation Requirements

To support billing CPT 90834, documentation should include:

  • Start and stop times or total duration

  • Presenting problem and diagnosis

  • Mental status exam

  • Interventions provided (e.g., CBT, psychodynamic therapy)

  • Patient response and progress toward treatment goals

  • Plan for next steps

Reimbursement Rates for 90834

Reimbursement varies by payer and region, but average Medicare rates for CPT 90834 are approximately $90–$120 per session. Commercial insurance may reimburse at higher rates.

Pro tip: Some payers may downcode if documentation doesn't justify the duration, so always include time and medical necessity.

Common Billing Errors to Avoid

  • Incorrect duration: Billing 90834 for sessions shorter than 38 minutes can lead to denials.

  • Missing documentation: Omitting start/stop times or key clinical details can trigger audits.

  • Incorrect modifiers: Failing to use appropriate place of service or telehealth modifiers (e.g., 95 or GT) can delay payment.

Final Thoughts

CPT code 90834 is a core billing code for individual therapy. Ensuring correct use and thorough documentation helps you get paid on time and stay compliant with payor policies.

Automate clinical & payor compliance

Automate clinical & payor compliance

Automate clinical & payor compliance