CPT 90834Mental Health

Psytx w pt 45 minutes

CPT code 90834 is used for a 45-minute psychotherapy session with a patient. This is the most commonly billed code for individual therapy sessions.

Showing rates for

National Average

Base Medicare rate

$104.16

This calculator gives a typical-case estimate using standard Medicare modifier rules. Actual payment depends on payer policies, documentation, code-specific CMS status indicators, and locality. Verify before billing.

RVU breakdown

Work RVU

2.45

PE RVU (NF)

0.72

MP RVU

0.05

Total RVU

3.22

Conversion factor: 32.3465 · Source: CMS MPFS RVU25A · Confidence: High

NCCI bundling edits

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Billing tips

Document exact start and stop times in clinical notes
Impact: Critical for audit defense. 90834 requires 38-52 minutes; sessions under 38 minutes must be billed as 90832 ($77.03) resulting in $27.13 loss per session. Sessions over 52 minutes should use 90837 ($130.86).
Bill facility vs non-facility correctly based on place of service
Impact: Using POS 11 (office) yields $104.16 while POS 22 (hospital outpatient) yields $90.89, a difference of $13.27 per session. Verify your actual practice location.
Never bill 90834 same day as psychiatric diagnostic evaluation (90791/90792) for same provider
Impact: Bundling edits will deny 90834 as inclusive. If both needed same day, use modifier 59 only if truly separate encounters with clear documentation of distinct services and medical necessity.
Verify telehealth coverage policies by payer before using modifier 95
Impact: While Medicare covers telehealth for 90834 through 2025, commercial payers vary. Some require originating site fees, others have state-specific restrictions that could result in 100% denial.
Link to specific ICD-10 diagnosis codes that support medical necessity
Impact: Vague diagnoses like Z71.9 (counseling NOS) trigger denials. Use specific codes like F33.1 (major depressive disorder, recurrent, moderate) to support necessity and avoid recoupments.
Do not bill 90834 for crisis intervention services exceeding 60 minutes
Impact: Crisis services have separate codes (90839/90840). Misusing 90834 for crisis work underpayments potential revenue and creates documentation mismatches during audits.

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Frequently asked questions

What is the difference between CPT 90834 and 90837?

90834 is for 45-minute psychotherapy sessions (38-52 minute range) with a 2025 Medicare rate of $104.16, while 90837 is for 60-minute sessions (53+ minute range) reimbursed at $130.86. You must document actual time spent to select the correct code; the difference is $26.70 per session.

How many times can you bill CPT 90834 per day?

Medicare allows one psychotherapy session per day per patient under normal circumstances. Billing multiple 90834 codes on the same day by the same provider will trigger denials without exceptional documentation of medical necessity and separate, distinct sessions with time gaps.

Can CPT 90834 be billed with an office visit?

Generally no. 90834 cannot be billed with E/M codes (99202-99215) by the same provider on the same day due to bundling edits. Exception: Use add-on code 90833 when psychotherapy is performed with E/M medication management by a physician, or use modifier 59 with extensive documentation showing separate services.

What is the time requirement for CPT 90834?

CPT 90834 requires 38-52 minutes of face-to-face psychotherapy time with the patient. Sessions under 38 minutes must use 90832 (30-minute code), and sessions 53 minutes or longer should use 90837 (60-minute code). Document exact start and stop times.

Does Medicare cover telehealth for CPT 90834?

Yes, Medicare covers 90834 via telehealth through December 31, 2025, at the same rate as in-person visits ($104.16 non-facility). Use modifier 95 or GT, ensure real-time audio and video technology is used, and verify the patient is in an eligible location per current regulations.

What diagnosis codes are required for CPT 90834?

90834 requires a mental health diagnosis code from ICD-10 Chapter 5 (F codes) such as F33.1 (depression), F41.1 (anxiety), F43.10 (PTSD), or other psychiatric conditions. Z-codes alone (counseling codes) typically do not support medical necessity and may result in denials.

Who can bill CPT code 90834?

Licensed mental health professionals including psychiatrists, psychologists, clinical social workers (LCSWs), licensed professional counselors (LPCs), marriage and family therapists (LMFTs), and psychiatric nurse practitioners can bill 90834. Provider must have independent practice authority and appropriate Medicare enrollment or commercial payer credentialing.