CPT 90845Mental Health

Psychoanalysis

CPT code 90845 is used for psychoanalysis sessions, a specialized form of in-depth psychotherapy that explores unconscious patterns and past experiences to treat mental health conditions. This is distinct from standard talk therapy and involves intensive, often frequent sessions.

Showing rates for

National Average

Base Medicare rate

$99.30

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

2.3

PE RVU (NF)

0.71

MP RVU

0.06

Total RVU

3.07

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

NCCI bundling edits

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Billing tips

Clearly document psychoanalytic technique (free association, interpretation of transference, dream analysis) to differentiate from standard psychotherapy codes 90834-90837
Impact: Prevents downcoding to lower-paying psychotherapy codes, protecting the $99.30 vs $87-95 for standard therapy
Bill 90845 only once per session regardless of duration; there are no time-based variations of this code unlike standard psychotherapy
Impact: Avoids duplicate claim denials and maintains compliance; typical psychoanalytic sessions are 45-50 minutes
Verify psychoanalysis-specific coverage before initiating treatment as many commercial payers exclude this code or require prior authorization
Impact: Reduces claim denials by 60-70% and prevents patient balance billing issues
Use diagnosis codes that support the medical necessity of intensive psychoanalytic treatment (F60.x personality disorders, F34.1 dysthymia, complex trauma)
Impact: Increases approval rates for this intensive modality; generic anxiety/depression codes may trigger denials
Document patient's commitment to and participation in the psychoanalytic process including frequency of sessions (typically 3-5x weekly)
Impact: Supports medical necessity and helps differentiate from less intensive psychotherapy approaches
For Medicare, note that psychoanalysis is covered but subject to the general mental health outpatient limitation and annual deductible
Impact: Patient responsibility will include 20% coinsurance after deductible, affecting collections

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Frequently asked questions

What is the difference between CPT 90845 and standard psychotherapy codes?

CPT 90845 is specifically for psychoanalysis, which uses classical psychoanalytic techniques like free association, dream interpretation, and transference analysis. Standard psychotherapy codes (90832-90838) cover insight-oriented, behavior-modifying, or supportive therapy using various therapeutic modalities. Psychoanalysis is typically more intensive (3-5 sessions weekly) and theoretically distinct from other therapy approaches.

How much does Medicare pay for CPT code 90845 in 2025?

Medicare pays $99.30 for CPT 90845 in non-facility settings and $87.34 in facility settings based on the 2025 national average rates. Actual payment may vary slightly based on geographic location and the Medicare Administrative Contractor's local adjustments.

Can CPT 90845 be billed with evaluation and management codes on the same day?

Generally no. CPT 90845 includes the evaluation component and should not be billed with E/M codes on the same date of service. If a separately identifiable E/M service is provided for a distinct medical issue unrelated to the psychoanalysis, modifier 25 could potentially be used, but this scenario is extremely rare and requires clear documentation of both services.

Do I need special credentials to bill CPT code 90845?

While there is no formal Medicare credentialing requirement specific to 90845, billing this code implies you have specialized training in psychoanalytic theory and technique. Most practitioners billing this code have completed psychoanalytic institute training or equivalent supervised psychoanalytic education beyond their basic mental health license.

Is CPT 90845 covered by commercial insurance plans?

Coverage varies significantly by payer. Many commercial plans specifically exclude psychoanalysis or limit coverage to a small number of sessions. Always verify benefits before beginning treatment and obtain prior authorization if required. Some plans may only cover standard psychotherapy codes regardless of technique used.

How often can CPT 90845 be billed per patient?

CPT 90845 can be billed once per session, and psychoanalytic treatment traditionally involves 3-5 sessions per week. However, payer policies may limit the number of sessions covered per week, month, or year. Medicare does not have specific frequency limitations but requires medical necessity documentation for all services.

Can CPT 90845 be billed for telehealth services?

Yes, CPT 90845 can be billed via telehealth when using appropriate modifiers (95 or GT) and when permitted by payer policy and state regulations. During the COVID-19 public health emergency, Medicare expanded telehealth coverage for mental health services. Check current Medicare and commercial payer telehealth policies as they continue to evolve.