When it comes to mental health billing, CPT code 90834 is one of the most commonly used codes for psychotherapy services. This code is specifically designated for individual psychotherapy sessions lasting approximately 45 minutes, making it the standard choice for many mental health professionals. It is used to document, bill, and receive reimbursement from insurance providers, including Medicare, Medicaid, and private insurers. Understanding this code is essential for clinicians, office staff, and patients who want clarity about psychotherapy billing practices.
Understanding CPT Code 90834
Definition and Purpose of CPT Code 90834
CPT 90834 refers to a psychotherapy session with a patient that typically lasts 45 minutes. Unlike shorter or extended sessions, 90834 is considered the standard length for individual therapy. Clinicians often use it to treat a range of mental health conditions, including anxiety, depression, PTSD, and other behavioral health concerns.
The code sits in the middle of three common psychotherapy codes:
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90832: Short therapy sessions (30 minutes)
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90834: Standard therapy sessions (45 minutes)
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90837: Extended sessions (60 minutes or longer)
Each code is differentiated primarily by time spent with the patient, although documentation requirements also differ, especially for 90837, which requires justification for longer sessions. CPT 90834 represents the most widely used code for standard, individual psychotherapy in clinical practice.
Who Can Bill CPT Code 90834?
Licensed mental health professionals including psychologists, clinical social workers, psychiatrists, and licensed professional counselors are authorized to bill this code. Medicare, Medicaid, and most private insurance providers recognize CPT 90834 for standard psychotherapy sessions. It is critical that the professional is properly credentialed, and the session documentation aligns with insurance requirements.
When is CPT Code 90834 Used?
CPT 90834 is used in a variety of therapy scenarios:
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Treatment for anxiety, depression, PTSD, or other mental health conditions
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Routine follow-up therapy sessions lasting around 45 minutes
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Individualized treatment plans requiring standard-length sessions
Clinicians typically recommend a weekly or biweekly frequency depending on the patient’s condition, severity, and treatment plan. The code ensures both accurate clinical documentation and insurance reimbursement.
CPT Code 90834 vs Other Psychotherapy Codes
CPT 90832 vs 90834 vs 90837 Comparison Table
| Code | Session Length | Typical Use | Billing Notes | Insurance Coverage |
|---|---|---|---|---|
| 90832 | 30 minutes | Short therapy sessions | Lower reimbursement | Widely covered |
| 90834 | 45 minutes | Standard psychotherapy | Standard reimbursement | Widely covered |
| 90837 | 60 minutes | Extended therapy | Higher reimbursement, requires justification | Sometimes limited |
How to Choose the Correct Code
Selecting the correct code requires accurate session timing and proper documentation:
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Use 90832 for brief sessions focused on targeted interventions.
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Use 90834 for standard-length, individual psychotherapy sessions.
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Use 90837 only for sessions lasting at least 60 minutes and when clinical documentation justifies extended therapy.
Incorrect coding can result in denied claims, reduced reimbursement, or audits, making it critical for clinicians and billing staff to understand the nuances of each code.
Guide to Using CPT Code 90834
Step 1 – Patient Assessment
Before billing, document the patient’s clinical presentation, diagnosis, and treatment goals. This includes mental health history, symptom severity, and therapeutic objectives. Clear documentation establishes the medical necessity of the session.
Step 2 – Session Planning
Structure the 45-minute session carefully:
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Begin with a brief review of previous sessions
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Engage in therapy interventions suited to the patient’s needs
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Document session progress and any modifications to the treatment plan
Time tracking is essential, as CPT 90834 requires approximately 45 minutes of face-to-face psychotherapy.
Step 3 – Documentation for Billing
Accurate documentation ensures insurance compliance:
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Include session date, start/end times, and total duration
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Describe therapy techniques used (CBT, DBT, supportive therapy, etc.)
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Note patient response and progress toward goals
Example documentation:
“45-minute individual psychotherapy session focused on cognitive behavioral interventions to address depressive symptoms. Patient demonstrated engagement and reported reduced anxiety since last session.”
Step 4 – Submitting a Claim
Once documented, submit the claim using CPT 90834 in insurance forms or electronic billing systems. Double-check for:
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Correct CPT code
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Accurate diagnosis codes
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Proper modifiers if required (e.g., telehealth modifier)
Common errors include using the wrong code, missing documentation, or mismatched session times, which can lead to claim denials.
Insurance and Billing Considerations for CPT Code 90834
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Coverage: Most major insurance providers, including Medicare and Medicaid, cover CPT 90834 for standard therapy sessions.
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Reimbursement Rates: Typically moderate; lower than 90837 but higher than 90832.
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Common Denial Reasons: Insufficient documentation, session length discrepancy, or using 90834 for inappropriate session types.
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Appeal Tips: Provide detailed session notes, justify therapy necessity, and ensure alignment with diagnosis codes.
Frequently Asked Questions (FAQs)
1. What is the difference between CPT 90834 and 90837?
CPT 90834 is a 45-minute standard therapy session, while 90837 covers 60-minute extended sessions and requires clinical justification.
2. Can CPT 90834 be used for teletherapy sessions?
Yes, many insurers allow CPT 90834 for telehealth services, often requiring a telehealth modifier.
3. Is CPT 90834 covered by all insurance providers?
While most private and public insurers cover it, coverage may vary by plan and region.
4. How long is a typical session for CPT 90834?
Approximately 45 minutes of face-to-face psychotherapy.
5. Can therapists bill both 90832 and 90834 for the same patient?
Only if separate sessions of different lengths occur on different days; the codes cannot overlap for a single session.
6. Do notes need to be detailed for insurance reimbursement?
Yes. Proper documentation of session length, techniques used, and patient progress is critical.
7. What happens if CPT 90834 is billed incorrectly?
Errors can lead to claim denials, reduced reimbursement, or audits.
8. Are there any patient limitations or exclusions for this code?
No specific limitations, but sessions must align with medically necessary psychotherapy services.
Key Takeaways and Conclusion
CPT 90834 is the standard psychotherapy code for 45-minute individual therapy sessions, widely used across mental health practices. It ensures proper documentation, compliance with insurance requirements, and appropriate reimbursement. Clinicians must understand its application, differentiate it from related codes (90832 and 90837), and maintain accurate records to avoid claim issues.
Proper use of CPT 90834 improves treatment consistency, supports insurance claims, and enhances patient care. For complex cases or billing questions contact AAAMB now!, consulting a professional coder or billing specialist is recommended to maintain compliance and optimize reimbursement.
By understanding what CPT code 90834 is, when to use it, and how to document sessions properly, mental health professionals can focus on providing effective care while minimizing administrative and financial challenges.