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Psychotherapy billing requires attention to detail, especially for time-based codes like CPT 90834, which covers a typical 45-minute individual therapy session. While this may seem straightforward, billing errors involving psychotherapy codes are common, often resulting in denied claims and delayed reimbursements.
To help you avoid costly mistakes, the billing specialists at MindCare have created this in-depth guide to CPT 90834. You’ll learn how this code is defined, when to use it, common billing scenarios, applicable modifiers, and essential documentation tips to ensure accurate claims and faster payments.
CPT Code 90834 – Description
CPT 90834 is defined as:
“Psychotherapy, 45 minutes with patient.”
This code is used for individual psychotherapy sessions, typically lasting 38–52 minutes. It focuses on improving the patient’s mental health through structured talk therapy, addressing emotional, behavioral, and cognitive challenges.
A CPT 90834 session may include:
- Exploring current symptoms and stressors
- Processing trauma, anxiety, depression, or relationship issues
- Teaching coping skills and behavior modification techniques
- Assessing progress toward treatment goals
Unlike codes that include evaluation or medical management (such as medication prescribing), 90834 is solely for psychotherapy without any medical services.
Scenarios Where CPT Code 90834 is Applicable
You would typically bill 90834 in these cases:
You would bill CPT 90834 in the following situations:
Ongoing Psychotherapy for Anxiety or Depression
A 45-year-old patient attends a 45-minute session focused on cognitive-behavioral therapy (CBT) to manage generalized anxiety disorder. The clinician employs evidence-based interventions, including identifying cognitive distortions and developing effective coping strategies.
Trauma-Focused Therapy for PTSD
A combat veteran participates in a 45-minute psychotherapy session addressing post-traumatic stress disorder (PTSD). The therapist provides trauma-informed care, processing distressing memories while teaching grounding techniques.
Adolescent Psychotherapy with Family Involvement
A 16-year-old struggling with academic stress and family conflict attends a 45-minute individual session. The clinician uses solution-focused therapy and briefly involves a parent for psychoeducation.
Telehealth Psychotherapy Session
A patient with mild recurrent depression who lives in a rural area attends a secure telehealth session. The therapist documents the full duration, confirms patient location, and uses Modifier 95 for billing compliance.
Applicable Modifiers for CPT Code 90834
When necessary, these modifiers can be used with 90834:
- Modifier 95 – Indicates psychotherapy provided via telehealth.
- Modifier GT – Another telehealth modifier required by some payers.
- Modifier 59 – Used when psychotherapy is distinct from other services offered on the same day.
- Modifier HO – Identifies the clinician as a master’s-level provider (if required by the payer).
CPT 90834 – Billing & Reimbursement Guidelines
Here’s how to ensure clean claims and proper payment:
Document Medical Necessity
Include:
- Patient’s presenting symptoms or reason for the session
- Progress since the previous session
- Specific interventions used (CBT, trauma-focused therapy, etc.)
- Patient’s response and updated treatment plan
Use the Right ICD-10 Codes
Pair with accurate mental health diagnoses such as:
- F32.1 – Major depressive disorder, moderate
- F41.1 – Generalized anxiety disorder
- F43.23 – Adjustment disorder with mixed anxiety and depressed mood
Time-Based Billing Rules
Session 38–52 minutes is used for 90834. If therapy is shorter, use 90832. If longer than 52 minutes, use 90837.
Telehealth Considerations
Most payers reimburse 90834 for telehealth sessions when billed with modifier 95 or GT. Always check payer-specific requirements for place-of-service codes.
Typical Reimbursement Scenarios
- Private Insurance: $120–$160 per 45-minute session
- Telehealth Sessions: Often reimbursed at the same rate when correctly billed
- Medicare: Slightly lower rates, generally $100–$140, depending on locality
Why MindCare is the Trusted Partner for Psychotherapy Billing
Psychotherapy billing is highly detail-oriented, and even a minor documentation or time-based coding error can result in claim denials and lost revenue. At MindCare, we specialize in behavioral health billing, offering tailored solutions for psychotherapy services like 90834.
Our advanced billing process has helped providers:
- Reduce claim denials by 85%
- Accelerate reimbursement turnaround by 40%
- Increase overall revenue by up to 70% through optimized coding and billing strategies
We proactively monitor payer rules, ensure accurate documentation, and manage the complexities of telehealth-specific billing to ensure seamless operations. With MindCare, you can confidently focus on delivering high-quality therapy sessions, while we handle the intricate billing process to ensure you’re fully reimbursed for your care.
Let Mind Care Billing Help
We help mental health providers use the correct CPT codes, avoid denials, and get paid faster. If you're unsure which code to use, or tired of dealing with rejections, our team can take billing off your plate entirely.
Schedule a Free Consultation with Mind Care Billing today — and leave the coding confusion behind.
