CPT Code 90834: Your 45-Minute Psychotherapy Session Billing Guide

Undoubtedly, the CPT Code 90834 plays a crucial role in mental health care by standardizing how 45-minute individual psychotherapy sessions are billed. This code allows providers to accurately account for the time spent directly with patients to ensure fair reimbursement. Beyond simply documenting therapy, CPT 90834 reflects the structured, evidence-based approach used by licensed mental health professionals to address emotional, cognitive, and behavioral challenges.

This blog will serve as a complete guide to CPT Code 90834, explaining its purpose, eligible providers, session components, and step-by-step billing process.

What is CPT Code 90834?

CPT Code 90834 is a billing code used for individual psychotherapy sessions lasting approximately 45 minutes. It captures only the face-to-face time spent on therapy and excludes administrative tasks such as scheduling, paperwork, and documentation. This code ensures proper billing for mental health services provided in an outpatient setting.

Who can Bill CPT Code 90834?

The following licensed mental health professionals are eligible to bill using CPT Code 90834:

• Licensed Clinical Social Workers (LCSWs)
• Licensed Professional Counselors (LPCs)
• Licensed Marriage and Family Therapists (LMFTs)
• Clinical Psychologists (PsyD or PhD)
• Psychiatrists (MD)

It is important to note that the providers must hold a valid license in their jurisdiction and provide therapy sessions that meet the 45-minute requirement.

Components of a CPT 90834 Session

A typical CPT 90834 session includes the vital elements that ensure effective therapy and proper documentation for billing.

• Evaluation and Assessment - During the session, the therapist carefully evaluates the patient’s mental health, identifies symptoms, and determines the most appropriate treatment plan for their needs.
• Psychotherapy - The therapist provides insight-oriented psychotherapy designed to help the patient explore emotions, thoughts, and behaviors, promoting self-awareness and emotional growth.
• Behavior Modification - Evidence-based techniques are applied to help the patient recognize, address and change maladaptive behaviors that may negatively affect their mental health.
• Supportive Interactions - The therapist offers guidance, empathy, and emotional support to help patients cope with challenges and develop healthier ways of managing stress.
• Administrative Tasks Not Included - Activities such as scheduling, documentation, and other non-therapy work are not counted toward the 45-minute session billed under CPT 90834.

Billing Guide for CPT Code 90834

Billing for CPT Code 90834 requires careful attention to detail to ensure proper reimbursement and compliance with payer guidelines. Below are the steps that cover all essential elements of billing for CPT 90834.

Step 1: Verify Coverage and Eligibility

Before scheduling a session, it is essential to confirm that the patient's insurance plan covers CPT Code 90834. You should check the coverage rules as they can differ between Medicare, Medicaid, and private insurers. In fact, checking eligibility and any session limits in advance ensures that the service will be reimbursed. This step avoid claim denials and payment delays.

Step 2: Confirm Medical Necessity

It is important to verify that each therapy session meets medical necessity requirements to qualify for reimbursement. Also, the providers should verify that the patient's condition, such as depression, anxiety, or other mental health concerns, supports the need for psychotherapy. In fact, pairing CPT 90834 with the appropriate ICD-10 diagnosis codes strengthens the claim and demonstrates clinical justification for the therapy session.

Step 3: Time Requirements for CPT Code 90834

To appropriately use CPT Code 90834, the session must last between 38 and 52 minutes of direct face-to-face interaction with patient. Accurate documentation of session start and end times is crucial to justify the use of CPT Code 90834. However, the sessions that fall outside this time window should be billed using different codes:

• CPT Code 90832: For sessions lasting 16–37 minutes.
• CPT Code 90837: For sessions lasting 53 minutes or more.

Step 4: Prepare Thorough Documentation

Accurate and detailed documentation is essential for billing CPT 90834. In fact, the providers should include the following elements in their session notes:

• Treatment Plan Updates - Document any adjustments to the treatment plan based on the outcomes of the session.
• Session Duration - Clearly document the start and end times of session.
• Patient Progress - Note any changes in the patient's condition or response to treatment.
• Therapeutic Interventions - Record the specific techniques and approaches used during therapy.

It is important to note that the proper documentation supports the medical necessity of the session and ensures accurate billing while protecting against audits.

Step 5: Include Telehealth Considerations

CPT Code 90834 can also be used for telehealth sessions, provided that the exact time requirements and documentation standards are met. When billing for telehealth services, providers should follow these steps--

• Use the Appropriate Modifier: Append modifier 95 to indicate that the session was conducted via real-time interactive audio and video technology.
• Verify Payer Policies: Confirm that the patient’s insurance plan covers telehealth and that CPT 90834 is an eligible code.
• Obtain Patient Consent: Document the patient’s consent for receiving telehealth services.

Step 6: Apply Add-On Codes When Applicable

In certain situations, additional codes may be used with CPT 90834 to provide more detail about the therapy session. These include:

• 90785: For interactive complexity when the session involves complicated treatment scenarios.
• 99050: For services provided outside of regularly scheduled office hours.
• 99051: For services provided during weekends or holidays during regular office hours.

These add-on codes should be used only when applicable and in accordance with payer rules. They help ensure accurate billing and fair reimbursement for the provider’s time and effort.

Step 7: Submit the Claim

Once the session is complete and documentation is prepared, the claim can be submitted. In fact, CPT code 90834 should be entered along with any applicable modifiers and add-on codes. Furthermore, attaching supporting documentation, such as progress notes and therapy details, strengthens the claim and reduces the likelihood of denial.

Step 8: Monitor Reimbursement and Rates

Reimbursement rates for CPT 90834 can vary depending on the payer, geographic location and provider credentials. As of 2025, Medicare typically reimburses between $100 and $150 per session. But the private insurance rates may differ, and some plans may offer higher reimbursement. Monitoring payments ensures that providers receive expected payments and helps identify any discrepancies early.

Step 9: Handle Denials and Appeals

If a claim is denied, providers should carefully review the reason for denial and provide additional documentation if necessary. Direct communication with insurance representatives can help clarify coverage issues and expedite resolution. As a result, properly managing denials and timely appeals is essential for maintaining revenue flow and avoiding repeated billing issues.

Conclusion

Accurately billing CPT Code 90834 is essential for maintaining smooth operations, proper reimbursement, and high-quality mental health care. Every step from documentation to telehealth sessions and add-on codes matters in ensuring claims are processed correctly. In fact, mental health providers can streamline this complex process by outsourcing mental health billing and coding services.

24/7 Medical Billing Services specializes in mental health billing and coding to help practices manage claims efficiently, reduce administrative workload, and maximize reimbursements. This allows mental health providers to focus on managing their practice efficiently with confidence that their billing processes are handled professionally and reliably.

FAQs

Q1. Can CPT 90834 be billed for group therapy?

CPT 90834 is specifically for individual psychotherapy sessions.

Q2. Can CPT 90834 be billed multiple times per day?

It is billed once per patient per day, unless otherwise approved by the payer.

Q3. Does CPT 90834 include family therapy?

It covers only individual therapy; family sessions use different CPT codes.

Q4. Can interns or trainees bill CPT 90834?

Only sessions provided by licensed mental health professionals are eligible for billing.