CPT 90834 is the code for a 45-minute individual psychotherapy (talk therapy) session. 1 It covers insight-oriented, behavior-modifying or supportive therapy provided one-on-one with the patient. 2 Use 90834 when psychotherapy is the primary service; if medical evaluation/management (E/M) is the main focus (e.g. medication management), bill the appropriate E/M code instead. 4
Who can bill: Psychiatrists (MD/DO) and other physicians, plus qualified non-physician practitioners within their scope (clinical psychologists, licensed clinical social workers, NPs, CNSs, PAs, etc.) 4 (As of 2024, licensed marriage/family therapists and professional counselors are also recognized Medicare telehealth providers.)
Place of service: 90834 is covered in all settings – for example, office (POS 11), hospital inpatient (21), and outpatient/clinic (22). 4 Medicare (and most insurers) generally does not restrict site of service for psychotherapy codes.
Session length: 90834 is a time-based code for 38–52 minutes of psychotherapy. Document the exact start and stop times (or total face-to-face minutes) of the session in the record. 4
Related durations: If therapy lasts only 16–37 minutes, bill CPT 90832 (30-min session); if 53+ minutes, bill 90837 (60-min). Do not report a psychotherapy code for sessions under 16 minutes. 4
Documentation: Progress notes should describe the psychotherapy provided, patient response, and progress toward goals. Clearly documenting the time and therapeutic content supports medical necessity and correct coding.
Standalone vs. combined: Use 90834 only when psychotherapy is the main service. Psychotherapy sessions involve counseling beyond a standard E/M. If the visit’s focus is a general medical E/M encounter (e.g. medication management), bill an E/M CPT code instead. 3
E/M with therapy: If a distinct E/M service and a 45-minute therapy session both occur, you may bill both. Report the applicable E/M code plus the psychotherapy add-on code 90836 (45-minute add-on). Each service must be separately documented and “significant and separately identifiable.” 3 (Similarly, 90833 is the 30-min add-on, and 90838 is the 60-min add-on.)
Interactive complexity (90785): If special factors are present (e.g. patient accompanied by family or interpreter, high emotional intensity, etc.), you may add CPT 90785 to 90834. 90785 is an add-on code and cannot be billed alone. 3
Extended time: For exceptionally long psychotherapy (over 90 minutes in one day), Medicare requires documentation of necessity and exact time in the chart. 3 Without such justification, payment is capped at 90 minutes.
Coverage: Medicare Part B covers 90834 under its psychology/psychiatry benefit; payment follows the physician fee schedule. Private insurers similarly cover psychotherapy codes but may have specific fee schedules, frequency limits, or pre-authorization rules. (Check each payer’s policy for details on therapy services.)
Coverage: CPT 90834 is included on Medicare’s permanent telehealth list and is covered when furnished via live two-way audio-video. Most commercial payers also reimburse psychotherapy delivered via telehealth (some expanded audio-only coverage during the public health emergency).
Claim coding: Submit 90834 as usual, but indicate it was delivered via telehealth. Use modifier 95 (synchronous telehealth) and the appropriate Place of Service (typically POS 02 for patient’s home). (Some payers accept POS 11 + modifier 95 instead). 5
Documentation: In the note, record that telehealth consent was obtained and note the modality and participant locations. Otherwise document the clinical encounter exactly as for an in-person visit.
Reimbursement: Medicare pays teletherapy at the non-facility (office) rate. 5 Many insurers reimburse tele-mental health at parity with in-person therapy (federal/state parity laws often apply), but rules vary by state and plan.
90832 vs 90837: 90832 is the 30-minute individual therapy code (16–37 min) and 90837 is the 60-minute code (53+ min). 4 90834 covers the mid-range (38–52 min). Choose the code that matches the actual session time.
Add-on codes: When psychotherapy is provided with an E/M service, use add-ons: +90833 (30 min), +90836 (45 min), +90838 (60 min). 3 (E.g. +90836 is 45-min add-on.) These add-on CPTs are never billed by themselves.
Other psychotherapy services: Family therapy (90846/90847) and group therapy (90853) have separate codes. 90834 is only for individual psychotherapy. Initial psychiatric diagnostic interviews use 90791/90792, not 90834.
E/M only: If only medical management or counseling is provided without significant psychotherapy, bill the appropriate E/M code instead of 90834. 3
CPT 90834 corresponds to the common “therapy hour” in outpatient care. A 45-minute session typically allows a meaningful therapeutic interaction and fits patient schedules. For clinicians, 90834 yields higher payment than a 30-minute session but requires less time than a full hour, balancing access and efficiency. Correct use of 90834 ensures therapists are reimbursed fairly for a standard-length counseling session and helps align practice workflow with patient needs.
Sources:
American Medical Association - CPT® code 90834: Psychotherapy, 45 minutes https://www.ama-assn.org/practice-management/cpt/cpt-code-90834-psychotherapy-45-minutes
TheraThink - CPT Code 90834: Complete Guide with Reimbursement Rates [2025] https://therathink.com/cpt-code-90834/
CMS - Billing and Coding: Psychiatry and Psychology Services (A57480) https://www.cms.gov/medicare-coverage-database/view/article.aspx?articleId=57480
CMS - Billing and Coding: Psychiatric Diagnostic Evaluation and Psychotherapy Services (A57520) https://www.cms.gov/medicare-coverage-database/view/article.aspx?articleId=57520&LCDId=33252&DocID=L33252
CMS - MM13452 - Medicare Physician Fee Schedule Final Rule Summary: CY 2024 https://www.cms.gov/files/document/mm13452-medicare-physician-fee-schedule-final-rule-summary-cy-2024.pdf
