CPT Code 90834: Complete Description (+Reimbursement Details 2024)

The 90834 CPT code is one code that can be used to bill for psychotherapy services. It’s essential that you use this code when it is accurate for the services that you, as a psychotherapist, provide. You may also use add-on codes when situations interfere or interact with psychotherapy sessions or provide individual psychotherapy sessions through telehealth.

Description of 90834 CPT Code

The CPT code 90834 is used for individual psychotherapy sessions that are 45 minutes long. Two other CPT codes are billed for individual psychotherapy sessions that are 30 minutes and 60 minutes long. It also differs from billing a psychotherapy intake or a couples of family psychotherapy sessions.

You use 90834 for services provided from the beginning of a face-to-face psychotherapy session until the end. Accurate reporting of psychotherapy’s start and end times is necessary to bill this code correctly. If you are doing a psychotherapy intake, you would bill the CPT code 90791 instead of an individual psychotherapy code.

Time Range for 90834 CPT Code

Time ranges for CPT codes differ based on the time in a therapy session. For CPT code 90834, individual psychotherapy sessions that last 45 minutes are billed under this code. Sessions from 38 minutes to 52 minutes of the client being in session are also billed under the CPT code 90834.

Sessions under 38 minutes are billed as the 90832 individual psychotherapy code, encompassing sessions lasting from 16 to 37 minutes. Individual psychotherapy sessions that last over 53 minutes and longer are billed as the 90837 psychotherapy code.

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When to Use the 90834 Code

If you’re a mental health professional, you would bill or use the CPT code 90834 for individual psychotherapy sessions only, accounting for a 45-minute session. Intake sessions, couples’ therapy, family therapy, and group therapy are all billed under different CPT codes.

Since the 90834 code is used to bill psychotherapy sessions, it may be helpful to know what kinds of services fall under psychotherapy. A psychotherapy session is also sometimes referred to as a talk therapy session. Psychotherapy encompasses treatments provided to individuals under the direction of a mental health professional who aims to treat a problem.

There are many reasons why someone may choose to engage in individual psychotherapy, such as:

• To treat mental health disorders
• To improve relationships with others
• To deal with life stressors
• To change or modify a behavior
• To live a more fulfilling life
• To improve life satisfaction
• To address past trauma
• To learn how to cope with grief

While this list isn’t all-encompassing, many people seek out psychotherapy because they want to understand themselves better, find relief from their symptoms, and make lasting changes in their lives. When dealt with through talk therapy, all of these reasons fall under the definition of psychotherapy.

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How to Use the 90834 Code

You bill the 90834 when you have spent 45 minutes or anywhere from 38-52 minutes in an actual face-to-face session providing psychotherapy. This code doesn’t include the time to bill a session or schedule the next appointment. When you submit documentation or a record of services to third-party payors, your session should be coded with the 90834 code when it falls into the appropriate time range for individual psychotherapy.

This code is used without an accompanying medical evaluation or management. If you are a mental health professional where it is within your scope of practice to perform a medical assessment and management of medical conditions and also provide psychotherapy services, you will not bill the 90834 code. A different code designates individual psychotherapy with medical evaluation and management and would be billed as the CPT code 90836.

This CPT code is one of the most common codes used to bill psychotherapy sessions. You may also have to add to the CPT codes when billing for a session. For example, 90834 with a modifier of 95 would occur when teletherapy services are provided. The 95 modifier is an add-on code to denote that telehealth services were provided.

There are also add-on codes for interactive complexity. The interactive complexity code is used in addition to the CPT code 90834 when communication factors complicate billing. Interactive complexity is billed as 90785.

You would use the interactive complexity code when the following are present:

• Maladaptive communication complicates the session
• Caregivers enter the session that disrupts the treatment planning
• Evidence of a reportable event, such as abuse or neglect
• The use of equipment to assist with communication, such as physical devices or play therapy equipment

Interactive complexity as an add-on code shouldn’t be used alone for translation or interpretation services as this likely violates federal statutes. The 90834 code can be used in conjunction with other codes when it is accurate and thoroughly describes the provided service.

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Why are CPT codes necessary?

The American Medical Association suggests that CPT codes are necessary because they help provide a universal language for healthcare services provided to patients. When services are coded accurately, it supports that all healthcare professionals have a uniform way to report a service they provide.

They also are essential because they help increase the accuracy of reporting services. The services you provide aren’t a mystery to others, or you aren’t confused when you look at your documentation as to what services were provided.

All category one CPT codes are 5-digit numbers used across many health disciplines. Psychotherapists are reimbursed for their services based on the CPT code they bill, so it’s essential to be accurate when billing CPT codes so you aren’t committing fraud.

CPT codes are often necessary to bill programs such as Medicaid, Medicare, and other third-party insurance payors. CPT Codes were developed by the American Medical Association (AMA) to have a standard language and billing procedure.

The 90834 code falls into a category one CPT code, meaning it is a distinct service provided by a healthcare professional and documented using a five-digit code. Other categories of CPT codes are used in varying situations.

For example, category two CPT codes are for supplemental procedures and are designated with a 4-digit CPT code. Category three CPT codes specify new or emerging technologies and use an alpha-numeric indicator.

CPT codes help you chart appropriately and receive proper reimbursement for your services. If you’re a psychotherapist, using a program or ensuring you write down your psychotherapy sessions’ exact start and stop times to ensure accurate billing may be helpful.

The Bottom Line

CPT codes provide a standard language for healthcare professionals to bill for services. Psychotherapists may use different CPT codes for various services, including individual, couples, family, and group psychotherapy. There are also varying codes used for different timeframes in actual sessions with your clients.

The 90834 CPT code is used to denote a 45-minute psychotherapy session, which includes the time from the start of a face-to-face session to the end of the face-to-face session. The time range for 90834 is 38 minutes to 52 minutes and must be billed accurately to ensure accurate reporting of services and proper reimbursement from third-party payors.

The 90834 designation can be used in addition to other codes that demonstrate the full depth of your service. Billing the codes accurately for the service provided helps prevent fraud and accurately ensures your documentation reflects the services provided.

If you need to add codes to fully describe the range of services, such as telehealth or interactive complexity, you will document those codes as services as an addition to the 90834 code. Resources are available to find the correct codes.

CPT codes are generally not complicated, but sometimes, there are complex factors in psychotherapy. Knowing what CPT codes there are and quickly accessing a list of standard CPT codes can help you stay on top of billing and documentation to ensure the accuracy of your services. If you want to save time with documentation and billing, consider signing up for Mentalyc today. Mentalyc offers incredible features for psychotherapists and can help with your documentation and billing.

References

• American Academy of Child & Adolescent Psychiatry. (2012). Interactive Complexity. https://www.psychiatry.org/File%20Library/Psychiatrists/Practice/Practice-Management/Coding-Reimbursement-Medicare-Medicaid/Coding-Reimbursement/cpt-interactive-complexity.pdf

• Dotson P. (2013). CPT® Codes: What Are They, Why Are They Necessary, and How Are They Developed? https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3865623/

• National Institute of Mental Health. (2023). Psychotherapies. https://www.nimh.nih.gov/health/topics/psychotherapies

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About the author

Marissa Moore, MA, LPC

Marissa Moore is a mental health professional who owns Mending Hearts Counseling in Southwest Missouri. She specializes in providing affirming counseling services to the LGBTQIA+ community. Marissa has 11 years of experience working in the mental health field, and her work experience includes substance use treatment centers, group homes, an emergency room, and now private practice work.

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