What Is CPT 90834?
CPT 90834 is used to report individual psychotherapy for approximately 45 minutes.
CMS's Medicare guidance identifies 90834 as psychotherapy, 45 minutes with the patient.
The actual billing requirements depend on the applicable payer.
When Should 90834 Be Used?
90834 should correspond to the psychotherapy service actually provided and documented.
It should not be selected solely because the appointment was placed on the schedule for 45 minutes.
The record should support the service and applicable time requirements.
90834 Time Documentation
CMS contractor guidance currently identifies approximately 38–52 minutes as the range for 90834 under the Medicare guidance cited by that contractor.
CMS also states that start/stop times or total time should be documented for time-based psychotherapy codes including 90834.
Commercial payer requirements can differ.
90834 vs 90837
Code General description ———————————– ———————————– 90834 Psychotherapy, 45 minutes
90837 Psychotherapy, 60 minutes
The correct code depends on the actual service and applicable coding requirements.
The billing team should not automatically "upgrade" or "downgrade" a psychotherapy code simply to increase reimbursement.
Common 90834 Denials
Potential issues include:
- Insufficient documentation
- Incorrect time
- Eligibility
- Authorization
- Provider enrollment
- Incorrect diagnosis
- Incorrect place of service
- Payer-specific requirements
90834 Telehealth
For Medicare professional claims, CMS currently uses POS 02 or POS 10 to distinguish telehealth provided outside versus inside the patient's home.
Other payers may have different requirements.
Before submitting a telehealth claim, verify the applicable payer policy.
90834 Billing Best Practices
A billing team should verify:
- Provider eligibility
- Patient eligibility
- Authorization requirements
- Correct CPT
- Diagnosis
- POS
- Modifier where applicable
- Documentation requirements
- Filing deadline
- Claim status after submission