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What is CPT Code 90834? A Simple Guide for Therapists with Examples

Stanley Efrem

Apr 4, 2025

CPT code 90834 is the most commonly used billing code in mental health and behavioral health practices today. Designed specifically for 45-minute individual psychotherapy sessions, this code has seen steady reimbursement increases, rising from $99.97 in 2023 to a projected $104.16 in 2025.

Mental health professionals need to understand how to use this vital billing code properly. The 90834 CPT code has become a significant part of outpatient therapy billing since its last revision in 2013. It covers sessions that range from 38 to 52 minutes. This piece offers a detailed guide to help you understand everything about the 90834 code, from simple definitions to real-life examples.

Let's explore the fundamentals of CPT code 90834, its documentation requirements, and practical examples to ensure you use it correctly in your practice.

Understanding CPT Code 90834: Basic Definition and Purpose

The Current Procedural Terminology (CPT) code 90834 stands for a standard 45-minute individual psychotherapy session. The American Medical Association (AMA) defines it as "Psychotherapy, 45 minutes with patient" [1]. This code represents therapeutic communication that eases emotional disturbances, changes maladaptive behaviors, and encourages personality growth.

What exactly is the 90834 CPT code?

CPT code 90834 belongs to Category One CPT codes, that indicates a specific service healthcare professionals provide. Healthcare providers must document face-to-face time between 38 and 52 minutes to use this code. The therapist uses specific therapeutic communication methods while the patient stays present during most or all of the service.

The code lets therapists include family members or informants in treatment, but the patient remains the main focus. Therapists can assess and adjust their psychotherapeutic interventions based on the patient's condition throughout the session.

The origin and development of psychotherapy CPT codes

The AMA created the CPT coding system in 1966 to standardize billing, documentation, and communication between healthcare stakeholders. The AMA's CPT Editorial Panel has guided the system's development over the years. This panel includes experts from medical specialties of all types, including mental health.

The early 2010s brought a major change. The psychotherapy codes were simplified to three main timed codes: 90832 (30 minutes), 90834 (45 minutes), and 90837 (60 minutes). This new structure covered most individual psychotherapy sessions in any clinical setting. The 2013 changes to Psychiatry codes created the framework we use today [4].

How 90834 is different from other therapy codes

Session duration creates the biggest difference between therapy codes. The 90834 code covers 38-52 minute sessions. Code 90832 fits shorter 30-minute sessions (16-37 minutes), and 90837 works for longer 60-minute sessions (53+ minutes).

The 90834 code is also different from add-on codes used with medical evaluation and management services. Providers must use E/M codes plus psychotherapy add-on codes (+90833, +90836, +90838) instead of standalone codes like 90834 in these cases [6].

Crisis intervention codes work differently too. Clinicians should use 90839 (first 60 minutes) and 90840 (each additional 30 minutes) for urgent assessment, crisis state history, mental status examination, and disposition [7][6].

Time Requirements for Billing the 90834 CPT Code

The right timing plays a vital role in using the 90834 CPT code for psychotherapy sessions. A clear understanding of time requirements will give a proper reimbursement and compliance with insurance guidelines.

The 38-52 minute sweet spot for 90834

The 90834 CPT code specifically covers psychotherapy sessions that last 38 to 52 minutes [7]. People often call it the "45-minute" therapy code [8], but the actual billable range gives clinicians some flexibility. This time frame follows the CPT "Time Rule," which lets providers pick the code that matches the actual session length [7].

Your face-to-face therapeutic interaction must fall within this specific window to use this code. You should bill sessions under 38 minutes using code 90832. Sessions that run longer than 52 minutes need code 90837.

What counts toward session time (and what doesn't)

The billable time for the 90834 code covers specific activities:

Face-to-face therapeutic interaction with the patient
Time spent with family members when the patient is present [8]

The billable time excludes administrative tasks such as:

Writing session notes or documentation
Scheduling future appointments
Collecting payments or copays
Filing insurance claims [8]

It's worth mentioning that teletherapy sessions of equivalent length should use 90834-95, which adds the telehealth modifier.

Documenting time properly to avoid audit issues

Your records must include these elements for each 90834 session to ensure compliance and claim approval:

Precise start and stop times [9]
Total session duration
Date of service [10]
Location/setting of the session

You should complete your documentation within 24-48 hours to maintain accuracy. This becomes especially important when you have insurance payers who examine time frames carefully. They might reject claims that don't match the designated session durations.

Problems with audits often come from incorrect time documentation. To cite an instance, billing 90834 for a 35-minute session could trigger an audit. You should always check if your documented session time matches the code you're using.

Documentation Essentials for 90834 Sessions

Documentation forms the foundations of successful 90834 billing and reimbursement. Insurance companies examine therapy notes carefully. Complete records help you get claim approval and defend your work during potential audits.

Required elements in your progress notes

Your 90834 session note must include these critical components:

Session time documentation: Record exact start and stop times to verify the session fits within the 38-52 minute range for the 90834 CPT code [11].
Medical necessity justification: Document the patient's diagnosis, symptoms, and functional impairments that show why therapy is needed [12].
Clinical interventions: Specify therapeutic techniques beyond simple "listening" and "supporting" [12].
Patient response: Show how the client responded to your interventions [12].
Progress toward treatment goals: Track whether the client improves, regresses, or maintains their current status [12].
Mental status examination: Add at least three components such as appearance, behavior, mood, or reasoning [13].
Risk assessment: Document safety concerns or note "client denies all areas of risk" [13].

Sample documentation template for 90834 sessions

A consistent note structure helps ensure compliance. This simple format works well:

Date: [Date]
Time: [Start time] to [End time] (Total: [XX] minutes)
Presenting Problem: Brief description of client's current symptoms
Interventions: Specific techniques used (e.g., CBT thought challenging, mindfulness exercises)
Client Response: How client interacts with and responds to interventions
Progress: Status toward treatment plan goals
Plan: Next steps and homework for client

You might find standardized formats like SOAP (Subjective, Objective, Assessment, Plan) or DAP (Data, Assessment, Plan) notes helpful.

Common documentation mistakes to avoid

Several documentation errors can lead to claim denials or audit issues:

Missing or inaccurate time documentation: You fail to record precise start/stop times or document duration outside the 90834 time range [14].
Vague clinical descriptions: Using generic language without specific interventions or observations.
Neglecting treatment plan updates: You don't connect session content to treatment goals [15].
Delayed documentation: Notes completed more than 48 hours after sessions lose accuracy.
Inconsistent documentation: Session times in progress notes don't match other records [8].

Complete your notes right after the session—within 24-48 hours works best. Note that clients, insurance reviewers, or legal proceedings might review your documentation [12].

Real-World Examples of Properly Billed 90834 Sessions

Real-life applications help us understand how to use the 90834 CPT code correctly. These examples show proper billing practices for therapy modalities and delivery methods of all types.

Case example: Individual CBT session

A 42-year-old client seeks help for co-morbid depression and anxiety after losing their job. The therapist provides a 45-minute cognitive behavioral therapy session that focuses on identifying negative thought patterns about employment concerns.

Session documentation:

Start time: 10:05 AM, End time: 10:50 AM (45 minutes)
Intervention: CBT thought challenging exercises targeting catastrophic thinking
Client response: Identified three cognitive distortions affecting job search
Treatment plan: Practiced reframing techniques; assigned thought record homework

The session qualifies for 90834 because it falls within the required 38-52 minute range and uses evidence-based interventions for a diagnosed condition.

Case example: Trauma-focused therapy session

A 35-year-old patient with diagnosed PTSD takes part in a 45-minute trauma-focused session.

Session documentation:

Duration: 40 minutes (within 38-52 minute range for 90834)
Intervention: Guided exposure technique addressing specific trauma triggers
Progress: Patient showed reduced autonomic arousal compared to previous session
Plan: Continue exposure hierarchy next session

The therapist bills 90834 appropriately and documents specific trauma-focused interventions instead of general supportive therapy.

Case example: Telehealth session with 90834-95 modifier

A therapist conducts a 45-minute virtual session with a client who has depression:

Session documentation:

42-minute video session (falls within 90834 time parameters)
Telehealth platform: HIPAA-compliant video conferencing
Billing code: 90834 with modifier 95 to indicate telehealth delivery
Place of service: Code 11 (office)

The combination of 90834-95 modifier shows that a standard 45-minute therapy session happened through telehealth. This modifier became standard practice for telehealth psychotherapy services in January 2017.

Conclusion

Mental health professionals must understand CPT code 90834 today. Becoming skilled at proper usage might seem challenging initially, but the core concepts are straightforward. You need to document 38-52 minute sessions accurately, justify medical necessity and keep detailed progress notes.

Note that successful billing relies on three essential elements: precise timing, complete documentation and proper use in various therapy modalities. Insurance companies review claims carefully, but these guidelines will help you secure smooth reimbursement.

CPT code 90834 serves as a tool that lets us focus on what really matters - delivering quality care to our clients. Proper billing management allows us to spend more time on therapeutic work instead of administrative tasks.

FAQs

What is the time duration for a 90834 CPT code session?

A 90834 CPT code session typically lasts between 38 to 52 minutes. This code is often referred to as the "45-minute" therapy session, providing flexibility for clinicians while ensuring proper billing and reimbursement.

How does CPT code 90834 differ from 90837?

CPT code 90834 is used for psychotherapy sessions lasting 38-52 minutes, while 90837 is for sessions lasting 53 minutes or longer. The 90834 code is commonly used for routine outpatient therapy, whereas 90837 is for longer, more intensive sessions when clinically necessary.

What are the essential documentation requirements for 90834 sessions?

Documentation for 90834 sessions should include precise start and stop times, medical necessity justification, specific clinical interventions used, patient response, progress towards treatment goals, and a brief mental status examination. It's crucial to complete this documentation promptly, ideally within 24-48 hours after the session.

Can CPT code 90834 be used for telehealth sessions?

Yes, CPT code 90834 can be used for telehealth sessions. When billing for a telehealth session, therapists should use the code 90834-95, where the 95 modifier indicates that the service was delivered via telehealth.

What is the typical reimbursement rate for CPT code 90834?

The reimbursement rate for CPT code 90834 has been increasing over the years. As of 2023, it was approximately $99.97, with projections suggesting it could rise to around $104.16 by 2025. However, actual reimbursement rates may vary depending on factors such as location and insurance provider.