What CPT 90834 is
CPT 90834 is the AMA billing code for individual psychotherapy lasting 38 to 52 minutes. The descriptor reads "Psychotherapy, 45 minutes with patient" — commonly referred to as the 45-minute psychotherapy session.
The time range is a hard boundary on both ends. Below 38 minutes, the session falls to CPT 90832 (16–37 minutes). At 53 minutes or above, the correct code is CPT 90837.
| Field | Value |
|---|---|
| Code | 90834 |
| Description | Psychotherapy, 45 minutes with patient |
| Time requirement | 38–52 minutes face-to-face |
| Typical session length | 45 minutes |
| Medicare rate (2026, non-facility, national) | ~$113.90 |
| Category | Psychiatry — Psychotherapy |
The Medicare rate above is the national unadjusted average from the 2026 Physician Fee Schedule final rule (CMS-1832-F, effective January 1, 2026). Actual payment varies by locality through Geographic Practice Cost Index (GPCI) adjustments.
Who bills 90834
The same licensed mental health professionals who bill 90837:
- Licensed Psychologists (PhD, PsyD)
- Licensed Clinical Social Workers (LCSWs)
- Licensed Marriage and Family Therapists (LMFTs)
- Licensed Professional Counselors (LPCs) / Licensed Mental Health Counselors (LMHCs)
- Psychiatrists (MD, DO)
State scope-of-practice rules determine which credentials can bill independently. Payer credentialing and reimbursement levels vary by credential type.
The 53-minute threshold
90834 is the correct code when face-to-face psychotherapy time is 38 to 52 minutes. If a session runs to 53 minutes or beyond, the correct code is 90837 — not 90834.
This matters for reimbursement. The 2026 Medicare non-facility rate for 90837 ($167.00) is roughly $53 higher than 90834 ($113.90). Commercial payers show comparable gaps. Billing 90834 for a session that ran 53+ minutes underreports the service delivered and leaves the higher-code reimbursement uncollected.
The correction is documentation: record exact start and stop times for every session. Face-to-face time is the time spent in therapeutic communication with the patient, not the total appointment slot.
How payers price 90834 relative to 90837
90834 reimburses lower than 90837 across all payers — Medicare, commercial, and Medicaid. The gap reflects the shorter time requirement.
On the Medicare fee schedule, 90834 reimburses at roughly 68% of the 90837 rate. Commercial payer ratios vary. Some payers compress the gap; others widen it. The ratio depends on how the payer sets its fee schedule relative to Medicare and what was negotiated in the provider contract.
RateScope's current data pipeline focuses on CPT 90837 commercial benchmarks. Commercial rate benchmarks for 90834 are not yet available but are planned for a future pipeline expansion. In the meantime, the Texas 90837 payer reports provide the closest reference point for understanding how each payer's commercial rates compare to Medicare.
Common modifiers
| Modifier | Meaning | Usage |
|---|---|---|
| 95 | Synchronous telehealth — real-time audio and video | Most commercial payers require modifier 95 for telehealth claims. Used with Place of Service 02 or 10. |
| GT | Interactive telecommunications | Legacy telehealth modifier. Medicare requires GT for telehealth claims as of 2026. |
| HE | Mental health program | Required by some Medicaid managed care plans. |
Modifier requirements vary by payer. Check the specific payer's billing guidelines before submitting.