The 90834 CPT code is commonly used to bill for individual psychotherapy services. Knowing when and how to use this code correctly is essential as a mental health professional.
If you’re conducting face-to-face sessions or telehealth, this will help you to understand the 90834 CPT code and when it applies.
What is the 90834 CPT Code?
The 90834 CPT code is used for 45-minute individual psychotherapy sessions. It’s just one of the codes for billing therapy, with others available for shorter (30-minute) or longer (60-minute) sessions.
This code doesn’t cover intake sessions or therapy involving families or couples, requiring different codes.
Key Details of the 90834 Code
The 90834 code applies strictly to individual psychotherapy sessions between you and a client. The time counted starts from the beginning of the session to the end. If you’re doing an intake session, use the 90791 code instead of 90834.
When to Use the 90834 Code
You’ll use 90834 for individual therapy sessions that last around 45 minutes. It’s strictly for one-on-one sessions, not group therapy or couples’ sessions, which have their billing codes.
What Counts as Psychotherapy?
Psychotherapy (sometimes called “talk therapy”) includes treatments a licensed mental health professional provides. People seek psychotherapy for various reasons, such as:
- Treating mental health disorders
- Improving relationships
- Managing life stress
- Changing behavior patterns
- Addressing trauma
- Learning to cope with grief
While the reasons for seeking therapy vary, all fall under the broad definition of psychotherapy and can be billed using 90834 as long as the session fits the time requirements.
How to Use the 90834 Code Correctly
You can bill the 90834 CPT code when you’ve spent 38 to 52 minutes in a face-to-face psychotherapy session with a client. Remember, this time doesn’t include administrative tasks like scheduling the next appointment or billing the session.
When submitting records to insurance or other third-party payors, ensure the session’s length falls within the range specified for 90834.
What If There’s a Medical Evaluation?
If you’re qualified to perform medical evaluations and psychotherapy, you won’t use 90834. Instead, you’d use a different code, such as 90836, which includes therapy and a medical assessment.
Using Add-On Codes with 90834
The 90834 CPT code can be used alongside other codes in specific situations:
- Telehealth sessions: If you’re providing therapy via telehealth, you’ll add the 95 modifiers to the 90834 code to indicate this.
- Interactive complexity: When communication is complicated due to disruptive caregivers or the need for special equipment (e.g., play therapy tools), use the 90785 add-on code. However, this add-on isn’t for translation services, as this may violate specific regulations.
Examples of Interactive Complexity Situations
You’ll use the 90785 code along with 90834 if any of the following occur:
- Disruptive communication during the session
- Caregivers interfere with treatment planning
- Reportable events like abuse or neglect arise
- Special communication tools or equipment are needed during the session
The interactive complexity add-on should never be used solely for translation or interpretation services.
Final Thoughts
The 90834 CPT code is widely used for individual psychotherapy sessions, and using it correctly ensures smooth billing and compliance with insurance guidelines. Relying on a trusted billing service, like Medical Claims Billing, can help ensure that all coding is done accurately and efficiently.
