What Is CPT Code 90834 and How Is It Billed?

Medical billing uses specialized codes for healthcare services. Understanding these codes helps patients comprehend their bills and ensures accurate claims. This article clarifies CPT code 90834 to help individuals understand their healthcare statements.

Understanding CPT Codes

Current Procedural Terminology (CPT) codes provide a standardized system for reporting medical services and procedures. Developed and maintained by the American Medical Association (AMA), these codes ensure a common language across the healthcare industry. Medical providers, insurance companies, and government programs all utilize CPT codes to process claims, manage healthcare data, and facilitate communication about patient care.

CPT codes are a numerical system that streamlines medical billing and improves accuracy. They are integral to billing medical services and procedures for reimbursement, acting as the language between providers and payers. This uniform system helps ensure that healthcare data is captured consistently and that claims are processed properly.

The Specifics of CPT 90834

CPT code 90834 specifically identifies an individual psychotherapy session lasting 45 minutes. This code is designed for face-to-face interactions between a patient and a mental health professional. The session typically involves assessment, diagnosis, treatment planning, and therapeutic interventions aimed at addressing mental, behavioral, or emotional disorders.

The actual documented face-to-face time for a 90834 session generally falls within a range of 38 to 52 minutes. This duration specifically accounts for the therapeutic interaction, excluding administrative tasks such as scheduling or collecting payments. Psychotherapy involves insight-oriented, behavior-modifying, supportive, or interactive communication to alleviate emotional disturbances and promote personality growth.

How CPT 90834 Appears on a Bill

When reviewing an Explanation of Benefits (EOB) from an insurance company or a direct bill from a provider, CPT code 90834 indicates a specific service. This code will typically appear alongside details such as the date the service was provided and the name of the healthcare professional. It signifies that an individual psychotherapy session of 45 minutes was billed for that date.

This helps patients understand the specific components of their healthcare charges. The code is part of the record that forms the basis for insurance processing and any resulting financial responsibilities.

Common Modifiers and Related Codes

CPT code 90834 can be further clarified or adjusted using two-digit modifiers. These modifiers are appended to the main CPT code to provide additional information about the service’s circumstances. For example, modifier -95 is used to indicate that the service was provided via synchronous telemedicine, such as a real-time audio and video session.

Some modifiers might denote the type of professional providing the service, such as -GN for a clinical psychologist or -GP for a physical therapist. Beyond 90834, other individual psychotherapy codes exist, differentiated primarily by session duration. For instance, CPT code 90832 is used for 30-minute sessions (16-37 minutes of face-to-face time), and 90837 is for 60-minute sessions (53 minutes or longer).