90834

Psychotherapy, 45 minutes with patient

Code 90834 represents individual psychotherapy performed face-to-face with the patient for a duration of 45 minutes. This service typically involves a range of 38 minutes to 52 minutes of face-to-face time. Psychotherapy involves the therapeutic use of interventions to address mental health conditions, improve emotional regulation, reduce maladaptive behaviors, enhance coping skills, and promote overall psychological well-being. It includes the assessment of the patient's mental status, development of treatment goals, and implementation of various evidence-based psychotherapeutic techniques.

Clinical Indications

  • Major depressive disorder (MDD)
  • Generalized anxiety disorder (GAD)
  • Panic disorder
  • Post-traumatic stress disorder (PTSD)
  • Obsessive-compulsive disorder (OCD)
  • Adjustment disorders with anxiety or depressed mood
  • Bipolar disorder (as an adjunct to pharmacotherapy)
  • Personality disorders requiring therapeutic intervention (e.g., Borderline Personality Disorder)
  • Grief and bereavement counseling
  • Stress-related disorders affecting daily functioning
  • Eating disorders (as part of a comprehensive treatment plan)
  • Substance use disorders (behavioral therapy component)

Procedure Steps

  1. Establish rapport and therapeutic alliance with the patient.
  2. Conduct a brief assessment of the patient's current mental state, symptoms, and presenting concerns.
  3. Review and affirm therapeutic goals aligned with the patient's treatment plan.
  4. Employ evidence-based psychotherapeutic techniques (e.g., Cognitive Behavioral Therapy (CBT), Psychodynamic Therapy, Dialectical Behavior Therapy (DBT), Supportive Psychotherapy) tailored to the patient's needs.
  5. Facilitate patient insight, emotional processing, and development of coping strategies.
  6. Address specific psychological stressors, relational patterns, or maladaptive behaviors identified in the treatment plan.
  7. Monitor patient progress, emotional response to interventions, and adjust therapeutic approach as necessary.
  8. Collaborate with the patient on homework assignments or skills practice between sessions, if applicable.
  9. Document the session's content, duration, interventions used, patient's response, and any modifications to the treatment plan.

Coding Guidelines

  • Report CPT code 90834 for psychotherapy sessions lasting 38 to 52 minutes face-to-face with the patient.
  • This code should be used when psychotherapy is the primary service rendered and no Evaluation and Management (E/M) service is billed on the same day by the same provider.
  • If an E/M service is performed on the same day by the same physician or other qualified healthcare professional, report the add-on code 90836 (Psychotherapy, 45 minutes with evaluation and management service) in conjunction with the appropriate E/M service code (e.g., 99202-99215, 99241-99255).
  • Psychotherapy services must be performed by a physician or other qualified healthcare professional legally authorized to provide such services.
  • Documentation must clearly reflect the start and end times of the face-to-face psychotherapy, the therapeutic interventions performed, and the medical necessity for the service.
  • Do not report 90834 with other psychotherapy codes (90832, 90837) for the same patient on the same day.
  • Telehealth services for psychotherapy may be covered, subject to payer-specific policies and state/federal regulations.

Associated ICD-10 Codes