CPT 90834: Psychotherapy 45 min
What this code means, what it should cost, and how to dispute an overcharge.
Fair Price Reference
What is CPT 90834?
CPT 90834 (Psychotherapy 45 min) is a behavioral health billing code defined by the American Medical Association. It's used to bill your insurance or you directly for this service.
What CPT 90834 should cost
The Centers for Medicare & Medicaid Services (CMS) pays approximately $100 for CPT 90834 under the 2025 Physician Fee Schedule. This is what the federal government has determined is a reasonable payment for this service.
Private insurance typically pays 1.2–1.8x Medicare rates ($120–$180). Hospital chargemaster prices for CPT 90834 often range from $150 to $500 — a markup of 1.5x to 5x over Medicare.
Common overcharges on CPT 90834
Time-based psychotherapy codes (90832/90834/90837) billed at higher levels than the session length supports. Insurance denials for 'not medically necessary' despite parity requirements.
About Behavioral Health billing
Behavioral health codes are time-based. Mental Health Parity law requires insurance coverage at the same level as medical/surgical care.
Request the session note. Verify face-to-face time matches the billed code. Appeal denials citing the Mental Health Parity and Addiction Equity Act (MHPAEA).
How to dispute a CPT 90834 overcharge
- Request the itemized bill. You are entitled to a detailed line-by-line bill showing every CPT code billed. Ask in writing.
- Compare to Medicare allowable. If the charge exceeds 150% of Medicare ($150), you have grounds to dispute.
- Request documentation. For E&M codes, ask for the visit note. For procedures, ask for the operative report. The documentation must justify the code billed.
- Send a formal dispute letter. Cite the specific discrepancy between the documentation and the code. Reference Medicare rates and NCCI edits where applicable.
- Follow up in writing. Give the provider 30 days to respond. If they don't, escalate to the state attorney general and insurance commissioner.
Got CPT 90834 on your bill?
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