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CPT 90834: Psychotherapy, 38-52 Minute Individual Session
CPT code 90834 designates an individual psychotherapy session of approximately 38 to 52 minutes. This widely used CPT code captures a core outpatient behavioral health service for treating mood, anxiety, adjustment, and other psychiatric disorders. Nationally, 90834 is important because it represents a common billable psychotherapy duration that drives access, clinical workflow, and payer policy around mental health care delivery. Key payers in this analysis include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare.
Readers will find a concise overview of clinical context for 90834, payer coverage considerations, and where this service fits within typical ambulatory behavioral health encounters. The publication highlights benchmark usage patterns, common billing relationships (including associated add-on codes), and relevant policy or coding updates that affect outpatient psychotherapy billing at this time. Clinical scenarios tied to common ICD-10 diagnoses illustrate typical indications for the service, while the summary clarifies service duration and setting expectations for clinicians and billing staff. Data not available in the input is noted where applicable.
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Billing Code Overview
CPT code 90834 describes a psychotherapy session focusing on treatment techniques for psychiatric disorders. The service typically involves direct patient interaction lasting 38 to 52 minutes and centers on therapeutic interventions to address mental health symptoms and functional concerns.
Service type: Psychotherapy, individual session
Typical site of service: Outpatient behavioral health clinic or office-based mental health setting
National Reimbursement Benchmarks
Medicare's mean rate for CPT 90834 sits at $117.3, while BUCA’s mean commercial rate is $219.3, indicating BUCA averages about $102.0 higher per service than Medicare. This gap highlights a substantial divergence between the federal fee schedule and an aggregated commercial payer level; median and percentile details differ by payer, but the headline comparison emphasizes Medicare's lower average relative to this representative commercial mean.
Examining dispersion via the interquartile range (P75–P25) shows variability across payers: Blue Cross Blue Shield has the widest IQR at $96.1 ($330.5−$234.4), followed by BUCA at $84.4 ($256.8−$172.4) and UnitedHealth Group at $79.7 ($168.5−$88.8). Aetna and Cigna are tighter with IQRs of $61.2 and $66.4 respectively, indicating more concentrated commercial contracting around their medians.