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See a sample rate comparisonCPT 90834 Fee Schedule
Last Verified: October 2026
Healthcare providers use this code to document and receive reimbursement for visits that address moderate-level medical decision-making, often including multiple diagnoses or prescription management.
Psychotherapy, 45 Minutes With The Pt And/Or Famil Y Member. Pt Must Be Pressent For All Or Some Of The Service. Focus Of The Session Is Still On The Pt And Not On The Family Unit.
| Key Fact | Detail |
|---|---|
| Service Type | Medicine Services and Procedures Psychiatry Services and Procedures |
| Common Place of Service | 11 - Office 10 - Telehealth in Patient's Home |
| Common Modifiers | 95 - Telemedicine - audio and video GT - Via interactive audio and video telecommunication systems |
| Complexity Level | Low |
| ASAM Level | Level 1 - Outpatient Services |
| Care Type | Treatment |
| Setting | Outpatient |
| Revenue Code | |
| Medicare Fee Schedule | $113.90 national non-facility rate (2026) · View Medicare rates for 90834 |
| Medicaid Fee Schedule | $90.35 median across 37 state programs · View Medicaid rates for 90834 |
National average reimbursement for CPT 90834 by major payers:
$111.90
$94.81
$107.19
$134.81
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CPT 90834
5 of 25 sample ratesHigher to lower in this preview
Icahn School Of Medicine At Mount Sinai, Beth Israel Medical Group Of Mount Sinai
$206.36Published rateVikramjit Gill
Presence Healthcare Services
$131.33Published rateRebecca Oteng-Mensah
Mental Health Specialty Group PA
$98.08Published rateNirilla Anthonimuthu
New York City Health And Hospitals Corporation
$96.41Published rateNana Cudjoe
$71.73Published rate
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See a sample payer proposalCPT 90834 vs. Other Psychiatry Services and Procedures Codes
The CPT 90834 code is part of the Medicine Services and Procedures services used for Psychiatry Services and Procedures. It represents a moderate-complexity encounter and is one of several codes that vary based on time spent, level of medical decision-making, and documentation requirements.
The CPT 90834 code involves more provider time and moderate medical decision-making, unlike lower-level codes that require less time and simpler assessments. It typically includes multiple diagnoses, medication management, or test interpretation, leading to higher reimbursement and more detailed documentation requirements.
| Code | Complexity | Description |
|---|---|---|
| 90832-CPT | Low | Psychotherapy Session 30 Mins, Psychotherapy Session With Psychiatrist Psychologist Or Other Mental Health Professional; 30 Minutes. |
| 90834-CPT | Low | Psychotherapy, 45 Minutes With The Pt And/Or Famil Y Member. Pt Must Be Pressent For All Or Some Of The Service. Focus Of The Session Is Still On The Pt And Not On The Family Unit. |
| 90837-CPT | Low | Psychotherapy Session 60 Mins, Psychotherapy Session With Psychiatrist Psychologist Or Other Mental Health Professional; 60 Minutes. |
| 90853-CPT | Low | Group Psychotherapy(Other Than Of A Multiple-Fam Medicaid Level Of Care 4 As Defined By Each State Nurse Pracitioner Rendering Service In Collaborati Medicaid Level Of Care 5 As Defined By Each |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 90834. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 90834 fee schedule helps patients estimate costs and providers optimize billing for accurate reimbursements.
Factors that affect fee schedules
Medicare & Medicaid Rates
Government-set reimbursement amounts
Private Insurance Rates
Negotiated rates between providers and insurance companies
Geographic Location
Costs may be higher in urban areas.
Provider Type
Hospital providers may have different rates than private practice.
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Frequently Asked Questions
To find out the cost of a specific medical procedure, you should inquire directly with your healthcare provider and your insurance company. For a more precise estimate based on CPT codes and your specific location, you can utilize tools like Payerprice's fee schedule lookup. This tool allows users to search with CPT codes and specific locations to find relevant pricing information.
CPT stands for Current Procedural Terminology. CPT codes are a set of medical codes used to describe medical, surgical, and diagnostic services and procedures performed by healthcare providers. They are crucial for accurate billing, allowing healthcare providers and insurers to communicate consistently about services rendered and their associated costs. They are essential for processing claims and determining reimbursement.
Fee schedules for healthcare services are typically complex and vary by payer, location, and specific provider contracts. While some general information might be publicly available, for precise, localized fee schedules based on CPT codes and your specific situation, it is highly recommended to use specialized tools. Payerprice offers a fee schedule lookup tool where you can search with a CPT code and specific location to find relevant pricing information.
Prices for the same medical service can vary significantly due to multiple factors, including: the specific healthcare provider or facility (e.g., hospital vs. independent clinic), geographic location, insurance company contracts and negotiated rates, the patient's insurance plan (e.g., deductible, co-pay, co-insurance), and whether the provider is in-network or out-of-network. Provider reputation and quality of care can also play a role.
An in-network provider has a contract with your insurance company, agreeing to provide services at pre-negotiated rates. When you see an in-network provider, you typically pay less out-of-pocket because your insurer covers a larger portion of the cost. An out-of-network provider does not have a contract with your insurance company, meaning they can charge more, and your insurance plan may cover a smaller percentage of the cost or none at all, leading to higher out-of-pocket expenses for you.
Payerprice enhances healthcare cost transparency by providing a fee schedule lookup tool that allows users to search for prices of medical services using CPT codes and specific locations. This empowers consumers to understand potential costs upfront, compare prices across different providers or regions, and make more informed decisions about their healthcare, ultimately helping to demystify complex medical billing and pricing.