Reimbursement
$113.90
Threshold
45m
2026 Status
Active
What is CPT Code 90834?
CPT 90834 is defined as: Individual psychotherapy with the patient, lasting for a duration of 45 minutes. This session may also include family members as long as the primary focus is the patient. It involves therapeutic techniques designed to alleviate emotional distress, reverse or change maladaptive patterns of behavior, and encourage personality growth and development.
This code is primarily used for Behavioral services. It falls under the category of Medicine / Psychiatry and is valid for the 2026 calendar year according to the CMS Physician Fee Schedule.
2026 RVU Components
Relative Value Units (Non-Facility)
Work RVU
1.8
Physician Effort
PE (Non-Fac)
1.55
Practice Expense
Malpractice
0.06
Risk Factor
Total RVU
3.41
Note: [(Work RVU * Work GPCI) + (PE RVU * PE GPCI) + (MP RVU * MP GPCI)] * Conversion Factor
2026 CMS Policy Intelligence
efficiency shield
Strategically exempt from the -2.5% efficiency adjustment. CMS prizes time-based behavioral health services and has maintained their full Work RVU value to ensure access to mental health care.
audio only permanent
The 2026 Final Rule confirms that behavioral health remains the only major sector where audio-only communication is permanently reimbursed at parity with in-person services.
conversion factor
Utilizes the 2026 Non-QP rate of $33.40.
Administrative Framework
Place of Service
Key Modifiers
Operational Requirements
time threshold
Coded as 45 minutes, but the actual face-to-face time with the patient must be between 38 and 52 minutes.
telehealth eligibility
Permanent permission for audio-only delivery when the patient is at home and does not have access to video, or if they decline video.
provider types
Can be billed by Psychiatrists, Psychologists, LCSWs, LPCs, and NPs/PAs with appropriate psychiatric specialty training.
in-person requirement
For telehealth patients, an in-person visit within 6 months of the initial telehealth service and every 12 months thereafter is recommended by CMS, but exceptions apply based on patient safety and preference.
Compliance Checklist
Audit Defense
No specific audit defense elements defined.
2026 Update
Exempt from the mandatory -2.5% efficiency cut. Audio-only (Modifier FQ) is now a permanent feature of the Medicare program for this code.
Common Clinical Scenarios
No clinical examples provided.
Target Specialties & Utilization
Typical Clinical Indications (ICD-10)
Frequently Asked Questions
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