CPT90834

Psychotherapy (45 min) Cost

Psytx w pt 45 minutes

$273Hospital outpatient total2026 Medicare, physician + facility
Hospital payments are wage-adjusted by locality, so the ZIP changes the numbers.
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National Medicare physician rate (2026)

Medicare (Hospital)
$91.85
Facility physician fee
Private plan est.
$148–$228
~130–200% of Medicare
Cash / self-pay est.
$91–$171
~80–150% of Medicare

What the whole procedure costs

The rate above is the physician’s fee on its own. The facility bills separately, and for most procedures the facility is the larger half of the bill. These are 2026 national Medicare amounts.

Physician fee alone
$92
Only 34% of the hospital total

Medicare may pay the facility separately for this code or package it into another service on the same day, so treat the facility share as an upper bound. Medicare allowed amounts are not what an uninsured patient is charged, and not a quote. Private plans typically allow more.

Get the rate for your ZIP

CMS adjusts this CPT by locality. A five-digit ZIP is enough — no account, no insurance card.

What psychotherapy (45 min) costs at hospitals near you

Everything above is a national average. The hospital you pick in your area moves the bill more than anything else you control.

Locked

Rates for your ZIP, 5 named hospitals with CMS ratings, the add-on codes, and the scheduler script.

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What these numbers are

Every figure on this page is a 2026 Medicare allowed amount: the physician line comes from the Physician Fee Schedule adjusted by geographic practice-cost indices, and the facility totals come from the CMS hospital outpatient (OPPS) and ambulatory surgery centre rates. None of them is a hospital chargemaster price, your insurer's contracted rate, or a quote. Anesthesia, pathology, imaging reads and follow-up care are billed under their own codes when they apply, and an inpatient stay is paid a different way again. For this code the office and hospital physician lines differ by $22.05.

How CMS prices CPT 90834

CMS descriptionPsytx w pt 45 minutes
Work RVU2.56
Practice expense RVU (office)0.83
Practice expense RVU (hospital)0.17
Malpractice RVU0.02
Conversion factor$33.4009

Work is about 75% of the office total RVU; practice expense is about 24%. Localities with a high PE GPCI move this code more when practice expense is a large share.

Office vs hospital for this code

Office (non-facility) physician rate: $113.90. Hospital (facility) physician rate: $91.85.

Medicare patients typically owe 20% of the allowed amount after the Part B deductible — about $23 for the office physician fee, before any Medigap coverage. That coinsurance does not include a hospital facility fee.

Labeled private-plan and cash ranges on this page are arithmetic multiples of Medicare, not negotiated quotes. Ask the billing office for the CPT code, the site of service, and a good-faith estimate.

What Is Psychotherapy (45 min)?

This is a standard individual psychotherapy session of about 45 minutes, the most commonly billed therapy length in the United States. You meet one-on-one with a therapist, in person or by video, to work on concerns such as anxiety, depression, or life stressors using approaches like cognitive behavioral therapy. Care typically involves weekly or biweekly sessions over months, so the per-session price compounds into a meaningful recurring expense.

What Affects the Cost

  • Therapy is a recurring cost; the number of sessions over a course of care dwarfs any single session fee.
  • Cash-pay rates vary enormously by city and clinician credential, and many therapists operate entirely outside insurance.
  • In-network copays or coinsurance per session are often much lower than cash rates, when you can find an in-network therapist with openings.
  • The technical difference between this 45-minute code and the 60-minute 90837 changes both the charge and what insurers reimburse.
  • Sliding-scale fees, training clinics, and employer EAP sessions can reduce or eliminate cost for a set number of visits.

How It Is Billed

CPT 90834 covers a session of 38 to 52 minutes of psychotherapy; shorter sessions bill 90832 and longer ones 90837, so the clock determines the code. It is billed per session with no bundling, and if your therapist is also your prescriber, therapy can be billed as an add-on to a medical visit under different codes. Missed-appointment fees are not billable to insurance and come straight to you under most practice policies.

Insurance & Coverage Notes

Parity law forbids plans from imposing stricter visit limits or higher cost sharing on therapy than comparable medical care, so hard annual session caps have largely disappeared from major plans, though concurrent review for very long courses still happens. Copays per session apply on most plans once any deductible is met. Out-of-network reimbursement via superbills typically returns only part of the fee based on the plan's allowed amount, and EAP benefits often provide a handful of genuinely free sessions before insurance even starts.

Questions to Ask Before Booking

  • 1.What is my per-session cost in network, and what would I actually get back if I see you out of network with a superbill?
  • 2.Do you offer a sliding scale or reduced rate if I pay cash?
  • 3.Does my employer EAP cover any sessions free before my insurance kicks in?
  • 4.How many sessions do you anticipate for my goals?
  • 5.What is your cancellation fee policy, since insurance will not pay those?

Psychotherapy (45 min) (CPT 90834): questions

The 2026 national Medicare physician rate for CPT 90834 is $113.90 in an office and $91.85 in a hospital. Enter a ZIP code to apply the geographic adjustment for your locality.

Medicare uses a different practice-expense RVU in a facility. For CPT 90834 that produces an office rate of $113.90 and a hospital physician rate of $91.85 (a $22.05 gap). The hospital’s own facility charge is extra and often larger than this entire physician line.

This is a standard individual psychotherapy session of about 45 minutes, the most commonly billed therapy length in the United States. You meet one-on-one with a therapist, in person or by video, to work on concerns such as anxiety, depression, or life stressors using approaches like cognitive behavioral therapy. Care typically involves weekly or biweekly sessions over months, so the per-session price compounds into a meaningful recurring expense. CMS bills it as “Psytx w pt 45 minutes.”

Not on its own. $113.90 is the physician allowed amount. Medicare also pays the facility, which takes the total to about $273 in a hospital outpatient department. Anesthesia, pathology and imaging interpretation billed under other codes are separate again. Private-plan allowed amounts are often higher than Medicare; your deductible and coinsurance still apply.

For cash-pay surgery shopping, use this CPT as the Medicare floor when you compare written quotes. How cash-price shopping works.

Data source: 2026 Medicare Physician Fee Schedule (CMS PPRRVU26B, released March 2026). Conversion factor: $33.4009. Prices shown are Medicare allowed amounts for the physician service and may not match what you are billed. Private insurance and self-pay ranges, when shown, are labeled estimates (typical multiples of Medicare), not quotes. This site is an independent cost tool, not medical advice.