90834 national averages run $94.81 to $134.81 at four large payers
Each payer's national 90834 average includes every clinician type. Where a payer allows you less than its average, ask the payer for that average at renewal.
Head of Growth and Operations, JotPsych
If your remittances show the same 90834 paid at a different amount by each payer, compare each payer's amount with its national average. For a 90834, Medicare's 2026 national rate is $85.43 for therapists and $113.90 for psychologists.
Cigna averages $134.81 and UnitedHealthcare $94.81 for 90834, a gap of $40.00, per PayerPrice national payer-file data, August 2026. Both averages include every clinician type.
Compare each payer's 90834 rate with its average
Sort a month of your 90834 allowed amounts by payer. The allowed amount is what a payer approves for a 90834, your patient's share included. Mark each payer whose national average tops what that payer allows you, and at your next contract renewal, ask each marked payer for at least its average.
Three steps for each 90834 note
- Count the psychotherapy minutes in each session. Under the CPT time rules a 2023 federal audit report quotes, 90834 covers 38 to 52 minutes of psychotherapy, 90832 covers 16 to 37, and 90837 covers 53 or more. Time you spend on tasks outside the therapy, such as scheduling, doesn't count.
- Write the minutes in every note. Give your start and stop time, or your total. The 2023 audit accepted either format. Without the minutes, a note doesn't support any of the three codes.
- Bill 90837 when your note shows 53 minutes or more. That audit sampled 216 Medicare psychotherapy visits. In one, a provider billed a 90834 for a February 2021 session whose note showed 55 minutes of psychotherapy. Medicare paid $67 for that claim, and the auditors found the provider was owed $31 more, because the note supported a 90837.
Medicare's figure is its 2026 national rate for therapists; the commercial figures are PayerPrice national averages, August 2026, one per payer with no split by clinician type. A commercial 90834 rate under Medicare's national therapist rate sits below all four averages.
If you're a clinical social worker, mental health counselor, or marriage and family therapist, Medicare sets your rate at 75% of the psychologist rate. Medicare's 90834 rates rose 9.4% for 2026, whatever your license.
Enter each payer's contracted 90834 rate in your fee schedule, and JotPsych flags a 90834 billed below that payer's rate.
Book 15 minutes- PayerPrice, CPT 90834 Fee Schedule by Payer: national payer-file averages, verified August 2026.
- Centers for Medicare & Medicaid Services (CMS), Physician Fee Schedule Relative Value Files, RVU25A (released 2025-01-10) and RVU26A (released 2025-12-29): national non-facility rates.
- U.S. Department of Health and Human Services, Office of Inspector General (OIG), Medicare Improperly Paid Providers for Some Psychotherapy Services, Including Those Provided via Telehealth, During the First Year of the COVID-19 Public Health Emergency, report A-09-21-03021, May 2, 2023.
- CMS, Medicare Learning Network, Medicare & Mental Health Coverage, booklet MLN1986542, March 2026, pages 13 to 24: physicians and psychologists paid 100% of the fee schedule amount, nurse practitioners 85%, and clinical social workers, marriage and family therapists, and mental health counselors 75% of the psychologist amount.