CPT 90834 + ICD-10 F43.10: Post-traumatic stress disorder, unspecified
Psychotherapy, 45 minutes billed with Post-traumatic stress disorder, unspecified — documentation requirements, denial reasons, modifiers, and reimbursement context.
CPT Code
90834
Psychotherapy, 45 minutes
ICD-10 Code
F43.10
Post-traumatic stress disorder, unspecified
Compatibility Notes
A common pairing for ongoing PTSD maintenance or stabilization-phase sessions where the full 60-minute window is not clinically needed. Insurers accept this combination without prior authorization in most standard outpatient benefit structures. Session time must fall in the 38–52 minute range.
Documentation Required
- ✓Session start and stop times confirming 38–52 minutes
- ✓Ongoing PTSD diagnosis with symptom status update
- ✓Treatment progress notes referencing current trauma-processing phase
- ✓Risk screen documented
Common Denial Reasons
- ✗Session time documented outside the 38–52 minute window — use 90832 or 90837 as appropriate
- ✗Diagnosis not updated to reflect acute (F43.11) or chronic (F43.12) specifier when duration is known
- ✗Notes do not distinguish this session from a different service type (e.g., crisis intervention)
Applicable Modifiers
Reimbursement Notes
OON UCR for 90834 is typically $100–$165 per session. Commercial plan reimbursement averages 50–70% of UCR. Significantly lower than 90837, so confirm session duration supports the higher code when time qualifies.
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