Statistical flags indicate unusual patterns — not proof of fraud or wrongdoing. Read our methodology

#14 of 11K

90834

Psychotherapy, 45 minutes

Psychotherapy, 45 minutes is the #14 most-billed Medicaid procedure code, with $8.82B in payments across 108.8M claims from 2018–2024. The national median cost per claim is $63.65.

Total Paid

$8.82B

0.81% of all spending

Total Claims

108.8M

Providers

28K

Avg Cost/Claim

$81

National Cost Distribution

How much do providers bill per claim for 90834? Based on 26K providers billing this code nationally.

Median

$63.65

Average

$68.78

Std Dev

$50.73

Max

$935.29

Percentile Distribution (Cost per Claim)

p10
$22.12
p25
$46.31
Median
$63.65
p75
$82.02
p90
$108.34
p95
$138.86
p99
$267.46

50% of providers bill between $46.31 and $82.02 per claim for this code.

90% bill between $22.12 and $108.34.

Top 1% bill above $267.46.

About This Procedure

HCPCS code 90834 (Psychotherapy, 45 minutes) was billed by 28K providers across 108.8M claims, totaling $8.82B in Medicaid payments from 2018–2024. This code was used for 54.3M unique beneficiaries.

Fraud Risk Context

Psychotherapy codes are frequently involved in mental health billing fraud, particularly when billed without face-to-face contact.

Source: HHS OIG Reports

Risk Assessment

Billing Statistics

Median Cost/Claim

$63.65

Providers Billing

26K

National Spending

$8.82B

Avg/Median Ratio

1.08×

Normal distribution

Top Providers Billing This Code

Ranked by total Medicaid payments for 90834

#ProviderTotal Paid
1Interborough Developmental And Consultation Center Inc.

Brooklyn, NY · Case Management

$107.1M
2Los Angeles County Department Of Mental Health

Los Angeles, CA · Clinic/Center, Mental Health (Including Community Mental Health Center)

$68.4M
3New York Psychotherapy And Counseling Center

Jamaica, NY · Community/Behavioral Health

$65.8M
4Bowen Health Inc

Warsaw, IN · Psychiatric Hospital

$57.1M
5Centerstone Of Tennessee Inc.

Nashville, TN · Clinic/Center Mental Health (Including Community Mental Health Center)

$46.2M
61023096864$45.2M
71043387152$44.9M
81598707002$42.4M
9Northeast Health Services, Llc

Taunton, MA · Clinic/Center, Mental Health (Including Community Mental Health Center)

$42.3M
10Behavioral Enhancement & Substance Abuse Medicine Treatment Pllc

Deer Park, NY · Community/Behavioral Health

$40.8M
11Clinical & Support Options Inc

Greenfield, MA · Community/Behavioral Health

$37.4M
12Behavioral Health Network Inc

Springfield, MA · Clinic/Center Mental Health (Including Community Mental Health Center)

$35.4M
131851444616$32.5M
14Helen Ross Mcnabb Center

Knoxville, TN · Clinic/Center Mental Health (Including Community Mental Health Center)

$32.2M
15Child & Family Services Inc.

New Bedford, MA · Counselor Mental Health

$31.6M
161053733378$31.5M
171003028549$30.3M
181669474979$30.1M
191225254881$29.7M
201730565839$29.6M

Showing top 20 of 28K providers billing this code