What Is CPT Code 90837?
CPT 90837 is an individual psychotherapy code. The CPT descriptor refers to psychotherapy, 60 minutes with the patient, and it is reported when a licensed clinician provides face-to-face psychotherapy to one patient for 53 minutes or longer. Psychotherapy here means treatment of a mental, behavioral or emotional disorder through structured therapeutic interaction, not a check-in or scheduling conversation.
CPT® is a registered trademark of the American Medical Association (AMA), and the official descriptor should be confirmed in the current CPT code book.
Who can provide it? Psychiatrists, psychologists, licensed clinical social workers, licensed professional counselors, licensed marriage and family therapists, and some advanced practice clinicians such as nurse practitioners and physician assistants may report psychotherapy, depending on state licensure, scope of practice and each payer’s credentialing rules.
When Should You Use CPT Code 90837?
Use 90837 when the session is individual psychotherapy and the documented psychotherapy time is 53 minutes or longer. Time is the only factor that separates it from 90834. Whether it is clinically appropriate is a separate question, and the one payers care about most.
Sessions of 53 Minutes or Longer
A session does not have to reach 60 minutes. A 55-minute session qualifies, and a 52-minute session does not. If the clinician spends the first few minutes on intake paperwork or the last few on scheduling, that time is not psychotherapy time and should not be counted.
Clinical Reasons for Extended Sessions
Some presentations genuinely need more than 45 minutes: a client with complex symptoms, a session that includes processing a significant event, or therapy where the intervention itself requires longer to deliver. Reasons can include:
- Trauma-focused work, where some protocols are designed around longer sessions and stopping early may be clinically counterproductive
- Complex presentations, such as co-occurring conditions that need to be addressed in the same session
- Periods of increased symptom severity or acute stressors that require extended intervention
Medical Necessity Considerations
The length of a session is not a clinical justification by itself. A note that says "60-minute session" does not explain why 45 minutes would not have been enough. Medical necessity is shown by the diagnosis, the functional impact of symptoms, the interventions used and the patient’s response. Payer policies differ, and some require a documented reason for extended sessions or review frequent use of 90837 against a practice’s overall psychotherapy mix.
CPT Code 90837 Time Requirements
The 53-Minute Minimum
Psychotherapy codes follow the CPT midpoint convention. The 90834 code is a 45-minute service and 90837 is a 60-minute service, so the midpoint is 52.5 minutes, and 53 minutes is the point at which the longer code applies. CMS’s billing and coding article for psychotherapy services, A57520, states that the biller should choose the code closest to actual time and identifies 53 or more minutes for 90837.
Appointment Time vs. Psychotherapy Time
A 60-minute appointment slot is not a 60-minute psychotherapy session. Only time spent delivering psychotherapy counts. Late arrivals, breaks, payment discussions, paperwork, and time spent writing the note do not. A client who arrives 10 minutes late to a 60-minute slot has received about 50 minutes at most, which is a 90834 session.
Start and Stop Times and Total Time
The safest practice is to record the actual start and stop times of psychotherapy, plus total psychotherapy time. Some payers accept total time only, but exact times are much harder to challenge. Notes where every session reads "60 minutes" in identical wording can look templated to a reviewer.
Practical Time Examples
| Situation | Documented psychotherapy time | Code |
|---|---|---|
| Session runs 2:02 to 2:58 PM | 56 minutes | 90837 |
| 60-minute slot, client arrives 12 minutes late | 48 minutes | 90834 |
| 60-minute slot with 6 minutes spent on scheduling and payment | 54 minutes | 90837 (if the time is documented) |
| Session ends at 52 minutes | 52 minutes | 90834 |
| Brief session of 35 minutes | 35 minutes | 90832 |
CPT 90837 vs. CPT 90834 vs. CPT 90832
| Code | Common label | Time threshold | Typically used for |
|---|---|---|---|
| 90832 | 30-minute psychotherapy | 16–37 minutes | Shorter sessions, check-ins with active therapy, or patients who cannot tolerate longer sessions |
| 90834 | 45-minute psychotherapy | 38–52 minutes | Standard outpatient therapy sessions |
| 90837 | 60-minute psychotherapy | 53 minutes or more | Extended sessions where the documented time and clinical need support it |
The three codes describe the same type of service. They differ only by time. Choosing between them is a documentation question first and a clinical question second: the code should reflect what happened in the room, not what was scheduled and not which one pays best. Anything under 16 minutes is not separately reportable as psychotherapy.
CPT Code 90837 Documentation Requirements
The note is the claim’s only defense. Medicare and commercial reviewers do not expect long narratives, but they do expect these elements to be present and consistent:
- Patient information: name, date of birth and date of service.
- Diagnosis and symptoms: the current diagnosis and the symptoms addressed in this session.
- Clinical necessity: how the symptoms affect functioning and why treatment at this level is needed.
- Start and stop times: or total psychotherapy time, as the payer requires.
- Psychotherapy interventions: the techniques used, such as cognitive restructuring, exposure-based work or supportive therapy.
- Patient response and progress: how the patient engaged and how treatment is moving toward its goals.
- Treatment plan: measurable goals, kept current, and referenced in the note.
- Provider authentication: signature, credentials and date, including electronic signatures that meet payer standards.
For telehealth sessions, add the patient’s location, the technology used and documentation of consent where required. A periodic medical billing audit of a random sample of 90837 notes is one of the most direct ways to find template and time-documentation problems before a payer does.
CPT 90837 Billing Guidelines
- Verify insurance eligibility. Confirm active coverage, behavioral health benefits, deductible and copay or coinsurance before the first session. Eligibility verification at scheduling prevents surprise patient balances.
- Review payer policies. Check whether the payer covers 90837 for your provider type, limits its frequency, requires specific modifiers or has its own time rules.
- Check authorization requirements. Some plans require prior authorization or concurrent review for ongoing outpatient therapy.
- Select the appropriate diagnosis. The ICD-10-CM code must come from the clinician’s documentation and support psychotherapy. Common examples include codes from the F32 and F33 depressive disorder categories, F41.1 (generalized anxiety disorder) and F43.1 (post-traumatic stress disorder) categories, but payers publish their own covered diagnosis lists.
- Submit accurate claims. Report 90837, one unit, the right place of service and any required modifiers. A consistent medical billing workflow with claim scrubbing catches mismatches before submission.
- Maintain supporting documentation. Keep notes, treatment plans and consent records available for payer record requests.
CPT 90837 Reimbursement Rate
There is no single 90837 rate. What a practice is paid depends on who the payer is, who provided the service and where it was delivered.
- Medicare: pays under the Medicare Physician Fee Schedule, which varies by geographic locality and changes every year. Payment may differ by provider type. For the current figure, use the CMS Physician Fee Schedule look-up tool for your locality instead of relying on a number quoted in an article. CMS’s CY 2027 fee schedule final rule may change the figures again.
- Commercial insurance: pays according to the contract between the payer and the practice, so two practices in the same city can be paid different amounts for the same code.
- Medicaid: varies by state and, in many states, by managed care plan, provider type and covered diagnosis.
Other factors include the clinician’s license, in-network or out-of-network status, facility versus non-facility payment under Medicare, how the claim is coded, and whether the payer downcodes the claim. Claims for the same code can be paid differently because each of these inputs varies.
Can You Bill CPT 90837 for Telehealth?
Often yes, but the rules are more specific than "yes." Psychotherapy codes including 90837 can be furnished by telehealth under Medicare, and many commercial and Medicaid plans cover them as well. What changes is the claim.
Telehealth Eligibility and Medicare Timing
Medicare covers behavioral health telehealth, including services delivered to patients in their homes. Under the Consolidated Appropriations Act, 2026, the statutory requirement for an in-person visit before certain mental health telehealth services has been delayed through December 31, 2027, according to the CMS Telehealth FAQ and several industry summaries. Dates and exceptions can change, and the rule affects some patients differently depending on when they started telehealth, so review the current CMS Telehealth FAQ for the date of service.
Audio-Video vs. Audio-Only
Medicare has allowed audio-only for mental health services in certain situations, such as when a patient cannot use or does not agree to video. Many commercial payers are stricter. Document why audio-only was used, and do not assume a payer treats it like video.
Modifier and Place of Service Considerations
- POS 10 identifies telehealth when the patient is at home. POS 02 identifies telehealth when the patient is somewhere else. Medicare has paid POS 10 at the non-facility rate since 2024, while POS 02 is paid at the facility rate.
- Modifier 95 identifies synchronous audio-video telehealth, and modifier 93 identifies audio-only. Some payers still ask for GT. Medicare’s instructions on how place of service and modifiers combine have changed over time, so check your Medicare Administrative Contractor’s current guidance.
- Commercial and Medicaid payers set their own combinations. Some want a modifier, some want only the place of service, and some want both.
A video session at home billed to a payer that follows common conventions might look like 90837 with modifier 95 and POS 10. Always confirm with the specific payer before submission.
Common CPT 90837 Denial Reasons
| Denial or downcode trigger | What usually happened | Fix |
|---|---|---|
| Insufficient psychotherapy time | Documented time was under 53 minutes | Bill 90834 when the time supports it |
| Missing time documentation | No start/stop or total time in the note | Require time fields in the note template |
| Lack of medical necessity | Note does not justify the longer session or the diagnosis | Tie interventions to symptoms and goals |
| Incorrect coding | Wrong code for the service, or 90837 billed with an E/M on the same day | Review coding rules before submission |
| Missing authorization | Authorization absent, expired or exhausted | Track authorization dates and visit counts |
| Incomplete clinical records | Unsigned notes, missing treatment plan or expired plan | Complete notes before billing |
Some payers also downcode 90837 to 90834 without issuing a formal denial, so reviewing remittance advice, not only denials, matters. When denials do occur, a consistent denial management process helps separate documentation problems from payer-policy problems.
How to Avoid CPT 90837 Billing Errors
- Track time accurately. Record actual start and stop times every session, not the scheduled slot.
- Write complete progress notes. Each note should be specific to that session, not copied forward.
- Code consistently. Use 90834 and 90837 according to documented time. If nearly every session is billed as 90837, expect questions.
- Verify payer policies. Review frequency limits, authorization rules and telehealth requirements for each plan.
- Audit regularly. Sample claims quarterly and compare documented minutes with the code billed.
No payer publishes a universal percentage above which 90837 use triggers review, so treat any figure you read as unverified. The better safeguard is documentation that stands on its own.
Frequently Asked Questions About CPT Code 90837
How many minutes are required for CPT 90837?
At least 53 minutes of face-to-face psychotherapy time, according to CPT midpoint rules and CMS billing guidance.
Can I bill 90837 for 53 minutes?
Yes, if 53 minutes of psychotherapy are documented and the session is medically necessary. Always check whether a specific payer publishes a different policy.
What is the difference between CPT 90834 and 90837?
Time. 90834 covers 38 to 52 minutes, and 90837 covers 53 minutes or more. Both describe individual psychotherapy.
Does Medicare cover CPT 90837?
Medicare covers medically necessary psychotherapy furnished by eligible clinicians, subject to local coverage policies, documentation and diagnosis requirements. Coverage depends on the provider’s Medicare enrollment and the Medicare Administrative Contractor’s policy.
Can CPT 90837 be billed for telehealth?
Often yes, using the correct place of service and any required modifier. Requirements differ for Medicare, Medicaid and commercial payers, so verify each.
What documentation is required for CPT 90837?
Patient and date information, diagnosis, symptoms addressed, medical necessity, start and stop times or total time, interventions, patient response, a current treatment plan and the provider’s authentication.
Can CPT 90837 be billed with an E/M service?
Not in the usual way. When a clinician who can bill an E/M service also provides psychotherapy in the same encounter, CPT provides psychotherapy add-on codes (90833, 90836 and 90838) that are reported with the E/M code. For 53 minutes or more, that add-on is 90838. The E/M and psychotherapy services must be significant and separately identifiable, and their time must not overlap. The AAFP and CMS’s billing and coding article A57480 discuss these rules in more detail.
Conclusion
CPT 90837 covers individual psychotherapy of 53 minutes or more. It is a time-based code, so the claim succeeds or fails on documented minutes, a note that supports medical necessity, and a diagnosis that fits the service. Telehealth, authorization and payer-specific rules add further detail, so verify them each time instead of relying on assumptions.
If your practice is spending too much time on downcoded claims or documentation gaps, DocRev Rcm provides medical billing and revenue cycle management support, from credentialing and payer enrollment through claim submission and accounts receivable follow-up. You can talk to an RCM specialist about your billing workflow.
Sources and Further Reading
- CMS Medicare Coverage Database: Billing and Coding, Psychiatric Diagnostic Evaluation and Psychotherapy Services (A57520)
- CMS Medicare Coverage Database: Billing and Coding, Psychiatry and Psychology Services (A57480)
- CMS: Telehealth FAQ (updated February 26, 2026)
- CMS: Physician Fee Schedule Look-Up Tool