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CPT Code 90837 is one of the most frequently used codes for outpatient mental health treatment. It is used to bill for individual psychotherapy sessions that last 60 minutes. Therapists, psychologists, psychiatrists, clinical social workers, and other qualified professionals rely on this code when providing extended sessions that address complex mental health needs.
Knowing when and how to use 90837 correctly can help ensure accurate billing and full reimbursement. It also helps reduce the risk of claim denials and audits, especially since longer sessions often attract more payer scrutiny.
What Is CPT Code 90837?
90837 is a procedural code for a psychotherapy session lasting approximately 60 minutes. This time frame includes the actual face-to-face session with the patient, but may also account for brief preparatory or follow-up work conducted on the same day.
The session typically involves in-depth talk therapy, assessment of mood, behavior, progress toward treatment goals, or crisis intervention. This code is often used for patients dealing with more severe conditions like major depressive disorder, PTSD, personality disorders, or complex trauma.
When Should You Use 90837?
Use CPT 90837 when the session with a patient lasts around 60 minutes and involves a high level of therapeutic engagement. This is not just about the time, but the depth and complexity of the clinical work performed.
Examples of qualifying sessions include:
Trauma-focused therapy involving structured interventions
Cognitive-behavioral therapy for persistent mood disorders
In-depth psychodynamic work with personality disorders
Crisis sessions that involve intensive therapeutic support
It is important that the documentation reflects why a full-hour session was necessary, especially if a payer typically expects shorter sessions like those billed under 90834 (45 minutes).
Key Documentation Guidelines
To support 90837, the provider should include:
Start and stop time or total time spent
Patient’s presenting concerns and progress
Therapeutic techniques used (e.g., CBT, EMDR)
Clinical decision-making and goals addressed
The note should clearly indicate that the extended time was medically necessary, not just a routine long appointment.
Reimbursement and Payer Notes
CPT 90837 generally reimburses at a higher rate than shorter therapy sessions. Medicare rates can range from $140 to $170, and private insurers may reimburse more depending on the plan.
Some payers are more likely to flag 90837 for review because of its higher cost. To avoid issues, always ensure that documentation supports the service.
If you are frequently providing therapy that fits this level of care, consider using standardized templates to streamline accurate documentation.
FAQ: CPT Code 90837
What is the minimum time for 90837?
Sessions should be close to 60 minutes. Many payers use 53 minutes as a minimum benchmark.
Can I use 90837 for telehealth?
Yes, if the payer permits it. Most insurers now allow 90837 for telehealth when all documentation requirements are met.
Do I need to include start and stop times?
Not always, but it is best practice to include them to justify the duration of the session.
Is 90837 audited more often?
Yes. Due to its higher reimbursement, it is often subject to review. Proper documentation is key.
Can I bill 90837 more than once a day?
In most cases, no. This code is typically limited to once per day, per provider, unless clearly justified.
