CPT 90834 vs 90837: Which Psychotherapy Code to Bill
Quick answer
The difference between 90834 and 90837 is time. Under CPT time rules, 90834 covers 38 to 52 minutes of face-to-face psychotherapy and 90837 covers 53 minutes or more, while 90832 covers 16 to 37 minutes. Choose the code from the psychotherapy minutes you actually spent, document start and stop times, and expect some payers to review frequent 90837 use.
Psychotherapy time thresholds
| Psychotherapy time | Code | With a same-day E/M |
|---|---|---|
| Under 16 minutes | Not reported as psychotherapy | Not reported |
| 16 to 37 minutes | 90832 | 90833 |
| 38 to 52 minutes | 90834 | 90836 |
| 53 minutes or more | 90837 | 90838 |
Time is face-to-face psychotherapy with the client. Family members may take part if the client is present for all or part of the session. Documentation, scheduling, and billing time do not count.
CPT 90834 vs 90837 side by side
| Attribute | CPT 90834 | CPT 90837 |
|---|---|---|
| CPT descriptor | Psychotherapy, 45 minutes with patient | Psychotherapy, 60 minutes with patient |
| Time range (CPT time rules) | 38 to 52 minutes | 53 minutes or more |
| Add-on version with a same-day E/M | 90836 | 90838 |
| Typical use | A standard weekly session | Longer sessions when clinically needed, such as trauma processing |
| Prior authorization | Often not required for initial visits; varies by plan | Some payers require it or review frequent use |
| Extra documentation focus | Minutes, intervention, response, progress | The same, plus why the longer session was clinically needed |
Documentation tips
- Record start and stop times (or total psychotherapy minutes) in every note. Many payers require them for time-based codes.
- Count only psychotherapy time with the client. Family members can take part if the client is present for all or part of the session.
- Leave out time spent writing the note, scheduling, billing, or talking with others about the client.
- For 90837, state why the longer session was clinically needed, for example trauma processing that could not be stopped safely, or a treatment plan that calls for longer sessions.
- Tie each session to treatment plan goals and describe the intervention and the client response.
- Never extend a session only to reach 53 minutes, and never round 50 minutes up to 90837.
Payer notes
- Payer rules vary. Some payers require prior authorization for 90837, and some apply utilization review when a clinician bills it for most sessions.
- Payers may request records to confirm the time and the clinical need. Consistent start and stop times are the simplest defense.
- Telehealth sessions use the same codes. Many payers add modifier 95 (or 93 for audio-only, where allowed) and a telehealth place of service code (02 or 10).
- If you also provide an E/M service the same day, report the E/M with add-on 90836 or 90838 instead of 90834 or 90837.
Full code guides
Frequently Asked Questions
Is 90837 a 60-minute session?
CPT labels 90837 as 60 minutes, but under CPT time rules it is reported once psychotherapy time reaches 53 minutes. A 53-minute session and a 75-minute session are both 90837.
Which code do I use for a 52-minute session?
90834. It covers 38 to 52 minutes. 90837 starts at 53 minutes of psychotherapy.
Does 90837 pay more than 90834?
Payers generally assign a higher allowed amount to 90837 because it represents more time, but actual rates depend on the payer, the contract, and the location. Bill the code the documented time supports.
Can I bill 90837 for every session?
There is no universal limit, but routine 90837 use without documented clinical need can draw payer review. Bill 90834 when the session lasts 38 to 52 minutes and document why longer sessions are needed when you use 90837.
Do I need start and stop times for 90834 and 90837?
CPT requires that the time be met, not a particular format. Many payers and Medicaid programs require start and stop times in the note, so recording them is the safest habit.
What about psychotherapy with a medication visit?
When the same clinician provides an E/M service and psychotherapy on the same day, the add-on codes apply: 90836 for 38 to 52 minutes and 90838 for 53 minutes or more, with psychotherapy time counted separately from the E/M.
Sources: American Medical Association (AMA), CPT Professional codebook: code descriptors, psychotherapy time rules, and add-on code guidance. Centers for Medicare & Medicaid Services (CMS): Medicare Physician Fee Schedule and National Correct Coding Initiative (NCCI) policy.
Payer rules vary. Confirm coverage, time, modifier, and documentation rules with each payer before billing. This page is general education, not billing or legal advice.