CPT Code 90837: Individual Psychotherapy, 53+ minutes
Reviewed against AMA CPT and CMS guidance. See sources.
What is CPT 90837?
CPT 90837 is individual psychotherapy, 60 minutes, billed when face-to-face psychotherapy time reaches 53 minutes or more under CPT time rules. Sessions of 38 to 52 minutes use 90834. CPT has no individual psychotherapy code for sessions longer than 90837, so a 75 or 90 minute session is still 90837. Some payers review frequent 90837 use more closely.
Individual psychotherapy for sessions lasting 53 minutes or longer. Appropriate when the clinical work requires the longer time, for example trauma processing or complex presentations. Some payers scrutinize this code more closely than 90834.
Time Requirements
53 minutes or more of psychotherapy time with the client (CPT lists 60 minutes). Longer sessions are still reported as 90837.
Modifiers
| Code | Description |
|---|---|
| 95 | Synchronous audio-video telehealth. Many payers also require a telehealth place of service code (02 or 10). |
| 93 | Synchronous audio-only service, where the payer allows audio-only care. |
| HO | Master's degree level clinician (required by some Medicaid programs). |
Billing a session by video or phone? See telehealth modifiers 95, 93, GT and POS 02 vs 10.
When to Use
- Psychotherapy sessions of 53 minutes or more
- Trauma-focused work such as EMDR or prolonged exposure when the session needs the longer time
- Sessions extended for safety planning when the situation does not meet the crisis definition for 90839
- Clients whose treatment plan documents why longer sessions are clinically needed
When Not to Use
- Under 53 minutes: use 90834 or 90832
- When non-therapy tasks (paperwork, scheduling) are what pushed the time past 53 minutes
- Same day as an E/M service by the same prescriber: use add-on 90838
- Urgent crisis psychotherapy of 30 minutes or more: consider 90839
- Family sessions: use 90846 or 90847
What to Document for CPT 90837
- Start and stop times, or total psychotherapy minutes (53 or more)
- Why the longer session was clinically needed
- The psychotherapeutic interventions used
- Client response and progress toward treatment plan goals
- Risk assessment when indicated, and the plan for the next session
Common Denial Reasons
- Time documented under 53 minutes
- No start and stop times or total minutes
- Routine 90837 use without documented clinical need for longer sessions
- A billing pattern far above peers that triggers a review or audit
- Prior authorization required but not obtained
Payer Notes
Payer rules vary. Some payers require prior authorization for 90837, flag clinicians who bill it for most sessions, or request records to confirm the time and clinical need. Document actual minutes and why the longer session was needed.
What is the time range for CPT 90837?
CPT 90837 is reported when psychotherapy time with the client reaches 53 minutes. The Medicare billing article A57520 states the ranges: choose the code closest to the actual time, 16 to 37 minutes for 90832 and 90833, 38 to 52 minutes for 90834 and 90836, and 53 or more minutes for 90837 and 90838. It also says not to report psychotherapy of less than 16 minutes, and that start and stop times or total times must be documented for 90832, 90834 and 90837.
There is no individual psychotherapy code for sessions longer than 90837. The Medicare billing article A57480 adds that for sessions lasting longer than 90 minutes, payment is made only when the record documents the face-to-face time and the medical necessity for the extended time. For a side-by-side guide, see CPT 90834 vs 90837.
Which add-on codes go with CPT 90837?
The add-on most often reported with 90837 is interactive complexity, 90785, when one of its communication factors is present and documented. The other codes people ask about replace 90837 rather than add to it. The rules below come from the Medicare billing article A57480.
| Code | Billed with 90837? | Rule |
|---|---|---|
| 90785 | Yes, when documented | Interactive complexity is an add-on for communication difficulties during the service, such as a caregiver whose emotions or behavior interfere with the treatment plan, or the use of an interpreter or play equipment. It is never billed alone. |
| 90838 | No, it replaces 90837 | When the same clinician provides an E/M service and psychotherapy on the same day, the E/M code is reported with the add-on 90833, 90836 or 90838. E/M time does not count toward the psychotherapy time. |
| 90839 and 90840 | No | The crisis codes are reported by themselves and may not be reported with 90832 to 90838 or with 90785. |
How much does CPT 90837 pay?
It depends on the payer, the year and the location, so this page states no amount. Medicare amounts come from the Physician Fee Schedule. The CMS PFS Look-Up Tool searches payment amounts by code, nationally or for a specific Medicare contractor locality, and shows the limiting charge for nonparticipating providers. Commercial plans and Medicaid programs set their own rates through contracts and fee schedules, so check the plan or your contract.
What does a note for a 90837 session look like?
A fictional example of the parts a reviewer looks for: "Individual psychotherapy by live video, client at home. Start 2:00 pm, stop 2:58 pm (58 minutes). Session extended to complete the planned trauma narrative exposure and return the client to baseline before ending; SUDS dropped from 80 to 35. Client identified two coping skills to use before the next session. Plan: continue weekly 60-minute sessions per the treatment plan."
The minutes, the reason the longer session was clinically needed, the intervention, the client response and the plan are what support 90837. The free SOAP note generator drafts the session note from what you type, and you review and edit it.
ICD-10 diagnosis codes
Every claim pairs the CPT code with the diagnosis the clinician documented. See the mental health ICD-10 code reference or a condition guide:
Related Codes
Compare CPT 90837
Frequently Asked Questions
How often can I bill 90837?
There is no universal frequency limit, but billing 90837 for nearly every session can draw payer review. Document why each longer session was clinically necessary and bill 90834 when the time is 38 to 52 minutes.
What if my session goes to 75 or 90 minutes?
It is still 90837. CPT has no individual psychotherapy code for sessions longer than 90837, so any session of 53 minutes or more is reported as 90837. Document the actual duration. If the session was an urgent crisis, the crisis codes 90839 and 90840 may fit instead.
What is the difference between 90837 and 90834?
Time. 90837 starts at 53 minutes of psychotherapy and 90834 covers 38 to 52 minutes. A 52-minute session is 90834. The documentation standard is the same, but notes for 90837 should also show why the longer time was needed. For a side-by-side table and payer notes, see our CPT 90834 vs 90837 comparison guide.
Does 90837 need prior authorization?
It depends on the payer. Many plans do not require it, while some require authorization or apply utilization review once 90837 is billed often. Check each plan and keep documentation that supports the longer time.
Can I bill 90837 for an intake session?
Not on the same day as 90791 by the same clinician. Bill the intake as 90791, then use 90837 for later psychotherapy sessions that reach 53 minutes.
How much does 90837 pay?
It varies by payer, year and location. Medicare amounts come from the Physician Fee Schedule, and the CMS PFS Look-Up Tool shows them nationally or by Medicare locality. Commercial and Medicaid rates are set by each plan or contract.
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.
- AMA: CPT overview
- CMS: National Correct Coding Initiative (NCCI) edits
- CMS Medicare Coverage Database: Billing and Coding, Psychiatry and Psychology Services (A57480)
- CMS: Physician Fee Schedule relative value files
- CMS MLN901705: Telehealth and Remote Monitoring (PDF)
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.
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