What Is CPT Code 90837: A Quick Guide to 60-Minute Psychotherapy Billing

CPT code 90837 is the key to billing for extended psychotherapy sessions. It represents 60 minutes of therapy—but payers expect at least 53 minutes of face-to-face time to qualify. Because it’s closely monitored by insurance companies, precise documentation and accurate billing are critical to ensure full reimbursement.

This guide walks you through everything you need to know about CPT 90837, from medical necessity and documentation to telehealth rules and reimbursement tips.

Understanding the CPT 90837 Code

The CPT 90837 billing code is used when a psychotherapy session lasts 53 minutes or longer. Anything less—say, 38 to 52 minutes—falls under CPT 90834.

Here’s the 90837 CPT code description in simple terms:

Psychotherapy, 60 minutes with the patient, focusing on improving emotional, behavioral, and mental health through talk therapy techniques.

The billing code 90837 is meant for sessions that require deeper clinical engagement, such as trauma processing, managing suicidal ideation, or addressing complex comorbid conditions.

If you’re wondering about the CPT code for 90-minute psychotherapy, there isn’t a specific one. Most payers recommend billing CPT 90837 once for the first 60 minutes and using an add-on code like 99354 for prolonged sessions.

To understand how 90837 fits alongside initial evaluation codes, see our guide on CPT Code 90791 Billing and Documentation for Therapists

Why CPT Code 90837 Requires Medical Necessity

Insurance companies don’t automatically approve all 60-minute psychotherapy sessions. They look for medical necessity, meaning the session must be justified based on the patient’s condition and needs.

Examples of When 90837 CPT Is Justified

You should use CPT 90837 when:

• The patient has severe depression, PTSD, or anxiety that needs extended therapeutic work.

• The session includes crisis intervention or managing suicidal thoughts.

• You’re using specialized interventions like EMDR, DBT, or trauma-focused CBT that can’t fit into shorter sessions.

• The treatment plan clearly shows why a shorter session (like 90834) wouldn’t be effective.

Sample Documentation for Medical Necessity

Due to escalation in panic symptoms and ongoing trauma triggers, the patient required prolonged EMDR intervention and grounding exercises that could not be completed in a 45-minute session.

This kind of documentation clearly supports the 90837 CPT code reimbursement and reduces audit risk.

The 53-Minute Rule: Time Tracking for CPT 90837

The biggest mistake many clinicians make with CPT 90837 billing is not meeting the 53-minute minimum.

Why It Matters

The 53-minute mark isn’t optional—it’s the threshold for using the 90837 billing code. Anything less must be billed under CPT 90834, no matter how intense the session was. If your sessions include mixed or overlapping services, reviewing the 8-minute rule can help you maintain accurate time-based coding and stay fully compliant with payer requirements.

How to Document Time Correctly

Always record both the start and end times of the session. For example:

Session start: 2:05 p.m.; end: 3:00 p.m.; total 55 minutes face-to-face.

That one detail can save you from denials or recoupments later.

Common Pitfall

Writing only a 60-minute session in your notes isn’t enough. Always include exact timestamps to meet CPT 90837 compliance standards.

What are the documentation rules for CPT 90837?

To protect your practice from audits, you need strong and clear documentation every time you use CPT 90837. Insurers want to see that your notes fully support the 90837 CPT code description.

What Insurers Expect in Your Notes

• A clear mental health diagnosis and an updated treatment plan

• The reason for the session, what therapy techniques you used, and how the patient responded

• The exact start and end times

• What progress was made—or what challenges the patient faced—and why the full 60-minute session was needed

Example of Strong 90837 Documentation

The client came in with severe trauma flashbacks. Used extended EMDR treatment to help with emotional distress. More time was needed to make sure the client was safe and calm before ending. Session lasted 60 minutes (3:15–4:15 p.m.).

This example shows medical necessity, proper time tracking, and a valid reason for using the 90837 billing code. That’s what helps support clean, audit-ready documentation and faster 90837 CPT code reimbursement.

CPT Code 90837 Billing Errors: Compliance Pitfalls and Solutions

Insurance payers watch closely for signs that CPT code 90837 is being used the wrong way. The most common red flags include:

• Billing 90837 often, but not showing session start and end times.

• Use 90837 CPT as your default code instead of checking if the session truly needed 60 minutes.

• No clear reason in your notes explaining why a shorter session wouldn't work.

• Using the same CPT codes for every client or provider, without variation.

• Mixing up psychotherapy time with case management or administrative tasks in your notes.

Common Mistakes with Billing Code 90837

• Use the 90837 billing code for sessions under 53 minutes.

• Writing vague notes that don’t show how intense or complex the session was.

• Automatically choosing 90837 for every client, regardless of need.

• Overlapping services like family therapy or medication check-ins, without explaining them clearly.

How to Prevent Errors with 90837 CPT

• Use a timer or EHR tool to record exact start and end times.

• Make sure your staff understands when and why to use CPT code 90837—not just how to bill it.

• Keep a simple checklist near your desk: code used, time spent, therapy provided, and how the client responded.

• Review your claims data every few months. Look for denied 90837 CPT claims and find out why they were flagged.

Do You Need Modifier 95 When Billing CPT 90837 for Telehealth?

Yes — if you’re providing therapy through telehealth, you can bill CPT code 90837 for virtual sessions, but you must include modifier 95. This shows the payer that the service was delivered through a live video connection.

Modifier Requirements

When billing for telehealth sessions, always add modifier 95 after the CPT code.

Example: 90837-95

This tells the insurance company that the session happened through a real-time, two-way video platform. Some payers also require you to use specific, HIPAA-compliant telehealth platforms, such as Zoom for Healthcare or Doxy.me.

Documentation for Telehealth

Even though telehealth is virtual, your documentation must meet the same standards as in-person sessions. Always include:

• Start and end times of the session

• Technology used (for example: “Conducted via HIPAA-compliant Zoom”)

• Clinical interventions and client progress

• Reason for extended time, especially when billing CPT 90837

Telehealth doesn’t make documentation easier—it only changes how you deliver the service.

How Can You Maximize Reimbursement for CPT Code 90837?

Knowing how CPT code 90837 reimbursement works helps you manage your billing better and keep your practice’s revenue consistent.

Average Reimbursement Rates (2025 Estimates)

Here’s what you can expect for CPT 90837 reimbursement in 2025:

• Medicare: about $154.29 per session

• Aetna: around $144.75 per session

• Blue Cross Blue Shield: roughly $124.64 per session

• UnitedHealthcare: around $109.59 per session

These rates may differ based on your location, license type, and contract terms with each payer.

Tips to Maximize Your Reimbursement

To make sure you’re getting the most out of your CPT 90837 billing, follow these key steps:

• Stay current on payer policies. Insurance rules often change, so review updates regularly.

• Regularly review your documentation standards. Small documentation errors can cost thousands under CMS review. Read our related article on how documentation mistakes can lead to significant revenue loss and compliance issues under CMS rules.

• Review your billing patterns every quarter. Overusing 90837 may raise red flags and lead to payer audits.

• Train your billing team often. Keep them updated on documentation standards and payer-specific rules.

A well-organized billing process can help increase your practice’s revenue by 15–20%, reduce denials, and ensure faster payments.

CPT Code 90837 vs. CPT Code 90834

Feature	CPT 90834	CPT 90837
Duration	38–52 minutes	53+ minutes
Complexity	Moderate	High or complex cases
Typical Reimbursement	Lower	13–20% higher
Common Use	Standard therapy	Trauma, crisis, or complex needs

When unsure, always document the exact time spent and let that determine which code applies. Never select a code based on reimbursement alone.

Compliance Checklist for 90837 CPT Billing

To stay compliant and protect your practice, use this quick reference list:

• Document exact start and end times (minimum 53 minutes).

• Explain why a shorter session wasn’t enough.

• Note all interventions and patient responses.

• Include the diagnosis and treatment goal in each session note.

• Use modifier 95 for telehealth sessions.

• Avoid auto-coding every session as 90837.

• Conduct quarterly self-audits to identify billing patterns.

These habits will strengthen both your compliance and cash flow.

FAQ

1. What are the billing guidelines for CPT 90837?

CPT 90837 is billed for 60-minute psychotherapy sessions. Always document start and end times, include clinical details, and add modifier 95 when sessions are done via telehealth.

2. What is the reimbursement rate for 90837?

Reimbursement for CPT 90837 varies by payer. On average, Medicare pays around $154 per session, while private insurers like Aetna, BCBS, and UnitedHealthcare pay between $110–$145.

3. Does Medicare cover telehealth mental health?

Yes. Medicare covers telehealth mental health services, including psychotherapy codes like 90837, when provided through approved HIPAA-compliant video platforms and documented with modifier 95 to confirm virtual delivery.

Conclusion

When you follow best practices for CPT code 90837, you protect your income, avoid issues with insurance payers, and make sure your sessions hold up during audits. By using a solid strategy and clear documentation, CPT 90837 remains a strong billing code for getting fair payment when providing intensive psychotherapy.