CPT code 90837 is the billing code for a 60-minute individual psychotherapy session, and it requires at least 53 minutes of face-to-face therapy with the patient. It is also the most commonly billed psychotherapy code, which is exactly why payers audit it so closely.
If you are a therapist, psychologist, or psychiatrist, choosing between 90837, 90834, and 90832 affects every claim you send. Pick the wrong one and you risk a downcode, a denial, or a clawback months later.
This guide explains the 90837 CPT code in plain language: the time rule, worked examples, the 90837 documentation requirements auditors check, 2026 payment rates, and the mistakes that cost practices money. Our team at Apna MBC delivers mental health billing services across the U.S., so we see these errors daily.
Key takeaways
- CPT code 90837 requires at least 53 minutes of psychotherapy, documented in the note.
- 38 to 52 minutes is 90834, and 16 to 37 minutes is 90832.
- Start and stop times are the single most important documentation element.
- Medicare pays about $167 for 90837 in 2026, so accuracy protects real revenue.
What Is CPT Code 90837?
CPT code 90837 describes individual psychotherapy lasting 53 minutes or more. It is a time-based code. The minutes of actual psychotherapy decide whether you can bill it, not the length of the appointment slot.
Depending on state licensure and payer contracts, psychiatrists, psychologists, clinical social workers, licensed counselors, and marriage and family therapists can all bill it. It covers individual therapy only. Group sessions use 90853, and family therapy uses 90846 or 90847.
Psychotherapy here means treating a mental health condition through therapeutic communication and techniques such as cognitive behavioral therapy. Psychological testing, case management, medication checks, and waiting-room time are separate services. They do not count toward the 53 minutes, and they should never be blended into a 90837 claim.
Prescribers who also perform an evaluation and management (E/M) service on the same day report the add-on code 90838 instead of 90837.
The 53-Minute Rule: CPT Code 90837 Time Requirements
The CPT 90837 time requirement is simple to state and easy to miss in practice. Three time bands separate the individual psychotherapy codes:
| CPT code | Psychotherapy time | Typical session |
| 90832 | 16 to 37 minutes | 30 minutes |
| 90834 | 38 to 52 minutes | 45 minutes |
| 90837 | 53 minutes or more | 60 minutes |
Only time spent in psychotherapy counts. Check-in, scheduling, charting, and phone calls do not. A 60-minute appointment can still be a 90834 if only 50 minutes were therapy. A 52-minute session is 90834, and a 53-minute session is 90837. Never round up.
CPT Code 90837 Examples
These worked scenarios show how the clock picks the code:
| Scenario | Psychotherapy time | Code |
| CBT session, documented 9:02 to 10:00 | 58 minutes | 90837 |
| 60-minute slot, 13 minutes spent on paperwork and insurance questions | 47 minutes | 90834 |
| Session ends right at the threshold | 53 minutes | 90837 |
| Video session, client at home | 55 minutes | 90837-95, POS 10 |
| Crisis call shortened by an emergency | 35 minutes | 90832 |
| Psychiatrist completes a medication visit, then separate therapy | 55 minutes of therapy | E/M plus 90838 |
The pattern is consistent. Documented psychotherapy minutes drive the code, and anything else is just context.
90837 vs 90834: Which Code Should You Bill?
The core difference is time. 90834 covers 38 to 52 minutes, while 90837 starts at 53. In 2026, Medicare pays about $167 for 90837 and about $114 for 90834, so the gap is real money.
That gap also explains the scrutiny. Practices that bill 90837 for nearly every client stand out. Some billing analyses treat a 90837 share above roughly 65 to 70 percent of psychotherapy claims as outside the norm. A realistic mix of 90834 and 90837 is normal, because not every session runs a full hour. Bill what the clock and the note support.
90837 Documentation Requirements Auditors Expect
Time documentation is where most claims fail. In an HHS OIG audit of 216 sampled Medicare psychotherapy visits, 94 were billed as 90837, more than any other code. In 60 visits the psychotherapy time was missing, and in 43 the treatment plan was missing or incomplete. Auditors estimated $580 million in improper payments out of roughly $1 billion Medicare paid for psychotherapy that year.
Medicare contractors reviewing 90832, 90834, and 90837 expect legible, signed records that show the patient name, date of service, and documentation of time. A strong note for 90837 billing includes:
- Patient name and date of service.
- Start and stop time, or total psychotherapy minutes. For example: “Psychotherapy 10:02 to 10:58 (56 minutes), video.”
- Modality. Individual, in person or telehealth, and the patient’s location for telehealth.
- Diagnosis. An ICD-10 code that supports medical necessity.
- Treatment plan link. Show how the session advances a current plan with goals.
- Interventions used. Name the techniques, such as CBT or DBT skills.
- Patient response and progress. Specific, not generic.
- Medical necessity for the longer session. Say why 53 or more minutes were needed.
- Signature and credentials.
Vague necessity language is the most common failure, and it takes seconds to fix.
How to Track Time for CPT Code 90837
Good time habits prevent most downcodes. A simple routine works for solo therapists and large groups alike:
- Start a visible timer when therapy actually begins, not when the appointment starts.
- Pause it for interruptions, admin questions, or breaks that are not treatment.
- Stop it when therapy ends, then enter the start and stop times in the note body, not only in a scheduling field.
- Check the total against the thresholds before you pick the code: 53 or more is 90837.
- Make the EHR block signing when the time field is empty.
If a payer reads only the claim and clinical note, a time field they cannot see is the same as no time at all.
90837 Reimbursement Rate in 2026
Medicare’s national non-facility payment for CPT code 90837 is $167.01 in 2026, up 8.2% from $154.29 in 2025. The facility rate is $135.27. Clinical social workers, counselors, and marriage and family therapists are paid 75% of the psychologist rate, or about $125.
| Payer | Average 90837 rate |
| Medicare (national, non-facility) | $167.01 |
| Cigna | $180.84 |
| Blue Cross Blue Shield | $158.25 |
| Aetna | $145.90 |
| UnitedHealthcare | $138.60 |
| State Medicaid (median) | $130.69 |
These are national averages before local adjustment, so your contract may differ. Some insurers also want prior authorization for extended or frequent sessions, so verify benefits before the first CPT code 90837 claim goes out. A downcode from 90837 to 90834 on a $167 claim costs more than $50 each time, and it adds up across a full caseload. Rates only matter if you are enrolled, so keep your medical credentialing services and payer contracts current.
90837 Telehealth Modifier 95 and Place of Service
Telehealth does not change the code, only how you report it. Use modifier 95 for live audio and video and modifier 93 for audio-only. Place of service 10 applies when the client is at home, and POS 02 applies elsewhere. A 55-minute video session with a client at home is 90837-95, POS 10.
Medicare extended its telehealth flexibilities through December 31, 2027, but payer rules differ, especially for audio-only. Confirm each payer’s policy before billing a long phone session at the higher code.
Common 90837 Billing Mistakes and Audit Triggers
- Rounding up. Billing 90837 for a 50-minute session is upcoding.
- Counting admin time. Paperwork and scheduling never count toward the 53 minutes.
- Hiding the time. In one Ohio group practice audit, 23% of 90837 claims were auto-downgraded to 90834 because the duration sat in a separate time field instead of the note.
- Templated notes. Cloned language signals that the session was not individualized.
- Defaulting to 90837. A near-100% share invites review.
- Missing treatment plans. These drive recoupments.
- Wrong modifier or POS. Telehealth claims fail on mismatches.
Strong claim denial management catches these before they become patterns, and periodic compliance audits show whether your notes would survive a payer request.
How Apna MBC Supports 90837 Billing
Apna MBC is a mental-health-focused medical billing company based in Arlington, Texas, serving practices in 30+ states. We check insurance, scrub claims for time and modifier errors, submit daily, follow up on accounts receivable, and appeal denials. We also work inside the systems you already use, such as SimplePractice, TherapyNotes, and Tebra, with HIPAA-compliant processes throughout. For CPT code 90837 specifically, that means we flag claims with missing minutes, mismatched modifiers, or an unusually high 90837 share before a payer ever sees them, and we help your team build note templates that capture time the way auditors expect.
Conclusion
CPT code 90837 pays well, but only when the note proves at least 53 minutes of psychotherapy. Match the code to the documented time, write start and stop times into every note, link each session to the treatment plan, and use the right telehealth modifier. Do that consistently and you protect both your revenue and your practice.
Want a second set of eyes on your 90837 billing? Request a free practice audit and let our team review your claims.
Frequently Asked Questions
What is CPT code 90837 used for?
CPT code 90837 is used to bill individual psychotherapy sessions of 53 minutes or more, typically a 60-minute appointment. It applies to licensed mental health providers and requires documented psychotherapy time in the note.
How many minutes do you need to bill 90837?
You need at least 53 minutes of face-to-face psychotherapy. Sessions of 38 to 52 minutes bill as 90834, and 16 to 37 minutes bill as 90832.
Can I bill 90837 for a 50-minute session?
No. A 50-minute session falls in the 90834 range. Billing 90837 for it is upcoding and can trigger denials, audits, and repayment demands.
What is the difference between 90837 and 90834?
The difference is time. 90834 covers 38 to 52 minutes, and 90837 covers 53 minutes or more. 90837 pays more and draws more audit attention.
Can 90837 be billed by telehealth?
Yes. Report live video with modifier 95, or audio-only with modifier 93 where the payer allows it. Use POS 10 for a client at home and POS 02 otherwise.
How much does 90837 pay in 2026?
Medicare’s national non-facility rate is about $167. Commercial national averages range from roughly $139 to $181, and Medicaid’s median is about $131.
Does 90837 require prior authorization?
It depends on the payer. Some insurers ask for preauthorization on extended or intensive therapy, while others do not. Verify benefits and authorization rules for CPT code 90837 before the first visit.
What happens if 90837 is audited?
The payer sends an additional documentation request. You submit signed notes showing the date of service, psychotherapy time, diagnosis, treatment plan, and interventions. Missing time or a missing treatment plan can lead to denied claims and repayment, so keep every note audit-ready from day one.
Can I bill 90837 with an E/M service on the same day?
No. Prescribers who perform separate E/M and psychotherapy report the E/M code plus add-on 90838 instead.
