While CPT code 90837 is often called the 60-minute psychotherapy code, using this description leads to one of the most common coding mistakes in behavioral health. A session is not considered 90837 if it is less than 60 minutes. The time threshold is 53 minutes.This distinction is really important. Billing based on the appointment length as opposed to the time you actually provided psychotherapy can result in a coding error or denial. Automatically selecting a shorter code because you documented a session that qualified for 90837 can also result in under-coding.
The best approach is simple. Code 90837 based on the time the service was provided instead of the appointment time. Make sure the psychotherapy time is documented and be sure the record supports the treatment you provided. Finally, understand how the other CPT codes relate to this code.This guide explains how to bill behavioral health CPT codes, supports documentation, explains the differences between psychotherapy codes, and where behavioral health practices typically have the most difficulties.
What Is CPT Code 90837?
CPT code 90837 indicates an individual psychotherapy service provided during a minimum 60 minute session. If the duration of the psychotherapy service renders 53 minutes or more, then code 90837 would apply.
The service may consist of therapeutic engagement, addressing the current symptoms, assessment of thoughts and actions, appraisal of psychosocial factors, application of psychotherapy techniques, and evaluation of the patient’s response and progress.
Depending on the nature and the plan of treatment of the patient, the session may consist of cognitive behavioral therapy, psychodynamic therapy, trauma-focused therapies, dialectical behavior therapy, acceptance and commitment therapy, EMDR, prolonged exposure, or other recognized psychotherapy techniques.
The code does not specify one particular therapy technique. It defines the psychotherapy service and the time category associated with the service.
This distinction is critical when considering selection of 90837. 90837 should not be selected because the therapist scheduled a 60 minute appointment, unless, of course, the 60 minutes of psychotherapy was recorded.
How Many Minutes Are Required for CPT 90837?
The psychotherapy codes are selected according to the amount of time spent providing psychotherapy. The applicable time ranges are:
- CPT 90832: 16–37 minutes of psychotherapy
- CPT 90834: 38–52 minutes of psychotherapy
- CPT 90837: 53 minutes or more of psychotherapy
Calling 90837 the “60-minute psychotherapy code” does not resolve the issue of defining 90837. A session does not have to last 60 minutes in order to satisfy 90837. For example, a session documented as 57 minutes of psychotherapy is a case of 90837. A 50-minute session would still be considered under cpt code 90834, even if the appointment was set as a full hour.
The code should therefore reflect the actual psychotherapy time provided and documented, not the length of the appointment slot.
Scheduled time is not the same as psychotherapy time
Consider a simple example.
A patient is scheduled from 2:00 PM to 3:00 PM but arrives late. Actual psychotherapy runs from 2:11 PM to 2:59 PM.
The appointment occupied a 60-minute calendar slot, but the psychotherapy itself lasted 48 minutes. Based on the time ranges above, the documentation would point toward 90834 rather than 90837.
This is why coding should follow the actual service, not the appointment template.
What Happens During a 90837 Psychotherapy Session?
The AMA reference you provided interprets 90837 from a clinical rather than billing perspective. That is useful because a psychotherapy claim should represent more than time.
While psychotherapy is occurring, a clinician may take interval history, assess the symptoms and the functional level of the patient, review and better understand the patient’s mental state, consider the patient’s thoughts and emotions and how they contribute to the behavior, assess the psychosocial and health stressors, and intervene as necessary.
A psychotherapy session report may communicate the:
- the issues the patient presented, the symptoms the patient communicated, and the psychotherapy issues
- techniques the clinician employed, and the interventions that the clinician performed
- the appearance and mental-status of the patient
- the participation of the patient and how the patient responded
- the propositional and actual outcomes of the psychotherapy session, as well as the treatment plan.
Time qualifies the code category, but it should be documented that psychotherapy was actually delivered.
CPT 90837 vs. 90834 vs. 90832
The difference between these three individual psychotherapy codes is primarily the psychotherapy time range.
CPT 90832
90832 is used for shorter individual psychotherapy services in the 16–37 minute range.
CPT 90834
90834 covers psychotherapy lasting 38–52 minutes. It is commonly associated with the traditional 45-minute psychotherapy session.
CPT 90837
90837 begins at 53 minutes and represents the longer psychotherapy time category.
The important billing lesson is not to treat one code as inherently “better” than another.
90834 is not an inferior code, and 90837 should not be chosen simply because reimbursement may be higher. The correct CPT code is the one supported by the psychotherapy time and service documented for that encounter.
Documentation Requirements for CPT Code 90837
Documentation is the weakest part of many otherwise valid 90837 claims.
Clinical documentation must support the psychotherapy service as well as the time needed to select the appropriate CPT code. Many of the reference articles strongly indicate the need for time of session documentation. One of the articles indicated the time could be documented by start and stop times or total minutes of psychotherapy. Some articles recommend the exact time be documented.
From a practical billing perspective, the record needs to clearly indicate the time.
Typically, a strong 90837 note will contain the following:
Psychotherapy time. Record the actual treatment time clearly rather than relying on the scheduled appointment duration.
Clinical reason for treatment. The diagnosis and current symptoms should connect logically to the psychotherapy being provided.
Therapeutic work performed. Identify meaningful interventions instead of using vague language such as “provided support.”
Patient response. Document how the patient participated, responded, progressed, or continued to struggle.
Treatment goals and plan. Connect the encounter to the broader course of treatment where appropriate.
Relevant mental-status or behavioral findings. Documentation should reflect the actual encounter rather than repeating generic text from prior sessions.
Provider authentication. The note should identify and be signed by the clinician responsible for the service.
The goal is not to create a longer note simply because 90837 was billed. The goal is to make the clinical record accurately reflect what happened during that particular session.
Avoid documentation that looks copied or automatic
One concern raised repeatedly in the competitor material is repetitive documentation.
If dozens of records contain identical descriptions of interventions, patient response, medical necessity and session length, the notes may be harder to defend when reviewed.
Templates can improve efficiency, but they should not replace encounter-specific documentation.
Medical Necessity and the Longer Psychotherapy Session
Some of the supplied articles mention 90837 and medical necessity.
This doesn’t mean that for every 90837, there needs to be a crisis or a severe case. It means that the documentation needs to have some clinical basis.
More extensive psychotherapy may be needed for more extensive therapy work, more complex symptoms, trauma work, other forensic therapy work, multiple problems, clinical strategies, complex psychosocial issues, other work that the therapist deems as requiring extensive therapy work.
The strongest documentation connects:
patient condition → therapeutic intervention → psychotherapy time → patient response
rather than adding a generic phrase stating that “60 minutes were medically necessary.”
Who Can Bill CPT 90837?
The reference materials identify a broad range of behavioral health professionals who may provide and bill psychotherapy when permitted by their licensure, scope of practice, payer enrollment and credentialing requirements.
These can include psychiatrists, psychologists, clinical social workers, professional counselors, marriage and family therapists, and other qualified behavioral health practitioners.
Provider eligibility should never be assumed solely from a professional title. The clinician must meet the applicable requirements of the payer and the jurisdiction in which the service is delivered.
Credentialing matters as well. A clinically appropriate service can still encounter payment problems when the rendering provider is not properly enrolled or credentialed with the patient’s plan.
CPT 90837 With an E/M Service: When 90838 Matters
One of the most important distinctions in psychotherapy coding involves encounters where a practitioner provides both psychotherapy and a separately reportable evaluation and management service.
When the encounter is psychotherapy without a separately reported E/M service, the standalone psychotherapy family includes:
90832, 90834 and 90837.
When a qualified practitioner performs a separately identifiable E/M service together with psychotherapy, the corresponding psychotherapy add-on codes become relevant:
90833, 90836 and 90838.
For the longer psychotherapy category, that means an appropriate E/M service may be reported with 90838, rather than reporting standalone 90837 alongside the E/M code.
The documentation should distinguish the work supporting the E/M service from the psychotherapy service. Simply discussing medication briefly during psychotherapy does not automatically establish a separately reportable E/M service.
Can 90785 Be Billed With 90837?
CPT 90785 describes interactive complexity and may be reported as an add-on to certain psychiatric services, including 90837, when qualifying communication factors complicate delivery of the service.
Examples in the supplied references include situations involving legally responsible parties, difficult family interactions, verbally undeveloped patients, or necessary involvement of third parties such as schools or probation personnel.
Interactive complexity should not be added simply because the session felt difficult.
When the add-on is reported, the documentation should support the qualifying communication factor.
90837 vs. Family, Group and Crisis Psychotherapy
A 53-minute session is not automatically 90837 simply because psychotherapy occurred.
Different services have their own codes.
90846 and 90847 apply to family psychotherapy under their respective patient-presence circumstances.
90853 represents group psychotherapy.
90839 and 90840 apply to qualifying psychotherapy for crisis.
That distinction matters when deciding what the encounter actually represents. Code selection should follow the nature of the service first and the applicable time rules second.
CPT 90837 Telehealth Billing
The reference articles confirm that psychotherapy services, including 90837, can be furnished through telehealth under applicable payer rules.
What should not be assumed is that every payer handles telehealth billing exactly the same way.
Depending on the payer and current policy, telehealth claims may involve specific:
- modifiers;
- place-of-service codes;
- audio-video requirements;
- audio-only rules;
- coverage requirements;
- provider-location or patient-location requirements.
The supplied references discuss modifier 95 and telehealth place-of-service concepts, but they also repeatedly caution that Medicare, Medicaid and commercial payer requirements can differ.
For that reason, practices should verify the current payer-specific telehealth rules instead of applying one modifier or POS combination to every claim.
CPT 90837 Reimbursement Guidelines
90837 generally represents a longer psychotherapy service than 90832 or 90834, so reimbursement may be higher. But there is no single reimbursement amount that applies to every 90837 claim.
Payment can differ based on:
- Medicare versus commercial coverage;
- provider type and credentials;
- geographic locality;
- facility versus non-facility setting;
- payer contract;
- network status;
- applicable fee schedule;
- telehealth policy;
- patient benefits and cost sharing.
Some of the supplied competitor articles publish specific 2026 Medicare or commercial reimbursement amounts, but those figures are not consistent across the reference set.
For a reliable billing workflow, practices should use the applicable payer fee schedule or contract rather than treating a national “average” as the expected payment.
Common CPT 90837 Billing Problems
The strongest competitor articles repeatedly identify the same practical problems: coding from appointment length instead of actual psychotherapy time, weak time documentation, repetitive notes, incorrect E/M combinations, and payer-specific telehealth errors.
Another concern is automatically billing 90837 for nearly every psychotherapy encounter because it pays more.
The references warn that unusually repetitive billing patterns may attract payer attention, but they do not establish one universal percentage at which a practice becomes noncompliant.
The more defensible rule is simpler:
Your code distribution should reflect the services that were actually provided and documented.
A practice should be able to explain why any individual 90837 claim was reported without relying on the fact that the appointment was booked for one hour.
Protecting 90837 Claims From Preventable Denials
Clean behavioral health billing starts at the point of documentation.
Check if the note supports the psychotherapy duration, and verify the correct psychotherapy code was sequenced as either a stand-alone or an E/M add-on code, and ensure any applicable interactive complexityadd-on is supported. Review the provider credentials, diagnosis placements, telehealth requirements, and the authorization rules, as needed.
These steps matter as it is easier to prevent coding denials than it is to appeal them.
Large volumes of psychotherapy claims in behavioral health practices make it necessary to conduct consistent coding reviews to find commonly missed time documentation, incorrect modifiers, payer edits and/or persistent downcoding.
Resilient Medical Billing Services has the expertise to offer quality behavioral health coding reviews, claims, follow ups with payers for denials, and A/R management all within the revenue cycle to assist behavioral health practices in fixing billing issues that can be prevented.
Main Takeaway
CPT code 90837 is associated with 60-minute psychotherapy, with the reporting threshold beginning at 53 minutes according to the supplied psychotherapy coding references.
Correct billing depends on more than reaching that number. The documentation should show the psychotherapy delivered, the time spent, the patient’s clinical needs and response, and the appropriate relationship to other services performed that day.
The best billing rule is also the simplest: report the service the record actually supports—not the code that happens to reimburse more.
Frequently Asked Questions
How many minutes are required to bill CPT code 90837?
The reference guidance places CPT 90837 at 53 minutes or more of psychotherapy. Sessions lasting 38–52 minutes fall under the time range associated with CPT 90834, while 16–37 minutes corresponds to CPT 90832.
Does CPT 90837 require exactly 60 minutes?
No. Although 90837 is commonly called the 60-minute psychotherapy code, the supplied coding references identify 53 minutes as the beginning of the reporting range. The actual psychotherapy time should be clearly documented.
Can CPT 90837 be used for telehealth?
Yes, psychotherapy services may be provided through telehealth when the patient’s payer permits it. Modifier, place-of-service, audio-only and other telehealth requirements can vary, so the current payer policy should be checked before billing.
Can 90837 be billed with an E/M code?
When a separately reportable E/M service and psychotherapy are both performed by an eligible practitioner, the psychotherapy add-on code family is used rather than standalone 90837. For the longer psychotherapy time category, 90838 is the corresponding add-on code. Documentation should clearly distinguish the E/M work from the psychotherapy service.
What are the most common reasons for 90837 billing problems?
Common issues identified across the supplied references include insufficient psychotherapy time, unclear time documentation, coding from the scheduled appointment rather than actual treatment time, repetitive or nonspecific notes, improper E/M combinations, telehealth billing errors, and payer-specific authorization or coverage requirements.
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