CPT Code 90837: 60-Minute Psychotherapy Billing Guide 2026

A scheduled 60-minute therapy session may look sufficient for CPT code 90837, but actual treatment time determines the correct code. Missing time records, unsupported medical necessity and incorrect telehealth reporting can cause denials, recoupments and audits. This guide explains the 90837 CPT code definition, 53-minute requirement, documentation, billing guidelines, modifiers, reimbursement and common denial solutions for 2026.

What Is CPT Code 90837?

CPT code 90837 represents individual psychotherapy described as a 60-minute service with the patient. Providers generally use it when they deliver at least 53 minutes of qualifying psychotherapy and the patient’s condition supports the longer session.

The American Medical Association’s CPT 90837 guidance describes therapeutic communication, evaluation of the patient’s mental state and psychotherapy approaches used to address symptoms, thoughts, feelings and behaviors.

CPT 90837 identifies the service performed. It is not an ICD-10-CM diagnosis code. Providers must separately report the diagnosis documented in the patient’s medical record.

CPT 90837 Description at a Glance

How Much Time Is Required for CPT 90837?

CPT 90837 generally requires at least 53 minutes of psychotherapy. The provider should select the code according to actual psychotherapy time rather than the appointment’s scheduled duration.

For example, a provider may schedule a patient for one hour. However, if the psychotherapy ends after 50 minutes, CPT 90834 generally represents the supported time range.

What Time Counts Toward CPT 90837?

Qualifying time includes the period during which the provider actively performs psychotherapy with the patient. Family members or other informants may participate when their involvement supports the patient’s treatment and the patient remains involved as required.

The provider should document either the session’s start-and-stop times or the total psychotherapy time. The record should make it possible for a reviewer to confirm that the session reached at least 53 minutes.

What Time Does Not Count?

Do not include:

• Waiting time
• Scheduling follow-up appointments
• Collecting payment
• Unrelated administrative work
• Progress-note writing after the session
• Separately reported E/M time
• Time when the provider did not perform psychotherapy

The scheduled appointment length does not determine the code. Actual documented psychotherapy time does.

When Should CPT 90837 Be Used?

CPT code 90837 may apply when:

• The provider performs individual psychotherapy.
• The session includes at least 53 minutes of psychotherapy.
• The patient actively participates in the service.
• The record supports medical necessity.
• The provider documents the interventions performed.
• The note describes the patient’s response and treatment progress.
• Another code does not describe the service more accurately.

A complex diagnosis does not automatically support 90837. Likewise, providers should not extend every session to 53 minutes simply because the code pays more than 90834.

When Should CPT 90837 Not Be Used?

CPT 90837 may be inappropriate when:

• Psychotherapy lasts 52 minutes or less.
• The encounter consists primarily of medication management.
• The provider performs only a psychiatric diagnostic evaluation.
• The service qualifies as group or family psychotherapy.
• The encounter meets the requirements for psychotherapy for crisis.
• Documentation does not support the reported time.
• The patient’s record does not establish medical necessity.

CPT Code 90837 Billing Guidelines

Before submitting CPT 90837, billing teams should follow a consistent review process:

1. Confirm that the provider performed individual psychotherapy.
2. Verify at least 53 minutes of actual psychotherapy time.
3. Review the treatment plan and medical necessity.
4. Select the documented ICD-10-CM diagnosis.
5. Determine whether the provider performed a separate E/M service.
6. Verify authorization and frequency requirements.
7. Check the place of service and telehealth modifier.
8. Confirm the rendering provider’s enrollment status.
9. Submit the supported units.

Providers normally report one unit for one qualifying psychotherapy encounter. They should not routinely bill multiple units for one continuous session without written payer guidance.

The diagnosis on the claim must match the medical record. Never change a diagnosis simply to obtain coverage.

CPT 90832 vs. 90834 vs. 90837

The main difference among these individual psychotherapy codes is actual treatment time.

The CMS psychiatric psychotherapy billing guidance confirms these time ranges. It also states that providers should document start-and-stop times or total psychotherapy time.

Therefore, a 52-minute session supports 90834 rather than 90837. Once actual psychotherapy reaches 53 minutes, 90837 may apply when the remaining requirements are satisfied.

CPT 90837 vs. 90838

CPT 90837 and 90838 both describe approximately 60 minutes of psychotherapy, but providers report them differently.

A psychiatrist or another eligible practitioner may perform medication management and psychotherapy during one encounter. In that situation, the record must clearly separate the E/M work from the psychotherapy service.

The provider cannot count psychotherapy time toward the E/M service. When the documentation supports both services, the provider may report the applicable E/M code with add-on CPT 90838 instead of reporting standalone 90837 with an E/M code.

For an established-patient encounter involving moderate E/M work, review the CureMD Billers 99214 CPT code guide. If the E/M work remains at the low level, compare it with the 99213 CPT code requirements.

The E/M level must reflect the documented medical decision-making or other applicable selection rules. Psychotherapy time cannot increase the E/M level.

CPT 90837 Documentation Requirements

Complete documentation should show what the provider performed, why the patient needed the service and how the treatment supported the care plan.

A strong psychotherapy record should include:

• Date of service
• Session start-and-stop times or total time
• Reason for the encounter
• Current symptoms
• Relevant functional impairment
• Treatment goals addressed
• Psychotherapeutic techniques used
• Patient response
• Progress toward treatment goals
• Changes to the treatment plan
• Risk or safety assessment when clinically relevant
• Follow-up plan
• Provider signature and credentials
• Telehealth details when applicable

A time statement may read: “The provider delivered 56 minutes of individual psychotherapy.” The surrounding note must still document the therapeutic work and medical necessity.

Avoid cloned notes that repeat identical symptoms, interventions and responses for every session. Individualized documentation gives payers a clearer picture of the patient’s progress and continuing treatment needs.

Diagnoses and Medical Necessity for CPT 90837

CPT 90837 identifies psychotherapy, while ICD-10-CM codes identify the patient’s documented condition. Potential diagnostic categories may include depressive, anxiety, trauma-related, bipolar and other mental health disorders.

However, no single diagnosis guarantees payment. The record should connect the patient’s symptoms and functional impairment with the treatment goals, interventions and session duration.

Providers should also individualize treatment frequency. Reporting 90837 for every patient at the same interval without clear clinical support may attract payer review.

Can CPT 90837 Be Billed for Telehealth?

Providers may report CPT 90837 for eligible telehealth psychotherapy when the service satisfies the time, technology, documentation and payer requirements. The same 53-minute threshold generally applies.

Place of service depends on the patient’s location:

Do not automatically append modifier 95 to every telehealth claim. Medicare, Medicaid and commercial payers may apply different modifier requirements.

The note should document the patient’s location, delivery method, consent when required and actual psychotherapy time. Providers should also record significant technical disruptions that reduced treatment time.

Can CPT 90785 Be Billed With 90837?

CPT 90785 is an interactive-complexity add-on code. A provider may report it with 90837 when defined communication factors complicate the delivery of the psychiatric service.

A difficult diagnosis or emotionally demanding session does not automatically support 90785. Documentation should identify the specific communication factor and explain how it complicated treatment.

Providers should not report 90785 solely because they used translation or interpretation services. They must verify current payer requirements before adding it to the claim.

CPT 90837 vs. Crisis Psychotherapy

CPT 90837 describes routine individual psychotherapy, while CPT 90839 and 90840 describe qualifying psychotherapy for crisis.

A crisis service involves an urgent assessment and immediate interventions for a patient experiencing severe distress or a potentially life-threatening situation. CPT 90839 generally represents the initial crisis service, while 90840 may cover qualifying additional time.

Do not routinely combine 90837 with crisis codes for the same continuous service. Select the code that accurately represents the treatment delivered.

What About Than 60 Minutes?

CPT 90837 begins at 53 minutes, but payment does not automatically increase when a session lasts 75 or 90 minutes. Deleted prolonged-service codes and inconsistent payer policies have created confusion about extended psychotherapy.

Providers should document the complete time and medical necessity. They should then verify the current payer and Medicare Administrative Contractor instructions before using another code or multiple units.

Do not split one continuous session into separate claims merely to increase reimbursement.

CPT 90837 Reimbursement in 2026

Medicare generally reimburses CPT 90837 through the Physician Fee Schedule. However, no single amount applies to every provider or claim.

Payment can vary according to:

• Geographic locality
• Provider type
• Facility or non-facility setting
• Participation status
• Place of service
• Applicable adjustments
• Payer contract
• Patient benefits

Practices should use the current CMS Physician Fee Schedule lookup to review Medicare payment information for the applicable year and locality.

Commercial insurers base reimbursement mainly on the provider’s contract. A published national estimate does not replace the contracted fee schedule or guarantee coverage.

Common CPT 90837 Denials and Corrections

When correcting a claim, use information already supported by the original record. Do not add unsupported time, symptoms or diagnoses after the service.

CPT 90837 Billing Examples

Example 1: 52-Minute Session

A therapist provides 52 minutes of individual psychotherapy. CPT 90834 represents the supported time range.

Example 2: 53-Minute Session

A therapist provides and documents 53 minutes of medically necessary psychotherapy. CPT 90837 may apply.

Example 3: Scheduled Session Ends Early

The appointment was scheduled for 60 minutes but ended after 48 minutes. The provider should code the actual psychotherapy time rather than the schedule.

Example 4: Medication Management and Psychotherapy

A psychiatrist performs a separately documented E/M service and 55 minutes of psychotherapy. The provider should evaluate the E/M code with add-on CPT 90838.

Example 5: Telehealth From Home

The patient receives synchronous telehealth at home. The provider should evaluate POS 10 and the payer’s modifier requirements.

Final Takeaway

CPT code 90837 generally requires at least 53 minutes of actual individual psychotherapy. Accurate reporting depends on documented time, medical necessity, therapeutic interventions and the patient’s response.

Providers should distinguish 90837 from 90834, 90838 and crisis psychotherapy codes. They should also verify current telehealth, authorization and reimbursement rules before submitting the claim.

Last reviewed: August 27, 2026

Coding and reimbursement requirements can change and may vary by payer and jurisdiction. This article provides educational information and does not replace current CPT, CMS, Medicare Administrative Contractor or payer guidance.

Frequently Asked Questions

What is CPT code 90837 used for?

CPT 90837 reports individual psychotherapy described as a 60-minute service. It generally requires at least 53 minutes of qualifying psychotherapy.

Can CPT 90837 be billed for 50 minutes?

No. A 50-minute psychotherapy session falls within the 38-to-52-minute range for CPT 90834.

What is the difference between 90834 and 90837?

CPT 90834 covers 38–52 minutes of psychotherapy. CPT 90837 applies when psychotherapy reaches at least 53 minutes.

What is the difference between 90837 and 90838?

CPT 90837 is a standalone psychotherapy code. CPT 90838 is an add-on code for at least 53 minutes of psychotherapy performed with a separate E/M service.

Does CPT 90837 require modifier 95?

Not automatically. Modifier 95 commonly identifies synchronous audio-video service, but the provider must follow the applicable payer’s instructions.

Is 90837 a diagnosis code?

No. CPT 90837 identifies a psychotherapy service. Providers must separately report the documented mental health diagnosis with an ICD-10-CM code.

Can 90785 be reported with 90837?

It may be reported when specific communication factors support interactive complexity. The provider must document those factors and verify payer requirements.

How much does Medicare reimburse for CPT 90837?

Medicare payment varies by locality, provider type, service setting and applicable adjustments. Use the current Physician Fee Schedule for the relevant date and location.

Why do payers deny CPT 90837?

Common causes include insufficient time documentation, unsupported medical necessity, authorization limits, incorrect telehealth reporting, E/M bundling and provider enrollment problems.