The problem of billing codes can be quite complicated because therapists must work with longer psychotherapy sessions. The last thing you need to know is that coding errors can cost you time and money, and one of the most audited and misinterpreted codes is the code 90837.
This code of conduct will take you through all you need to know about CPT Code 90837. We will ensure that it is simple, direct, and can be directly applied to your practice. You will come to know the time requirements, its reimbursement rates in 2025, its similarity to other related codes such as 90834, and the best practices of billing it without attracting denials.
Let’s get started. These longer sessions are where most breakthroughs in therapy have been made, and it is vital that you not only record properly but also know how you can protect your practice with finances. Having this information, you will be more assured of the payer system.
What is CPT Code 90837?
CPT 90837 according to the American Medical Association (AMA) has the official definition as:
“Psychotherapy for 60 mins with patient.”
This simply means that it is the code of billing when you are having a face to face psychotherapy session with a patient of 60 minutes. It is designed to be interactive, in depth therapeutic treatment involving a more time frame than a regular one.
Critical to the overall behavioral health billing process are such codes as 90837. They can be used to guarantee correct reimbursement and payer adherence. Most therapists opt to use 90837 as it indicates the depth and intensity of their work, especially when dealing with patients who bring with them trauma, complex anxiety or long term depressive symptoms and cannot be sufficiently addressed in a shorter session.
CPT 90837 Time Requirements: Getting It Right
One of the most important details about 90837 is the time requirement. Payers are strict on this, and mistakes here are the leading cause of denials:
- Standard Rule of Thumb: 90837 will be charged on sessions between 53 to 60 minutes. This is the standard and some clinical flexibility is permitted under AMA.
- Specifics of Payer: There are insurance companies who might demand a full 60 minutes. There is the 53-minute rule that is tolerated by others. Be sure to check your payer contracts.
- Documentation Tip: It is important to record the start time and end-time in the progress note with all times. An indistinct 1-hour session will not suffice in case you are subject to an audit.
One of the most widespread traps that result in the denials or recoupments is the failure to comply with the time requirements. In order to be on the safe side, one should take into consideration clinical justifications of the necessity of a full 60 minutes, like patient crises or complicated symptom appearance. This additional information will help to defend your charting against audit by insurance.
90837 Reimbursement Rates 2025
The national amount is not fixed to reimburse CPT 90837. It is provided on the basis of your payer contract, geographic location and insurance plan. The average rates in 2025 are shown below:
| Payer Type | Average Reimbursement (2025) | Notes |
| Medicare | $120 – $135 | Varies slightly by state/locality |
| Commercial Insurance | $110 – $160 | Contract-dependent |
| Medicaid | $70 – $95 | Typically lower, state-driven |
Critical: Rates are not determined by the CPT code but instead, by your personal agreement with payers. You should always look at your fee schedules to be sure of what to expect.
Knowledge of reimbursement rates is essential to your budgeting and forecasting. Remember that, even in a commercial insurance setting, certain companies are paying considerably higher rates on 90837 than others. A good thing to make sure you are not leaving money on the table is to negotiate payer contracts, keep track of reimbursement trends and upkeep your fee schedule on an annual basis.
90834 vs. 90837: Choosing the Right Code
There is a lot of confusion between these two codes among the therapists. The following would be a straight comparison:
| Feature | CPT 90834 | CPT 90837 |
| Session Length | 38–52 minutes | 53–60 minutes |
| Official Description | Psychotherapy, 45 minutes | Psychotherapy, 60 minutes |
| Reimbursement (2025 Avg) | $85 – $120 | $110 – $160 |
| Clinical Use | Standard session | Extended session, deeper work |
Decision Tip:
- Enter CPT Code 90834 when you have a session shorter than 53 minutes.
- Code 90837 when the session is 53 minutes or more.
- Do not upcode (bill 90837 when using shorter sessions) because it may result in compliance risks.
Although the reimbursement is higher when it comes to 90837, its overuse will prompt payer audits. The code decisions made by therapists should be made on the true basis of the length of the sessions and clinical justification rather than financial profitability. Shorter sessions are clinically suitable in most instances and a mix of codes is expected to be seen in the billing history of a provider.
How to Bill CPT 90837 Correctly and Avoid Denials
Billing 90837 is infamously difficult since it is one that payers examine closely. The most common denial causes and their prevention methods are the following:
1. Inadequate Time Records.
- Record start and end time.
- g.: “Session 2:05 PM-3:02 PM.
2. Overuse of 90837
- Some payers flag providers who use 90837 in most sessions.
- Strategy: Adjust codes according to real session times.
3. Lack of Medical Necessity
- Make sure your clinical notes reflect the reason why you had to spend some more time.
- Halt patient complexities, traumatic experiences, or more intense therapeutic requirements.
4. Missing Authorization
- 90837 is pre-authorized by some insurers.
- Always check before billing.
5. Incorrect Modifier Use
- You might require a modifier in the telehealth (e.g., 95).
- Check with payment plans.
Actionable Tip: It is possible to collaborate with a specialized medical billing service for small practice to cut down on denials and increase the accuracy of claims especially those of small practice. Furthermore, periodic internal audit and employee education will provide assurance that your team is informed of the payer-specific regulations and minimize compliance risks and leakage of revenue.
Conclusion
CPT Code 90837 is required where therapists offer psychotherapy sessions that last a long duration. Yet, it is also accompanied by very rigid regulations and a high level of control by payers. Often, you can increase reimbursement and prevent denials by learning the time requirements, comparing it with the corresponding codes such as 90834 and adhering to the best practices when documenting.
Proper application of 90837 not only shields your revenue, but also safeguards the larger behavioral health billing system. To achieve long-term sustainability, improving your coding practices is a prudent move in the unfolding practices. Staying abreast of payer trends and compliance standards will put your clinic in a better position to have a smoother cash flow and less headaches in administration.
FAQs
What does CPT code 90837 mean?
It is a 60-minute psychotherapy session between the patient and psychotherapist face-to-face. It is commonly applied by therapists to treat a complex condition where the interaction and exploration of mental health issues need time.
What is the difference between 90834 and 90837?
90834 is considered in the case of a session of 38-52 minutes, and 90837 in the case of a session of 53-60 minutes. Selecting the right one is not only limited to the duration of the session but also the recording of medical necessity. This is observed by payers.
How many minutes is a 90837?
A 90837 session should be a minimum of 53 minutes, but some payers will need the 60 minutes. It is best to verify the contract of the payer always and write down so that you could argue in favor of the selection of a billing.
What does CPT code 90838 mean?
90838 is an add-on code of psychotherapy given and an evaluation and management (E/M) service. It enables the therapists and prescribers to charge therapy time on top of medication management or assessment visits.
