What is the CPT code 90837?
Asked by: Prof. Lee Schinner MD | Last update: June 12, 2025Score: 4.4/5 (17 votes)
What does CPT code 90837 mean?
CPT® code 90837: Psychotherapy, 1 | American Medical Association.
How many minutes is a 90837 session?
Code 90837 is for 60-minute therapy sessions, defined as 53 minutes or longer. Anything less than 53 minutes would use code 90834 (45-minute session). For 90837, the actual session time must be documented in your notes. Rounding up or down is not allowed.
What is code 90837 for reimbursement?
The reimbursement rates for CPT Code 90837 vary depending on the year and insurance provider. As of 2023, the Medicare reimbursement rate for a 60-minute individual therapy session is $147.07. In previous years, the rates were $164.84 (2022), $152.48 (2021), and $141.47 (2020).
How to justify 90837?
- Did the nature of the treatment justify the time length of the session? ...
- Does the nature of the treatment justify the frequency of treatment sessions? ...
- Was the treatment rendered medically necessary?
Medical Coding Guidelines for Advanced Coders - Week 9: CPT Path & Lab
How much is a 60 minute therapy session?
Even if you don't have benefits that cover mental health services, Talkspace is still more affordable than most in-person therapy. The average cost of a traditional in-person therapy session is $175 - $500 per session — a big departure from our plans!
Can a psychiatrist bill 90837?
patient for more than 15 minutes you may code using 90832, the 30-minute code; and if you see a patient for 35 minutes, you would also use 90832. However, if you see the patient for 38 to 52 minutes, you would use 90834, the 45-minute code; and for 53 minutes or more you would use 90837, the 60-minute code).
Is 90837 GT or 95?
The 95 modifier informs your Medicare payer that you provided medical service via telehealth. The GT modifier is being requested less and less these days and is use to be the standard. Now, most insurance companies want you to use 95 instead, which is defined as synchronous Telehealth.
Why do therapists do 50 minute sessions?
The rationale behind the “50-minute hour” is that it provides the right amount of time to do the therapeutic work. At the same time, it leaves time for the therapist and client to wind down at the end. It also gives the therapist enough time to take a quick break and write notes in between clients.
How do you bill for a 1.5 hour therapy session?
Psychologists who conduct sessions that require more than 60 minutes should report CPT® code 90837: Psychotherapy, 60 minutes with patient. Regardless of how long the session lasts, the psychologist's reimbursement will be based on the payment amount ultimately associated with 90837.
What does CPT stand for?
The Current Procedural Terminology (CPT®) codes offer doctors and health care professionals a uniform language for coding medical services and procedures to streamline reporting, increase accuracy and efficiency.
What modifier is needed for 90837?
What modifiers can I use with CPT code 90837. A common modifier used with CPT code 90837 is modifier 95. This is the modifier for teletherapy. Before using this modifier or scheduling teletherapy with a patient, make sure their plan covers this modifier.
What is the diagnosis code for psychotherapy?
90832 – Psychotherapy, 30 minutes (16-37 minutes) 90834 – Psychotherapy, 45 minutes (38-52 minutes) 90837 – Psychotherapy, 60 minutes (53 minutes and over) 90846 – Family or couples psychotherapy, without the patient present.
Can I bill my insurance for therapy?
If you plan to use your insurance to cover your therapy costs, ask your provider what billing codes they use to code their sessions. Then, call your insurance's customer service number and ask if your plan covers those billing codes.
Is behavioral health considered a specialty?
As a highly specialized field, becoming a behavioral health specialist requires a solid educational foundation and ongoing training.
How do you justify 90837?
your client may have a trauma history: “90837 is medically necessary because significant trauma hx necessitates taking time to create safe space for disclosure and then containment.”
How much is a copay for therapy?
If you have insurance with mental health coverage, the cost of a therapy session with an in-network therapist is usually the same as your co-pay to see a medical specialist. On average, specialist co-pays are about $30 to $50 per session.
Is a 2 hour therapy session too long?
You might find it difficult to concentrate during a lengthy session. Or a session that's a couple of hours long might be emotionally draining for you, especially if you're discussing trauma. Keep in mind that therapy sessions that are an hour or a little less are standard in talk therapy.
Will Medicare pay for telehealth in 2025?
Medicare patients can receive telehealth services for non-behavioral/mental health care in their home through March 31, 2025. There are no geographic restrictions for originating site for Medicare non-behavioral/mental telehealth services through March 31, 2025.
What is a 95 modifier?
-95: Synchronous telemedicine service rendered via a real-time interactive audio and video communications system.
Can you bill a telehealth and office visit on the same day?
E-visits should not be billed on the same day the physician reports an office visit E/M service (CPT codes 99202-99205 and 99211-99215) for the same patient. Additionally, e-visits should not be billed when using the following codes for the same communication: 99091.