CPT Code 90837: Description, Cost, Scenarios, and Rules

CPT code 90837 is a psychotherapy code used to report an individual therapy session lasting 60 minutes. It is billed when a licensed mental health provider delivers face-to-face psychotherapy focused on diagnosis, treatment planning, emotional regulation, behavior change, or symptom management. This code is commonly used for complex mental health conditions that require extended therapeutic time and documented clinical intervention.

What Is the Description of CPT Code 90837?

90837 CPT code description, as per the American Medical Association, is: “Psychotherapy, 60 minutes with patient and/or family member.”

How Much Time is Required for CPT Code 90837?

CPT code 90837 is time-based and reported for psychotherapy sessions lasting 53 minutes or more (typical session = 60 minutes). Many payers and specialty guidance use a 53-minute minimum to distinguish 90837 from shorter psychotherapy codes; document total face-to-face psychotherapy minutes to support the code. 

What are the Modifiers for CPT Code 90837?

The CPT code 90837 is reported with modifiers that indicate delivery method, reduced/partial service, repeat procedures, or distinct same-day services.

Modifier 95: Synchronous Telehealth

Modifier 95 is used when the 60-minute psychotherapy session is delivered via real-time interactive audio-video telecommunication.

Modifier GT: Via interactive audio and video telecommunication (legacy)

Modifier GT may be used where payer policy requires it instead of or in addition to modifier 95 for synchronous telehealth.

Modifier 52: Reduced Services

Modifier 52 indicates the psychotherapy service was partially reduced or discontinued and should be used when the session was medically necessary but shortened.

Modifier 59: Distinct Procedural Service

Modifier 59 is used only when the CPT code 90837 code represents a distinct service from other procedures or services performed on the same day. Do not use modifier 59 to justify concurrent E/M + psychotherapy reporting

Modifier 76 / 77: Repeat Procedure Same Day (same/different physician)

Modifier 76 (same physician) or 77 (different physician) is used when the psychotherapy session is repeated later the same day and documentation justifies the repeat.

Which Documents Are Required For CPT Code 90837?

Documentation for 90837 CPT code must record total face-to-face psychotherapy time (start/stop or total minutes), the psychotherapy content/techniques used, clinical diagnosis, treatment plan/goals, and the provider’s signature/date.

• Session start and stop times or total face-to-face minutes (show ≥53 minutes for 90837).
• Presenting problem and ICD-10 diagnosis linked to therapy.
• Brief progress note of psychotherapy content (interventions, techniques, patient response).
• Treatment plan with measurable goals and frequency.
• Any E/M documentation if performed (or separate E/M + appropriate add-on code).
• Telehealth consent and platform documentation when applicable.
• Provider signature, credentials, and dated entry.

What Are Example Clinical Scenarios or Use Cases for CPT Code 90837?

CPT code 90837 is used when an individual psychotherapy session lasts 60 minutes (53 minutes or more) and involves active therapeutic intervention for a diagnosed mental health condition.

Scenario 1: PTSD with severe hypervigilance and trauma processing

ICD-10: F43.10 (Post-traumatic stress disorder, unspecified)

This diagnosis supports CPT code 90837 because the patient requires extended psychotherapy time for trauma-focused intervention, symptom regulation, and functional stabilization.

Scenario 2: Major depressive disorder with suicidal ideation and safety planning

ICD-10: F33.2 (Major depressive disorder, recurrent, severe without psychotic features)

This diagnosis supports CPT code 90837 because the session includes extended clinical time for suicide risk assessment, safety planning, and structured psychotherapy intervention.

Scenario 3: Generalized anxiety disorder with panic symptoms and functional impairment

ICD-10: F41.1 (Generalized anxiety disorder)

This diagnosis supports CPT code 90837 because the patient requires a full-length psychotherapy session to address persistent anxiety symptoms, maladaptive thought patterns, and impairment in daily functioning.

What is the Cost of CPT Code 90837?

The cost of the 90837 code CPT changes on the rates offered by Medicare, agreements with payers, and the location of the procedure. 

RVUs & Medicare Payment

CPT code 90837 has approximately 5.00 total RVUs non-facility (work 3.78, practice expense 1.20, malpractice 0.02) and about 4.05 total RVUs facility. Medicare multiplies these by the conversion factor and GPCIs to compute payment, leading to a national average payment for 60-minute individual psychotherapy is approximately $167 in 2026 for non-facility settings.

Commercial Payers

Commercial allowed amounts vary widely, and typical national commercial ranges for CPT code 90837 are roughly $130 to $200+ per session. Examples of commonly reported allowed amounts include BCBS around $158, UnitedHealthcare around $139, Aetna around $146, and Cigna around $196.

Place-of-Service & Geographic Adjustments

Place of service and geographic indices affect payment. Non-facility (office) payments are typically higher than facility outpatient payments, and local GPCIs adjust total RVUs up or down by ZIP code.

What Are the CPT Code 90837 Rules To Ensure Successful Reimbursement?

Successful reimbursement for CPT code 90837 requires careful documentation of session time, clinical necessity, and adherence to payer bundling and frequency rules. Understanding the CPT code definition helps clarify that each code represents a specific time-based psychotherapy service, which directly impacts billing accuracy and payment eligibility. To ensure compliant billing and avoid denials, follow these key rules:

Bundling / NCCI / Same-Day Procedure Rules

90837 must not be billed in a way that duplicates or overlaps services covered by other codes on the same date. Psychotherapy services (90832/90834/90837) should not be billed together for the same session. When combining psychotherapy with an E/M service, report the appropriate E/M code plus the psychotherapy add‑on code (90838) only if documentation supports a significant, separately identifiable service.

Units, MUEs & E/M Frequency Rules

Psychotherapy codes like 90837 reflect a single session per date of service. Most payers limit units to 1 per day unless there are distinct, separate encounters. Payer MUE/frequency edits often apply, and repeated same‑day sessions may require justification or pre‑authorization. Choose the correct code based on face‑to‑face time: <53 minutes → 90834; ≥53 minutes → 90837.

Top Reasons For Denials Specific To 90837 & Quick Remedies

1. Session Time Not Documented or Less Than The Required Threshold: Record exact start/stop times and total minutes; ensure 53+ minutes are clearly supported in the note.
2. Insufficient Clinical Justification For Extended 60‑minute Session: Document why the complexity, crisis intervention, or clinical needs required extended time beyond a 45‑minute session.
3. Missing or Incorrect Telehealth/Place of Service Documentation: Include patient consent, telehealth platform, patient location, and correct modifier per payer policy.
4. Overuse or Frequency Limits Flagged By Payers: Space extended 90837 sessions per treatment plan; consider prior authorization when payer policies restrict frequent 60‑minute sessions.