CPT 90837: 60-Minute Individual Psychotherapy
CPT 90837: 60-Minute Individual Psychotherapy, Explained
CPT 90837 covers an individual psychotherapy session lasting 53 minutes or longer. It’s the highest-reimbursing individual therapy code, which also makes it the one payers scrutinize most closely.
What is CPT 90837?
90837 is a time-based psychotherapy code used when a clinician provides individual psychotherapy to a patient for 53 minutes or more, face-to-face. It sits at the top of the standard individual therapy time tiers, above 90834 (38-52 minutes) and 90832 (16-37 minutes).
It’s billed per session, not per hour, so a 53-minute session and a 90-minute session are both reported the same way under this single code. There’s no separate code for sessions running longer than an hour.
When to use it
Use 90837 when the actual face-to-face time with the patient, and documented as such in the note, reaches 53 minutes or more. It applies to individual therapy across most clinical modalities (CBT, psychodynamic, etc.), it’s not tied to a specific treatment approach, only to time and the individual (not group or family) format.
The time threshold is strict. A session documented at 50 minutes doesn’t round up to 90837, it falls under 90834. Billing based on the scheduled appointment length rather than the actual, documented session length is one of the most common unintentional errors practices make.
What your documentation needs to show
The clinical note needs to clearly state the session’s actual start and end time, or total minutes spent, not just “60-minute session” as a label. Payers reviewing a 90837 claim are specifically checking whether the documented time supports the code, a note that only describes the content of the session without a clear time reference is a common point of failure during audits.
Beyond time, the note still needs everything a standard therapy note requires, the interventions used, the patient’s response, and how the session connects to the treatment plan and diagnosis.
Common reasons this code gets denied
Time not clearly documented. This is the single most frequent issue. If the note doesn’t make the 53+ minute threshold obvious, expect a downcode or denial on review.
Usage patterns flagged against peer benchmarks. Some payers compare how often a provider bills 90837 relative to 90834 against typical patterns for similar practices. Billing it disproportionately more often than peers can trigger added scrutiny, even when every individual claim is accurate.
Same-day billing conflicts. Billing 90837 alongside certain other services on the same date, without the correct modifier, can trigger a bundling denial depending on the payer.
Frequency limits. A handful of payers cap how many 90837 sessions they’ll reimburse per patient within a given period without additional clinical justification.
Related codes
Frequently asked questions
Can I bill 90837 for a 50-minute session? +
No. The threshold for 90837 is 53 minutes or more. A 50-minute session falls under 90834 (38-52 minutes), even if it was scheduled as a 60-minute appointment.
Is there a time cap on how long a 90837 session can be? +
No upper limit is defined by the code itself, a 53-minute session and a 90-minute session are both billed as 90837. That said, unusually long sessions billed frequently can draw payer attention, so documentation matters even more at the high end.
Why do we keep getting denied even though our notes look complete? +
Usually it comes down to the note describing what happened in the session without clearly stating the actual time spent. A thorough clinical note and a billing-ready note aren’t always the same thing, the time documentation has to be explicit, not implied.
Seeing a pattern of 90837 denials?
We work specifically with behavioral health practices. A free audit looks at your actual claims and shows you exactly what’s behind your denial pattern, not a generic checklist.