Code of the Month: CPT 90837 – How to Bill Extended Psychotherapy Sessions Correctly

Extended psychotherapy sessions can be crucial for patients facing serious mental health conditions. But if you’re billing for them incorrectly, you could be facing denials, audits, or delayed payments — especially when using CPT 90837.

This comprehensive guide from offshore medical billing company- Reenix Excellence explains everything providers need to know about CPT 90837 billing guidelines — from session length requirements to payer compliance.

What is CPT 90837?

CPT 90837 is used to report individual psychotherapy sessions lasting 60 minutes, provided by a licensed mental health professional. According to official coding guidance, the session must last at least 53 minutes.

1. Services can be delivered in-person or via telehealth, depending on payer policies.
2. The code is appropriate for psychiatrists, psychologists, clinical social workers (LCSWs), and licensed counselors.

When Should You Use CPT 90837?

You should report CPT 90837 when:

• The psychotherapy session is 53 minutes or longer
• The provider offers psychotherapy only (not combined with an E/M service)
• The session addresses mental, emotional, or behavioral health disorders
• The patient’s condition justifies extended time due to complexity or severity

Clinical Scenarios That Warrant 90837:

• Trauma therapy (e.g., PTSD, complex grief)
• Treatment-resistant depression or anxiety
• Borderline personality disorder with DBT
• High-risk suicidal ideation requiring deep therapeutic engagement

CPT 90837 Billing Guidelines: Documentation Essentials

Billing CPT 90837 comes with greater scrutiny due to its higher reimbursement. Following accurate CPT 90837 billing guidelines is essential for claim approval.

Your session notes should include:

✔ Start and end times (total time documented)
✔ Description of psychotherapy interventions used
✔ Patient’s response to treatment
✔ Evidence of medical necessity for extended time
✔ Diagnosis and therapeutic goals

Missing time documentation is one of the most common denial reasons for CPT 90837.

CPT 90837 vs. CPT 90834: Know the Difference

CPT Code	Time Requirement	Use Case
90834	38–52 minutes	Standard psychotherapy session
90837	53+ minutes	Extended psychotherapy due to complexity

Don’t upcode. Using 90837 instead of 90834 without justification is a compliance risk.

Why Do CPT 90837 Claims Get Denied?

Despite being valid, CPT 90837 is frequently denied due to:

• Session time less than 53 minutes
• No medical necessity for extended care
• Lack of psychotherapy documentation
• Overuse of the code (pattern detected by payers)
• Payers requiring prior authorization for frequent 90837 use

Properly following CPT 90837 billing guidelines helps reduce these denial risks significantly.

CPT 90837 and Telehealth:

Many payers allow CPT 90837 to be billed via telehealth, as long as:

• Services are delivered synchronously (real-time audio + video)
• The provider uses the correct telehealth modifier (e.g., 95 or GT)
• The session still meets the 53+ minute requirement

Always verify the payer’s most current telehealth policy before submitting claims.

How Reenix Excellence Supports CPT 90837 Billing?

At Reenix Excellence, we help behavioral health providers across the U.S. streamline and safeguard their psychotherapy billing — especially for high-risk codes like 90837.

What We Offer:

1. Real-time claim scrubbing to catch time errors
2. Modifier and documentation compliance
3. Payer-specific rules for 90837 use
4. Prior auth support where needed
5. Denial tracking and appeals

By applying industry-standard CPT 90837 billing guidelines, our team helps reduce rejections, recover delayed payments, and improve compliance.

Client Snapshot: 4-Provider Behavioral Health Group

One of our clients — a growing therapy group in Illinois — was facing frequent 90837 denials due to inconsistent session notes.

After working with Reenix:

• Session times were standardized using new templates
• Denials dropped by 38% within 60 days
• Reimbursements for 90837 increased by over $18,000 in one quarter
• Compliance audit readiness improved significantly

FAQ:

1. How many minutes are required for CPT 90837?

At least 53 minutes of documented psychotherapy.

2. Can I use CPT 90837 for telehealth?

Yes — if allowed by the payer and paired with the correct modifier (usually 95 or GT).

3. Does CPT 90837 require medical necessity?

Absolutely. You must justify the extended time with clear clinical reasons and therapeutic interventions.

Final Thoughts

Extended therapy sessions are essential for many patients — but coding them incorrectly puts your revenue and compliance at risk.

Following proper CPT 90837 billing guidelines ensures:

• Fewer denials
• Faster payments
• Audit-proof documentation
• Better revenue outcomes

Let Reenix Excellence take the billing burden off your plate, so you can focus on what matters most — patient care.

Let’s Talk

Need help reducing denials and improving collections on behavioral health codes?

Book a FREE billing audit with Reenix Excellence today.

References

1. CPT® 2023 Codebook, American Medical Association
2. CMS Psychotherapy Services Guidelines
3. APA Practice Organization – Coding & Reimbursement Support