90837 CPT Code: Complete Guide to Billing, Documentation & Compliance

For mental health providers, the 90837 CPT code represents the cornerstone of psychotherapy billing—but it's also one of the most scrutinized codes by insurance auditors. This 60-minute individual psychotherapy session code carries specific documentation requirements that, when not met, can trigger claim denials, payment recoupments, and compliance violations.

Whether you're a solo practitioner or managing a large behavioral health organization, understanding the nuances of CPT code 90837 is essential for maintaining revenue integrity and avoiding costly audit findings.

This comprehensive guide breaks down everything you need to know about billing, documenting, and staying compliant with the 90837 CPT code.

What Is CPT Code 90837?

CPT code 90837 is defined as "Psychotherapy, 60 minutes with patient." It's the highest-level individual psychotherapy code and represents:

• Face-to-face time: 53–60 minutes of direct patient contact
• Service type: Individual psychotherapy (not group or family)
• Provider types: Licensed mental health professionals including psychiatrists, psychologists, LCSWs, LMFTs, and LPCs

The 90837 CPT code description specifically requires that the entire session be dedicated to psychotherapy—not medication management, case management, or administrative tasks.

90837 CPT Code Reimbursement Rates

Reimbursement for the 90837 CPT code varies significantly based on:

• Geographic location: Medicare rates range from $120–$180
• Insurance type: Commercial payers often reimburse 10–30% above Medicare rates
• Provider credentials: MD/PhD providers may receive higher rates than master's level clinicians
• Facility vs. non-facility: Office-based services typically reimburse higher than hospital outpatient

Current 2024 Medicare national average for 90837 is approximately $152.48 for non-facility settings.

Documentation Requirements for CPT Code 90837

Insurance auditors expect specific elements in every 90837 CPT code documentation:

1. Time Documentation

• Start and stop times must be clearly documented
• Total face-to-face time must be 53–60 minutes
• Any interruptions should be noted and time adjusted accordingly

2. Medical Necessity

• Clear diagnosis supporting need for 60-minute sessions
• Documentation of complexity requiring extended time
• Treatment plan goals addressed in session

3. Session Content

• Therapeutic interventions used
• Patient response to interventions
• Progress toward treatment goals
• Any barriers to treatment addressed

4. Clinical Rationale

• Why 60 minutes was clinically necessary (not just scheduled)
• How extended time benefited the patient
• Ongoing need for this level of service

Common 90837 CPT Code Billing Errors

Auditors frequently cite these documentation and billing mistakes:

1. Routine use without medical necessityBilling 90837 for all patients regardless of clinical needSolution: Match session length to patient acuity and document rationale
2. Billing 90837 for all patients regardless of clinical need
3. Solution: Match session length to patient acuity and document rationale
4. Time padding or roundingBilling 90837 for 50-minute sessionsSolution: Use 90834 (45 minutes) when appropriate
5. Billing 90837 for 50-minute sessions
6. Solution: Use 90834 (45 minutes) when appropriate
7. Inadequate session notesGeneric or templated documentationSolution: Include specific interventions and patient responses
8. Generic or templated documentation
9. Solution: Include specific interventions and patient responses
10. Missing time documentationNo start/stop times recordedSolution: Document exact session times, not scheduled times
11. No start/stop times recorded
12. Solution: Document exact session times, not scheduled times

When to Use 90837 vs. Other Psychotherapy Codes

Choosing the correct CPT code prevents compliance issues:

• 90832 (16–37 minutes): Brief sessions, crisis intervention
• 90834 (38–52 minutes): Standard therapy sessions
• 90837 (53–60 minutes): Complex cases requiring extended time
• 90838 (60+ minutes with E/M): Add-on code for crisis psychotherapy

The 90837 CPT code should be reserved for patients with:

• Severe symptoms requiring intensive intervention
• Complex trauma work
• Multiple comorbidities
• Crisis situations requiring extended stabilization

Insurance Audit Red Flags for 90837

Payers flag these patterns for review:

• High volume billing: More than 50% of sessions billed as 90837
• Consistent patterns: Every session with certain patients is 60 minutes
• Diagnosis mismatch: Mild conditions billed with extended sessions
• Documentation gaps: Missing time stamps or clinical rationale

Best Practices for 90837 CPT Code Compliance

1. Establish Clear Policies

• Define when 60-minute sessions are clinically appropriate
• Create documentation templates that capture required elements
• Train staff on time tracking and documentation standards

2. Implement Quality Checks

• Regular internal audits of 90837 claims
• Compare billing patterns across providers
• Review denied claims for documentation issues

3. Use Technology for Compliance

• EMR prompts for required documentation elements
• Automated time tracking to ensure accuracy
• AI-powered compliance monitoring to catch errors before billing

How Brellium Helps with 90837 CPT Code Compliance

Managing 90837 CPT code compliance across multiple providers and locations is challenging. Brellium's AI-powered platform automatically:

• Verifies time documentation: Flags sessions missing start/stop times or falling short of 53 minutes
• Checks medical necessity: Ensures documentation supports the need for extended sessions
• Identifies patterns: Alerts when providers bill 90837 at rates that may trigger audits
• Prevents claim denials: Catches documentation gaps before claims submission

By automating these compliance checks, Brellium helps behavioral health organizations reduce audit risk, improve documentation quality, and maintain appropriate billing practices.

Learn more: Brellium's Clinical Compliance Platform

Telehealth Considerations for 90837

With the expansion of telehealth, additional considerations apply:

• Modifier usage: Use modifier 95 for telehealth services
• Platform documentation: Note the telehealth platform used
• Technical issues: Document any interruptions and actual therapy time
• State regulations: Ensure compliance with state-specific telehealth rules

Future Changes to 90837 CPT Code

Stay informed about potential changes:

• CMS continues to review psychotherapy code valuations
• Documentation requirements may become more stringent
• Telehealth regulations continue to evolve post-pandemic

Regular training and compliance monitoring help practices adapt to changing requirements while maintaining revenue integrity.

External Resources for 90837 CPT Code

1. American Medical Association CPT Resources – Official CPT code descriptions and updates
2. CMS Physician Fee Schedule – Current Medicare reimbursement rates
3. APA Practice Central – Billing and coding resources for mental health providers