Understanding medical bills and insurance codes can feel confusing, especially when a five-digit number like 90837 shows up without any real explanation attached to it. If you’ve come across this code on a therapy invoice, an insurance statement, or a provider’s website and want a straightforward answer, this guide covers exactly what it means, who uses it, and what it costs.
This blog covers everything from the basic definition of CPT 90837 to session length, billing rules, insurance coverage, telehealth use, and common reasons claims get denied. By the end, you’ll have a clear picture of how this code works and what to expect from it, whether you’re a patient trying to understand a bill or a provider brushing up on billing details.
What Is CPT Code 90837?
CPT stands for Current Procedural Terminology, a standardized set of codes healthcare providers use to tell insurance companies what service was provided. Think of a CPT code as a shorthand label on a medical bill.
CPT 90837 refers to individual psychotherapy, which means a one-on-one therapy session between a mental health provider and a patient. The code is generally used when the session lasts 53 minutes or longer. Shorter therapy sessions use different CPT codes.
Mental Health Billing SRG provides 90837 sessions, in which the therapist and patient may discuss emotions, work through a specific problem, develop coping strategies, or continue treatment for an ongoing mental health concern. The code is for individual therapy, not couples or group therapy.
For example: If a patient has a 55-minute one-on-one therapy session to discuss anxiety triggers and develop coping strategies, the provider may bill the session using CPT 90837.
How Long Is a CPT 90837 Session?
A 90837 session is 53 minutes or longer of actual face-to-face therapy time. You’ll often see it marketed or referred to as a “60-minute therapy session” that’s just a common shorthand, since most sessions billed this way land somewhere around the 53-60+ minute mark. The label “60 minutes” isn’t a strict rule, though; it’s the general expectation, not the exact clock time in every session.
Who Can Bill CPT 90837?
Providers who can bill this code generally include:
- Psychologists
- Psychiatrists
- Licensed therapists and counselors (LPC, LMFT, LCSW, etc., depending on state licensing)
- Clinical social workers
- Other licensed mental health providers authorized under their state and insurance plan to provide psychotherapy
Billing eligibility can vary slightly by insurance plan and state licensing rules.
When Is CPT 90837 Used?
A longer session like 90837 might be used when a client needs more time to work through a topic in depth, when a session involves processing something complex, or when the standard 45-minute session isn’t enough to cover what needs to be addressed that day. It doesn’t automatically mean the person has a severe or more serious condition; it simply reflects that a longer session was clinically appropriate for that visit.
CPT 90837 vs 90834 vs 90832
Code | Simple meaning | Time |
90832 | Short therapy session | 16–37 min |
90834 | Standard therapy session | 38–52 min |
90837 | Longer therapy session | 53+ min |
These time ranges are also reflected in Berries’ psychotherapy-code comparison.
How Much Does CPT 90837 Cost?
The cost of a 90837 session depends on several factors:
- The provider’s individual rate or their contracted insurance rate
- Geographic location (rates vary by state and even by city)
- Whether the session is billed through insurance or paid out of pocket (self-pay)
- The specific insurance plan’s negotiated reimbursement rate with that provider
Self-pay rates are typically set directly by the provider, while insurance-billed rates follow whatever rate the insurer has negotiated. This is why the same code can cost noticeably different amounts depending on the provider and where you live.
Does Insurance Cover CPT 90837?
Most private insurance plans do cover 90837, since it’s a standard, widely recognized psychotherapy code. Medicare and Medicaid also generally cover it, though specifics can vary by state Medicaid program.
Coverage details that can differ by plan:
- Whether it’s subject to a deductible before insurance pays
- Copay or coinsurance amount
- Whether the provider is in-network or out-of-network
- Session limits or prior authorization requirements
Because coverage varies so much plan to plan, it’s worth verifying individual benefits directly with the insurance provider before assuming a session is fully covered.
CPT 90837 and Telehealth
Yes, CPT 90837 can be used for telehealth sessions. Many insurers now accept this code for video-based therapy, often with a telehealth modifier or place-of-service code attached to the claim to indicate it wasn’t an in-person visit. The therapy itself is treated the same as an in-person session, the coding just reflects the format.
CPT 90837 vs 90839
90837 and 90839 look similar but serve different purposes. 90837 is for standard individual psychotherapy that are planned, ongoing sessions. 90839 is used specifically for psychotherapy for crisis, meaning an urgent session addressing an acute crisis situation rather than routine treatment. The two codes aren’t interchangeable, and using the wrong one can lead to claim issues.
Why Can a CPT 90837 Claim Be Denied?
Common reasons a 90837 claim gets denied include:
- Incorrect coding since charge entry is where codes first get entered before submission.
- Documentation that doesn’t support the time or service billed
- Insurance-specific requirements not being met (like missing prior authorization)
- The provider being out-of-network for that particular plan
- Exceeding session limits set by the insurance plan
What Should Be Documented for CPT 90837?
Good documentation for a 90837 session typically includes:
- How long the session actually lasted
- What type of therapy or intervention was provided
- What topics or issues were discussed or treated
- Notes on the patient’s progress
- Justification for why the longer session length was appropriate that day
Need Help With Medical Billing?
Have questions about CPT 90837 or other medical billing codes? Contact our team today for professional medical billing support. We can help you with accurate coding, claim submission, and reimbursement.
Frequently Asked Questions
Q: Is CPT 90837 for individual therapy?
Yes, it’s specifically for individual (one-on-one) psychotherapy sessions.
Q: What is the difference between 90834 and 90837?
90834 covers 38–52 minute sessions; 90837 covers sessions 53 minutes or longer.
Q: What is the difference between 90837 and 90839?
90837 is for standard psychotherapy; 90839 is specifically for crisis psychotherapy.
Q: Does CPT 90837 tell me my diagnosis?
No, it only reflects the type and length of session provided, not a specific diagnosis.
