60 minutes of individual psychotherapy is reported using the 90837 CPT code. It is used in situations where psychotherapy is delivered without an evaluation and management service. Documented psychotherapy time is used by Medicare for the selection of the individual psychotherapy codes. The Medicare code 90837 is supported for 53 minutes or more.
This guide covers the 90837 CPT code description, billing code, time period, documentation, reimbursement and modifiers. It also compares 90837 with 90834 and 90838.
Quick Answer
90837 is the psychotherapy code for 60 minutes with the patient. Medicare pays for 53 minutes or more to report 90837. The service does not include a separate E/M service. Documentation to support psychotherapy time, medical necessity, treatment provided and diagnosis reported.
| Field | Information |
|---|---|
| CPT Code | 90837 |
| Service | Individual psychotherapy |
| CPT Descriptor Time | 60 minutes |
| Medicare Time Range | 53 minutes or more |
| E/M Included | No |
| Common Comparison | 90834 |
| Related Psychotherapy Add-on | 90838 |
| Time-Based Code | Yes |
| Common Use | Individual psychotherapy |
What Is the 90837 CPT Code Description?
The 90837 CPT code description identifies psychotherapy lasting 60 minutes with the patient. The service represents psychotherapy without a separate E/M component. This distinguishes 90837 from 90838, which is an add-on psychotherapy code.
The distinction becomes important when reviewing claims. A provider may perform psychotherapy alone during one encounter. Another encounter may include psychotherapy with a separately identifiable E/M service. Those situations use different coding structures.
What Is the 90837 cpt code Time Range?
The 90837 time range depends on the applicable payer’s rules. For Medicare, 90837 is generally selected for 53 minutes or more of psychotherapy. Medicare uses 16 to 37 minutes for 90832 and 38 to 52 minutes for 90834.
| CPT Code | CPT Time | Medicare Timing Range |
|---|---|---|
| 90832 | 30 minutes | 16–37 minutes |
| 90834 | 45 minutes | 38–52 minutes |
| 90837 | 60 minutes | 53 minutes or more |
These ranges should not be treated as universal payer rules. Commercial insurers may publish their own billing policies. Always verify the current payer requirements before submitting claims.
Does 90837 cpt code Require Exactly 60 Minutes?
No, Medicare does not require exactly 60 minutes for reporting 90837. Medicare’s methodology uses the code closest to the actual documented psychotherapy time. Therefore, 53 minutes or more generally supports 90837 under Medicare rules.
For example, a documented 55-minute psychotherapy session can generally support 90837 for Medicare. A documented 50-minute session generally falls within the 90834 range. These examples assume all other applicable requirements are satisfied.
The important point is accurate time documentation. Providers should not extend documented time simply to reach a higher-paying code. The record should reflect what actually occurred during the encounter.
What Documentation Supports 90837 cpt code?
Documentation should clearly support the psychotherapy service reported on the claim. It should establish the clinical reason for treatment and demonstrate medical necessity. Time documentation is especially important because 90837 is a time-based psychotherapy code.
Medicare guidance requires start and stop times or total psychotherapy time. The documented time should represent the psychotherapy service itself. When psychotherapy accompanies E/M services, E/M time should not be included in psychotherapy time.
A useful record may include the following information:
- Date of service
- Patient identification
- Psychotherapy start and stop times
- Total psychotherapy time
- Clinical issues addressed
- Therapeutic interventions
- Patient response
- Progress toward treatment goals
- Medical necessity
- Treatment plan connection
- Diagnosis information
- Provider identification and signature
The exact documentation format can vary between payers. However, the record should consistently support the service billed. A reviewer should understand what happened and why psychotherapy was necessary.
Why Is Time Documentation Important for 90837 cpt code?
Medicare’s methodology requires a psychotherapy code to be used depending on the time. As a result, a time without support may result in coding and payment issues. CMS is very specific about the start/stop time or total time for any 90832, 90834 and 90837.
For instance, “one hour therapy session” might give minimal assistance. This record will include actual psychotherapy time, which gives a better indication. The clinical note and claim should be consistent as well.
This distinction is important during audits. Reviewers may compare documented time with the reported CPT code. Inconsistent records can raise questions about coding accuracy and medical necessity.
How Is the 90837 Billing Code Used?
The 90837 billing code is used when the documented psychotherapy service meets the applicable coding requirements. For Medicare, the provider should select the psychotherapy code closest to actual time. The service must also satisfy medical necessity and documentation requirements.
Before submitting a 90837 claim, review the following:
- Confirm psychotherapy was actually provided.
- Verify the documented psychotherapy time.
- Confirm medical necessity.
- Review the diagnosis supporting treatment.
- Confirm provider eligibility.
- Check authorization requirements when applicable.
- Verify place-of-service information.
- Review telehealth requirements when applicable.
- Check applicable modifier requirements.
- Confirm payer-specific billing policies.
This process helps align the clinical record with the submitted claim. It also helps identify errors before they become payment problems.
Can 90837 cpt code Be Billed With an E/M Code?
90837 is Psychotherapy not including medical E/M service. Generally an add-on psychotherapy code is used instead of psychotherapy performed with E/M. CMS classifies the six minute psychotherapy add-on code as CMS 90838.CMS recognizes the six-minute psychotherapy add-on code as CMS 90838.
The E/M service and psychotherapy must be substantial and distinct. Also, psychotherapy time should not be billed at the same time as E/M time. CMS specifically states that E/M time should not be included in psychotherapy time.
90837 vs 90834
The main difference between 90834 vs 90837 cpt code is psychotherapy time. Both codes represent psychotherapy without a separate E/M service. However, Medicare assigns different time ranges to each code.
| Feature | 90834 | 90837 |
|---|---|---|
| Service | Psychotherapy | Psychotherapy |
| CPT Descriptor | 45 minutes | 60 minutes |
| Medicare Range | 38–52 minutes | 53+ minutes |
| E/M Included | No | No |
| Common Distinction | Shorter session | Longer session |
A documented 45-minute session generally supports 90834 under Medicare. A documented 55-minute session generally supports 90837. The record must support the actual time and service provided.
90834 vs 90837: Which Code Should Be Used?
The answer depends on documented psychotherapy time. Providers should not choose between these codes based only on scheduled appointment length. The actual service should guide code selection.
Medicare specifically instructs providers to select the code closest to actual psychotherapy time. This approach helps prevent both unsupported upcoding and inaccurate undercoding.
90837 vs 90838
The primary difference between 90837 vs 90838 involves the E/M component. Both codes represent psychotherapy associated with a 60-minute service. However, 90837 represents psychotherapy without E/M. Code 90838 is an add-on code used with an appropriate E/M service.
| Feature | 90837 | 90838 |
|---|---|---|
| Psychotherapy | 60 minutes | 60 minutes |
| E/M Service | No | Yes |
| Code Type | Standalone psychotherapy | Add-on psychotherapy |
| Medicare Range | 53+ minutes | 53+ minutes |
| Billing Structure | Psychotherapy alone | E/M plus psychotherapy |
This separation helps to avoid a common coding mistake. 90838 should not be reported if the psychotherapy was 60 minutes. A qualifying E/M service should also be provided.
What Modifiers Apply to 90837 cpt code?
The modifier to be used with CPT code 90837 will vary based on the manner in which the psychotherapy service is provided. There is no single modifier that will be required for all 90837 claims. The modifier should instead be used to indicate the circumstances of the service and the rules for reimbursement.
Modifier 95 for Telehealth
When 90837 is furnished with qualifying simultaneous (synchronous) telehealth, modifier 95 may be used. For certain professional telehealth services, there is specific guidance for modifier 95 from CMS. The claim should also include the correct telehealth place of service (POS) code.
For Medicare, POS 10 identifies telehealth services provided when the patient is located at home. POS 02 identifies telehealth services provided when the patient is located somewhere other than home. These place-of-service codes can affect payment.
Modifier 93 for Audio-Only Telehealth
Modifier 93 is used for eligible synchronous audio-only services under applicable Medicare telehealth rules. CMS states that audio-only Medicare telehealth services may require modifier 93. The applicable service and technology requirements must also be satisfied.
This does not mean every 90837 performed by telephone automatically qualifies. The service must meet current Medicare telehealth requirements. Payer-specific rules may also differ from traditional Medicare requirements.
Modifier 25 and 90837 cpt code
Modifier 25 is not routinely appended to 90837 simply because another service occurred. It is generally associated with a significant, separately identifiable E/M service. Psychotherapy with E/M is instead reported using the appropriate psychotherapy add-on code when requirements are met.
For example, 90837 represents psychotherapy without medical E/M. When psychotherapy is performed with a qualifying E/M service, 90838 is the corresponding 60-minute psychotherapy add-on code.
Modifier 59 and 90837 cpt code
Modifier 59 should not be added automatically to 90837. Modifier 59 is intended to identify a distinct procedural service when applicable requirements are satisfied. Its use depends on the specific claim circumstances and payer edits.
A coder should first determine why the services are considered distinct. The documentation must support that distinction. A modifier should never be added merely to force separate payment.
Modifier KX and 90837 cpt code
Modifier KX is not a routine modifier for CPT 90837 psychotherapy claims. CMS uses the KX modifier for certain outpatient therapy services when services exceed applicable Medicare therapy thresholds. However, this policy should not be confused with behavioral health psychotherapy coding.
For CY 2026, CMS lists the KX threshold as $2,480 for physical therapy and speech-language pathology combined. The threshold is also $2,480 for occupational therapy. These thresholds concern outpatient therapy services and do not establish a routine KX requirement for 90837.
90837 cpt code RVU Values for 2026
For 2026, CPT 90837 has a work RVU of 3.78. Its practice expense RVU is 1.20 in the non-facility setting. The facility practice expense RVU is 0.25. The malpractice RVU is 0.02.
| 2026 RVU Component | Non-Facility | Facility |
|---|---|---|
| Work RVU | 3.78 | 3.78 |
| Practice Expense RVU | 1.20 | 0.25 |
| Malpractice RVU | 0.02 | 0.02 |
| Total RVUs | 5.00 | 4.05 |
These values come from CMS’s July 2026 Physician Fee Schedule relative value file. CMS identifies RVU26C as the July 2026 release.
The difference between facility and non-facility totals comes from practice expense. The non-facility calculation uses 1.20 PE RVUs. The facility calculation uses 0.25 PE RVUs. Therefore, the totals are 5.00 and 4.05 RVUs, respectively.
90837 cpt code Medicare Reimbursement for 2026
The 2026 Medicare Physician Fee Schedule uses geographic adjustments. It also uses different conversion factors for qualifying APM participants and other practitioners. CMS reports a $33.57 conversion factor for qualifying APM participants. The non-qualifying APM conversion factor is $33.40.
Using the July 2026 non-QP conversion factor of $33.4009, the national payment amount at GPCI values of 1.000 can be calculated. The non-facility amount is approximately $167.00. The facility amount is approximately $135.27.
| CPT 90837 Payment Data | 2026 Amount |
|---|---|
| Non-facility Total RVUs | 5.00 |
| Facility Total RVUs | 4.05 |
| Non-QP Conversion Factor | $33.4009 |
| National Non-Facility Amount at GPCI 1.000 | $167.00 |
| National Facility Amount at GPCI 1.000 | $135.27 |
These are national reference amounts, not guaranteed reimbursement rates. Actual Medicare payment changes according to the locality’s GPCIs and other applicable payment adjustments. CMS publishes the underlying national payment files for this purpose.
How Is the 90837 cpt code Medicare Amount Calculated?
Medicare applies the work, practice expense, and malpractice RVUs after geographic adjustment. The resulting adjusted RVUs are multiplied by the applicable conversion factor. CMS explains that geographic practice cost indices account for cost differences between geographic areas.
For a national illustration, the non-facility calculation is 5.00 RVUs × $33.4009. This produces approximately $167.00 before locality-specific adjustments. The facility calculation is 4.05 RVUs × $33.4009. This produces approximately $135.27.
Important Note About 90837 cpt code Reimbursement
The $167.00 figure should not be presented as the universal 90837 reimbursement rate. It represents a national calculation using GPCI values of 1.000. Actual Medicare payment can differ by locality and applicable provider status.
For example, the July 2026 calculation for Los Angeles produces a non-facility allowed amount of approximately $179.29. That difference results from the locality’s geographic practice cost indices.
This is exactly why the article should distinguish RVU value, national payment amount, and actual payer reimbursement. Commercial insurance payments can differ substantially because contracted rates and benefit arrangements are not determined by Medicare’s national payment amount.
How Much Does Aetna Pay for 90837 cpt code?
There is no single national Aetna reimbursement amount for CPT 90837. Aetna payment depends on the applicable provider contract, member benefit plan, fee schedule, and payment arrangement.
Therefore, the 2026 Medicare amount of $167.00 should not be described as Aetna’s 90837 rate. Aetna’s provider resources include payment and fee-schedule tools for determining applicable contracted amounts.
For an article targeting medical coders and billers, this distinction is important. Medicare reimbursement and commercial payer reimbursement should never be presented as interchangeable figures.
Common 90837 cpt code Billing Mistakes
Billing 90837 for Every Hour-Long Appointment
An appointment scheduled for one hour does not automatically support 90837. The documented psychotherapy time should support the selected code.
Reporting Unsupported Psychotherapy Time
The medical record should support the time reported on the claim. CMS requires total time or start and stop times for these psychotherapy codes.
Confusing 90837 cpt code With 90838
90837 represents psychotherapy without E/M. Code 90838 represents psychotherapy performed with a qualifying E/M service.
Including E/M Time in Psychotherapy Time
Psychotherapy time should remain separate from E/M time. CMS specifically addresses this distinction for psychotherapy with E/M services.
Ignoring Medical Necessity
Correct CPT selection does not automatically establish medical necessity. The clinical record should support the need for psychotherapy.
Using Unsupported Modifiers
Modifiers should describe actual billing circumstances. They should not be added solely to obtain separate payment.
Ignoring Payer-Specific Requirements
Medicare rules do not automatically apply to every commercial payer. Aetna and other insurers may establish additional requirements.
Real-World 90837 Coding Examples
Example 1: 55-Minute Psychotherapy Session
A patient receives 55 minutes of documented individual psychotherapy. The session addresses established treatment goals and meets applicable medical necessity requirements. Under Medicare’s timing methodology, 90837 generally represents the documented psychotherapy time.
The claim must still satisfy other Medicare requirements. Commercial payer policies should also be checked before submitting the claim.
Example 2: 50-Minute Psychotherapy Session
A patient receives 50 minutes of documented individual psychotherapy. There is no separate E/M service during the encounter. Under Medicare’s timing methodology, 90834 generally represents this service.
Reporting 90837 would generally not match the Medicare time range. The record should continue to reflect the actual psychotherapy time.
Example 3: Psychotherapy With E/M
A qualified provider performs a separately identifiable E/M service. The provider also provides psychotherapy during the encounter. The documentation supports both services independently.
In this situation, 90838 may apply instead of 90837. The appropriate E/M code must also satisfy its own coding requirements.
90837 cpt code Audit Considerations
A 90837 audit should begin with the medical record. The auditor should compare documented services with the submitted claim. Time is especially important because 90837 is a time-based code.
An audit may evaluate whether the record supports:
- Actual psychotherapy time
- Medical necessity
- The reported diagnosis
- Treatment goals
- Psychotherapy interventions
- Patient response
- Provider eligibility
- E/M services when applicable
- Modifier use
- Payer-specific requirements
CMS requires documentation supporting the selected CPT and ICD-10-CM codes. Records should also be available for review when requested.
The strongest documentation creates a clear connection between treatment and clinical need. It also provides enough detail to explain the service without unnecessary information.
90837 cpt code and Prolonged Psychotherapy
A 90837 session can involve more than 60 minutes of psychotherapy. Medicare guidance allows a prolonged service code when psychotherapy without E/M reaches 90 minutes or more. The medical record must support the prolonged face-to-face time and medical necessity.
This rule should not be interpreted as permission to automatically add prolonged services. The applicable prolonged-service requirements must be satisfied.
The distinction is also important for 90838. CMS states that prolonged services may not be reported with psychotherapy performed with E/M services.
Key Takeaways
Medicare typically chooses for 60 minutes or more when picking 90837. Code selection should be based on actual documented psychotherapy time. Medicare typically pays for 38 to 52 minutes, or more, in 90834. A qualifying E/M service plus 90838 is billed for therapy that is conducted in 90 minutes.
The 90837 reimbursement rate does not have a single set rate. Aetna payment is subject to the contract, fee schedule, benefits and payment agreement. Accurate coding is all about accurate clinical documentation. Providers and coders need to confirm the current requirements of payers prior to claiming.
