The difference between 90837 and 90834 is time. 90834 is for psychotherapy sessions of 38 to 52 minutes, and 90837 is for sessions of 53 minutes or more. A 45 or 50-minute session is a 90834; a full 55 or 60-minute session is a 90837. The note has to show the time either way.
90837 vs. 90834 side by side
| 90834 | 90837 | |
|---|---|---|
| Descriptor time | 45 minutes | 60 minutes |
| Time range billed | 38 to 52 minutes | 53 minutes or more |
| Add-on with an E/M visit | +90836 | +90838 |
| Payment | Lower | Higher (more work) |
| Payer scrutiny | Routine | Some payers review frequent use or require authorization |
How to choose the right code
- Add up the psychotherapy time spent with the patient and/or family, with the patient present for all or part of it.
- Do not count time for documentation after the session or for unrelated tasks.
- Under 53 minutes, bill 90834 (or 90832 below 38). At 53 minutes or more, bill 90837.
- Record start and stop times or the total time in the note.
Is it worth scheduling 60-minute sessions?
That is a clinical decision first. Financially, 90837 pays more per session, but it also takes a longer slot and draws more payer review. Compare the payment per hour of clinician time in your own contracts using your fee schedules and the CMS Physician Fee Schedule look-up tool (opens in a new tab) before changing your schedule.
Frequently asked questions
Can I bill 90837 for a 52-minute session?
No. 52 minutes falls in the 90834 range. 90837 starts at 53 minutes.
Will billing 90837 often trigger an audit?
It can draw attention when it is much higher than peers, but accurate, time-documented 90837 claims are appropriate. The protection is documentation, not avoiding the code.
Related mental health billing guides
- CPT 90791: psychiatric diagnostic evaluation
- CPT 90832: 30-minute psychotherapy
- CPT 90834: 45-minute psychotherapy
- CPT 90837: 60-minute psychotherapy
- CPT 90785: interactive complexity add-on
- Mental health billing services
CPT is a registered trademark of the American Medical Association. Code rules change every year, and payer policies differ. This guide reflects general guidance at the time of writing; your payer contracts and documentation decide what is billable.
Not sure your codes match your sessions?
We review a sample of your psychotherapy notes and claims and show you where the time and the code disagree.