CPT 90837: Time Rules, Documentation, and Audit-Proofing Your Notes

CPT 90837 is the code for the longest individual psychotherapy sessions, and it gets more scrutiny from payers than the shorter codes. Below is how the time rules work, what auditors look for in your notes, how reimbursement and telehealth billing vary by payer, and a simple structure for documenting why a session ran 53 minutes or more.

What is CPT code 90837?

The 90837 CPT code is used for individual psychotherapy lasting 53 minutes or more. Although CPT describes 90837 as “psychotherapy, 60 minutes,” the billing threshold begins at 53 minutes of psychotherapy time.

The code should match the service that was actually provided. The record should support the psychotherapy time billed and the clinical work performed during that time.

Therapists and other qualified behavioral-health clinicians may use 90837 when the service, their credentials, and the patient’s plan allow it. Payer rules still matter, especially when documentation or telehealth requirements differ. CMS classifies 90832, 90834, and 90837 as time-based psychotherapy codes and requires documentation of start and stop times or total psychotherapy time (CMS psychotherapy billing guidance).

90837 vs 90834 vs 90832: time ranges and when each applies

The three common individual psychotherapy codes are separated by time:

These are time-based codes. CMS requires start and stop times or total psychotherapy time to be documented for 90832, 90834, and 90837. Psychotherapy lasting less than 16 minutes is not reported with these codes (CMS psychotherapy billing guidance).

90837 vs 90834

The 90837 time range begins at 53 minutes, while 90834 covers 38–52 minutes. If the documented psychotherapy time is 50 minutes, 90834 falls within the applicable range. At 55 minutes, the service falls within the 90837 range.

The distinction matters because the note and the submitted code should tell the same story. A scheduled “60-minute session” is not a substitute for documenting the psychotherapy time actually provided.

Time alone is not the whole picture. The record should also support why the service was clinically appropriate for that patient. Payer standards differ, so clinicians should check the requirements of the patient’s plan rather than assuming one payer’s rules apply everywhere.

What do payers look for when they audit therapy notes?

When a payer reviews psychotherapy claims, it may request the intake or assessment, diagnosis, treatment plan, progress notes, and information showing the date, time, and type of service provided. The broader question is whether the record supports the medical necessity of treatment and the CPT code and time billed.

If a post-payment review finds that the documentation does not support the service billed, the result can include recoupment, often referred to as a clawback.

The exact request varies by payer and by the type of review, but the same documentation themes appear repeatedly in Medicare guidance and commercial-payer record standards. Aetna’s current behavioral-health record criteria, for example, include a diagnosis, treatment plan, and a progress note for every session (Aetna Provider and Behavioral Health Manual).

A practical pre-audit checklist

• Assessment and diagnosis: The presenting problem, relevant history, symptoms, functional concerns, and a diagnosis supported by the record.
• Treatment plan: Current goals that connect to the diagnosis and provide a way to evaluate progress.
• Progress notes: A note for each billed session showing what was addressed, the interventions used, and the patient’s response or progress.
• Date and psychotherapy time: The date of service and either total psychotherapy time or start and stop times when time determines the code.
• Type and modality of service: Enough information to identify what was provided and, when relevant, whether the encounter was in person or delivered by telehealth.
• Medical necessity: Documentation connecting treatment and its duration to the patient’s symptoms, functioning, treatment goals, and clinical needs.
• Authentication: The clinician’s signature or electronic identifier and professional credentials, along with any other payer-specific requirements.

A reviewer is not simply looking for the presence of a note. The pieces should agree. The diagnosis should make sense with the treatment plan, the progress note should reflect the work performed, and the documented psychotherapy time should support the code submitted. Treat this as a preparation checklist, not as a promise that every payer will request the same records in the same way.

Time-justification documentation: why specific fill-ins beat copy-paste

There is no universal sentence that makes a 90837 note defensible. What matters is that the record supports the psychotherapy time billed, the work performed, and the medical necessity of the service.

If you want the reason for a 53-minute-or-longer session to be easy to find during a review, a simple structure can help:

This is where copy-paste becomes risky. A CMS fact sheet on behavioral-health documentation cautions against cloned notes that appear identical across visits because they may not reflect the uniqueness of the encounter (CMS behavioral-health documentation guidance). Reusing a structure is different from reusing a finished note. A useful template keeps the recurring pieces organized while leaving the clinical content specific to that session.

Text Blaze’s Therapy Progress Note Templates (SOAP, DAP, BIRP) are built around that idea. Type a shortcut such as /soap in the field where you already chart, fill in the details that change for that session, and the structure appears with those details in place. The clinician still supplies the clinical content.

Get the progress-note pack and adapt the structure to the way you document.

Payer differences and 90837 reimbursement

There is no universal reimbursement amount for 90837. What a clinician is paid can vary by contract, plan, geographic market, network status, year, and other payment arrangements.

How much does Aetna pay for 90837?

There is not one Aetna rate that applies to every clinician. Aetna’s provider cost estimator uses the provider’s applicable fee schedule together with the patient’s benefit plan to estimate what Aetna may pay and what the patient may owe. Aetna also notes that its separate physician fee-schedule tool is not available to behavioral-health providers who are not MDs or DOs. For your own 90837 reimbursement, check the payment tools in your provider portal, your contract, and remittance information from processed claims (Aetna payment estimator and fee-schedule guidance).

How much does Cigna pay for 90837?

The same principle applies to Cigna Healthcare behavioral-health benefits administered through Evernorth. The applicable reimbursement terms come from the provider agreement, while what is payable on a particular claim also depends on the patient’s benefit plan (Evernorth Behavioral Health Administrative Guidelines).

If you want your actual 90837 rate, start with the payment information in your payer or provider portal, your contract, and remittance information from processed claims. An EOB, explanation of payment, or electronic remittance can show the allowed and paid amounts for that claim.

The useful number is the rate that applies to your contract and your patient’s plan, not a dollar amount quoted in an article or discussion forum.

Telehealth billing for 90837: check the payer before adding a modifier

CPT 90837 can be furnished as a telehealth service when the payer’s requirements are met, but do not assume every telehealth claim should simply be submitted as 90837-95.

For Medicare professional billing, current CMS guidance uses POS 02 when the patient receives telehealth somewhere other than home and POS 10 when the patient is at home. Commercial payer instructions can differ. Evernorth, for example, instructs behavioral-health providers to add modifier 95 to identify a virtual service (CMS telehealth guidance; Evernorth behavioral-health telehealth guidance).

Where the reusable documentation lives

Reusable language should save typing without turning every session into the same note.

Text Blaze’s Therapy Progress Note Templates provide fill-in structures for SOAP, DAP, BIRP, treatment goals, plans, and other recurring documentation. You type the shortcut where you already work, fill in the details that change, and keep the session-specific clinical judgment in your hands.

For the administrative side, the Superbill & Insurance Form Templates pack provides reusable structures for superbill fields, insurance verification requests, out-of-network benefit explanations, and related practice paperwork.

Get the progress-note and superbill packs, add them to Text Blaze in one click, and edit the structures to fit your own workflow.

Quick answers about CPT 90837

What is CPT 90837?

It is the CPT code for individual psychotherapy lasting 53 minutes or more.

What is code 90837?

It is another way of referring to the same time-based individual psychotherapy service.

What is 90837?

It is a psychotherapy billing code used when documented psychotherapy time reaches at least 53 minutes.

What is 90837 CPT code?

It refers to CPT 90837, the code for individual psychotherapy of 53 minutes or more.

What is procedure code 90837?

It is the procedure code used to report individual psychotherapy when psychotherapy time reaches the 53-minute threshold.

What is CPT code 90837 used for?

It is used for individual psychotherapy lasting 53 minutes or more. Shorter psychotherapy services generally fall within the 90834 or 90832 time ranges.