90837 CPT Code – Overview
American Medical Association introduces CPT codes that help document health care services and insurance claims coding and billing more effectively and efficiently.
CPT code 90837 is an outpatient mental health code frequently used in documenting mental health care services.
90837 CPT Code Description
Psychotherapy, 60 minutes with patient and/or family member.
As evident from the description of CPT code 90837, it encompasses the psychotherapy services rendered for 60 minutes. Behavior modification and supportive and interactive psychotherapy are some of the services included in 90837.
When billing for medicare services, the following services should also be included in the claims:
- Monitoring and grooming activities of daily living
- Vocational training
- Recreational therapy and leisure activities
- Socialization and community interaction
Time required for 90837 CPT Code
90837 is the code for a psychotherapy session of approximately 60 minutes. It usually ranges from 53 minutes to 89 minutes. The session’s time frame is the only thing that differentiates between 90834 (session for 45 minutes) and 90837. The other services being offered remain the same for both of the codes. The 90832 code is used to document even shorter sessions ranging from 16 to 37 minutes or approximately a psychotherapy session of 30 minutes.
Additional note 1:
Any session lasting at least 16 minutes should not be coded under these psychotherapy codes.
Additional note 2:
As the time frame for sessions may vary from short to even more than 60 minutes, the coding should not limit the quality of services provided. Hence, any session over 60 minutes should be coded under 90837 with add-on codes.
How to bill CPT code 90837?
The Healthcare provider, while reporting psychotherapy service, can use the “Time Rule” and choose to document 90837 only if a session takes more than 53 minutes.
Documenting “add-on” codes:
The add-on codes represent the health services of other domains that can be provided in combination with mental health services. In case of additional services offered, both the primary code and add-on code should be mentioned on the billing form.
Following are some of the add-on codes that can be listed with 90837:
90785; this add-on code is listed with 90837 in the billing form when an interactive complexity is encountered while providing psychotherapy services. This interactive complexity leads to complications in the delivery of Mental Health Services. CPT manual identifies the complicating factors that decide whether the Healthcare providers should report the interactive complexity code as an add-on code for psychotherapy services.
These above factors may include difficulty communicating with participants, verbally undeveloped children, disclosure of any abuse or neglect mandated to report to the state agency, and use of any play equipment interpreter or translator to communicate with the patient.
90863; the prescribing psychologists report 90863 as an add-on code when prescribing and reviewing the medication during pharmacological management in a psychotherapy session.
90839 and 90840; these codes are for crisis psychotherapy sessions that require urgent attention to the patient in high distress presenting with a life-threatening or complex condition requiring critical assessment, history taking, and mental status examination. 90839 is billed for the first 60 minutes of a psychotherapy session for the patient in crisis. If the session lasts longer than 60 minutes, then the add-on code 90840 is billed for each additional 30 minutes of the session.
Add on codes for extended psychotherapy sessions guide :
As 90837 is only billed for psychotherapy sessions up to 89 minutes, any sessions longer than 90 minutes do not have any principal service code. Some add-on codes are used to bill psychotherapy sessions for more than 90 minutes. Following are the add-on CPT codes for extended sessions:
- 99354 is billed as an add-on code with 90837 if the psychotherapy session takes 90-134 minutes to end ( 90837 + 99354).
- Additional note: 99354 is an add-on code, so it should either be billed with 90837 or with 90847. Billing it with 90834 is not allowed.
- 99355 is built as an add-on code with 90837 and 99354 when the psychotherapy session takes 135-164 minutes to end. Remember to add 99354 before 99355 ( 90837 + 99354 + 99355).
- If a psychotherapy session takes 165 to 194 minutes to end, use add-on codes 99354 once and 99355 twice with principal service code 90837 ( 90837 + 99354 + 99355 + 99355).
- 99050 is billed when the psychotherapy services are provided outside of business hours as an add-on code after billing 90837 as a principal service code.
- 99051 is billed as an add-on code for the already planned services provided in the evening, on the weekend, or during a holiday after billing 90837 as a principal service code.
Additional information for 90837 CPT Code
The length of the psychotherapy session does not include the time spent arranging for mental health or psychotherapy services, communicating with healthcare professionals and family members, or providing or arranging reports. These services are part of pre or post-service work already described in psychotherapy codes.
Pre-service work includes the preparation to see the patient or family members, going through the previous records, and communicating with other healthcare professionals and the patient’s caretakers.
Post-service work includes documenting work activities, providing telephone and written reports to healthcare professionals, caretakers, and third-party payers, and arranging further psychotherapy services.
Licenses required for billing 90837:
Only Healthcare providers with the following licenses can bill 90837 for 60-minute individual psychotherapy sessions.
- Licensed clinical social workers (LCSW)
- Licensed professional counselors (LPC)
- Licensed marriage family therapist (LMFT)
- Clinical psychologists (PsyD or Ph.D.)
- Psychiatrists (MD)
- Psychotherapy Services Frequently Asked Questions; American Psychological Association.
- Psychotherapy Codes for Psychologists; American Psychological Association.
- The Definitive Guide to Psychiatry CPT Codes;
- Barbara Griswold, LMFT; Longer Couples and Family Therapy Sessions: A New Way to Bill?; The Insurance Maze; 2019.
- CPT® code 90837: Psychotherapy, 1; American Medical Association.