90834 vs 90837: How to Choose the Right Psychotherapy Code
Key Takeaways
- 90834 covers 38 to 52 minutes of psychotherapy. 90837 covers 53 minutes or longer.
- The traditional 50 minute hour sits inside 90834, not 90837.
- Only documented face to face time selects the code. Acuity and clinical preference do not.
- Psychotherapy under 16 minutes is not separately reportable with these codes.
- 90837 attracts utilization review because it pays roughly 25 to 35 percent more and is trivially auditable.
- Record actual start and stop times. A duration copied from the appointment slot proves the slot length, not the session length.
Reviewed as of September 2026
The difference between 90834 and 90837 comes down to one thing: how much psychotherapy time you actually provide and document.
CPT 90834 covers 38 to 52 minutes of psychotherapy. CPT 90837 starts at 53 minutes.
So if you provide a 50-minute session, you would typically bill 90834. If the session lasts 53 minutes or longer, 90837 may be appropriate.
The rest of this blog covers what time actually counts, why 90837 may get a closer look from some payers, and what your documentation should include.
What are the time ranges for psychotherapy codes?
Psychotherapy lasting fewer than 16 minutes is not separately reportable with these codes.
And if a session goes longer than 60 minutes? It is still generally reported with 90837 under the standard psychotherapy code set.
The former prolonged-service codes 99354 and 99355 were deleted in 2023. For sessions lasting 90 minutes or longer, check the payer’s current policy before billing, since payer and Medicare contractor guidance can vary.
Why does 90837 start at 53 minutes?
CPT establishes published time ranges for psychotherapy services. You do not need to calculate them yourself.
The easiest rule to remember is:
38 to 52 minutes = 90834
53 minutes or more = 90837
That also means the traditional 50-minute therapy hour falls within 90834.
If your note supports 50 minutes but the claim says 90837, the code and documentation do not match. That mismatch can lead to a denial, adjustment, or recoupment.
What time counts toward psychotherapy billing?
Use the time you actually spent providing psychotherapy to the client. That includes psychotherapy delivered in person or through a real-time telehealth session.
It does not include time spent:
- Writing the progress note
- Reviewing the chart before the session
- Waiting for the client to arrive
- Scheduling the next appointment
- Collecting payment
- Speaking with collateral contacts outside the psychotherapy session
Here’s a common example.
A client is scheduled for 60 minutes but arrives 12 minutes late. You provide 48 minutes of psychotherapy.
That session falls under 90834.
The calendar does not choose the code. The actual psychotherapy time does.
Note: a no-show is not a short session. If no psychotherapy took place, there is no psychotherapy time to report with 90832, 90834, or 90837.
Why might 90837 get more scrutiny?
Because 90837 often reimburses at a higher rate and has a clear time threshold, some payers may look more closely at whether the documentation supports the longer session.
Regularly billing 90837 is not automatically a problem. Your documentation simply needs to support at least 53 minutes of psychotherapy each time you use the code.
Because psychotherapy codes are time-based, this is relatively easy for a reviewer to check. If the claim says 90837 but the note does not support at least 53 minutes of psychotherapy, you may have a harder time defending the claim.
What documentation supports 90837?
There are really two separate questions here.
How long was the session?
That determines the code.
Why was a longer session clinically appropriate?
That helps support the record if the claim is reviewed.
Start with clear documentation of psychotherapy time.
You can record actual start and stop times, such as 2:04 p.m. to 3:01 p.m.
Or you can document the total psychotherapy time.
What matters is that the record clearly supports the time-based code you billed. Your note should also reflect what happened during the session, including the interventions used, the client’s response, and progress toward treatment goals.
When relevant, document why the longer format was clinically appropriate. Examples might include trauma processing, exposure and response prevention, risk assessment, or extended grounding.
But remember: clinical need does not change the clock. A highly complex 50-minute session is still 90834.
Does 90837 require prior authorization?
Sometimes. Prior authorization requirements can vary by insurance company, plan, provider type, and state.
One plan may allow 90837 without prior authorization, while another may require it. Medicaid plans and EA
Are you a TA customer? A Read our support article on to edit a modifier, POS, or CPT code on a specific appointment in your TA calendar.
