90837 vs 90834 vs 90832: Which Psychotherapy Code to Bill

Psychotherapy codes are chosen by the minutes of therapy with the patient: 16 to 37 minutes is 90832, 38 to 52 minutes is 90834, and 53 minutes or more is 90837. A “50-minute hour” is 90834, not 90837. Document start and stop times (or total psychotherapy minutes) in every note, because the time is what the payer checks first.

These three codes are the ones therapists, counselors, social workers and psychologists bill most. They are simple on paper, and still cause a large share of mental health denials and audit take-backs.

The time thresholds

Code	Description	Psychotherapy time
90832	Psychotherapy, 30 minutes	16 to 37 minutes
90834	Psychotherapy, 45 minutes	38 to 52 minutes
90837	Psychotherapy, 60 minutes	53 minutes or more

The “30, 45, 60” in the names are the typical times. The billing rule is the time range. Fewer than 16 minutes cannot be billed as psychotherapy.

What counts toward the time: time spent in psychotherapy with the patient, or with the patient and a family member when the patient is present for all or part of the session.

What does not count: writing the note afterward, scheduling, billing, or time with family members when the session is really about the family (that is family therapy, 90846 or 90847).

90837: worth billing, but document it well

90837 pays more than 90834, and it is the right code for a full-hour session. It is also the code payers review most. A provider who bills 90837 for nearly every visit, while peers bill a mix, is more likely to get a records request.

That is not a reason to down-code. It is a reason to document well:

• Start and stop times in the note, or total psychotherapy minutes
• A reason the longer session was needed, such as the treatment plan, symptom severity or the work done in session
• Notes that are not identical from week to week

If a payer asks for records and the notes support 53 minutes or more, the claims stand.

Add-on codes that go with 90832, 90834 and 90837

Code	When to use it
90785	Interactive complexity: a third party (parent, guardian, interpreter, other agency) makes communication harder. Added to the psychotherapy code.
90839 + 90840	Psychotherapy for crisis. 90839 is the first 60 minutes (billed for 30 to 74 minutes), 90840 each additional 30 minutes. Billed instead of 90832/90834/90837, not with them.

Codes for other kinds of sessions

• 90791: psychiatric diagnostic evaluation (the intake), without medical services
• 90846 / 90847: family psychotherapy without / with the patient present
• 90853: group psychotherapy (other than multi-family groups)
• 90833 / 90836 / 90838: psychotherapy add-ons billed by prescribers with an E/M code. See billing 99214 with 90833.
• 96130–96139: psychological and neuropsychological testing. See psychological testing codes.

Common mistakes

Mistake	What happens	Fix
Billing 90837 for a 50-minute session	Down-coded or taken back in audit	Bill 90834, or schedule true 60-minute sessions
No time in the note	Denial or take-back of the whole claim	Record start/stop times every session
Counting note-writing time	Code not supported in audit	Count only therapy time with the patient
90785 billed without a reason	Add-on denied	Name the third party and the complication in the note
Wrong place of service for telehealth	Denial or lower payment	Use the payer’s telehealth rules (see our telehealth guide)

What they pay

Rates depend on the payer, your license type, your state and your contract. Medicare publishes its rates in the Physician Fee Schedule, and commercial rates are in your payer contracts. If you are not sure whether your contracted rates are being paid correctly, underpayments are one of the things we check in a free claims audit.

Codes and payer rules change. We check current CPT guidance and each payer’s policy before submission.

Frequently asked questions