Time requirements
| Code | Time range | Typical reimbursement |
|---|---|---|
| 90832 | 16–37 minutes | $60–95 |
| 90834 | 38–52 minutes | $95–140 |
| 90837 | **53+ minutes** | $130–180 |
Time is based on actual face-to-face minutes, not appointment slot length. Document start and end times in the visit note.
Medical-necessity documentation expectations
Why payers scrutinize 90837
Several large commercial payers (UHC, Anthem, Aetna among others) have flagged 90837 utilization patterns as audit-worthy. The 30–40% reimbursement bump over 90834 creates billing-incentive concerns when used routinely without clinical justification.
To support 90837 billing, document:
- Why the session genuinely required 53+ minutes (not just "ran long").
- Specific clinical complexity (severe symptoms, complex comorbidity, crisis material, breakthrough work).
- Treatment plan justification linking session length to goals.
- Patient response and progress evidence over time.
Best practice: use 90837 when the session genuinely required 53+ minutes for therapeutic reasons, and don't routinize it across all patients regardless of clinical fit.
Common ICD-10 pairings
90837's longer duration is often used for higher-complexity presentations:
- F33.2 Recurrent MDD, Severe (no psychotic features)
- F43.10 PTSD, Unspecified, trauma-focused therapy commonly requires longer sessions
- F60.3 Borderline Personality Disorder, DBT and TFP modalities
- F31.1 Bipolar I Disorder
- F50.0 Anorexia Nervosa
- F42.2 OCD, ERP exposure protocols
Sources
- American Medical Association. Current Procedural Terminology (CPT) 2026, code 90837.
- Centers for Medicare & Medicaid Services. Physician Fee Schedule.