90834 vs 90837: the 3 minutes that decide a claim

90834 is psychotherapy of 38 to 52 minutes. 90837 is 53 minutes or more. A 50-minute session, the classic therapy hour, is 90834. Billing it as 90837 is one of the most common coding mistakes in psychotherapy, and one of the first things a plan looks at when it reviews your records.

Enter any session length in our psychotherapy CPT time calculator to see the code it supports.

The time ranges

The ranges come from the CPT time rule: a unit of time is reached once you pass the midpoint between two named times. Halfway between 45 and 60 is 52.5, so 53 minutes is where 60-minute psychotherapy starts.

Under 16 minutes isn't billable as psychotherapy at all.

What counts toward the time

Count the minutes you spend in psychotherapy with the client, or with the client and family members when the client is present for part of it.

Don't count:

• Writing progress notes after the session.
• Scheduling, billing or collecting payment.
• Time spent on a separate service, such as an evaluation and management visit billed the same day.
• Waiting for a telehealth client to connect.

Why the three minutes matter

90837 pays more than 90834, so plans watch it. A clinician who bills 90837 for nearly every session looks different from peers and is more likely to get a records request. If the notes don't show 53 minutes, the plan can take the difference back.

That doesn't mean you should avoid 90837. If your sessions run 55 minutes, bill 90837. It means the note has to prove it.

How to document the time

• Write the start and stop time, or the total minutes of psychotherapy. "60-minute session" on a template isn't enough if the session ran 50.
• Make the content match the length. A 55-minute note that reads like a 20-minute check-in invites questions.
• Note why a session ran long, when it did. A client in acute distress is a reason.
• Use the right place of service for telehealth: 10 when the client is at home, 02 when they're somewhere else, and modifier 95 for video if the plan asks for it.

Family sessions and crisis sessions

Family psychotherapy is 90846 without the client present and 90847 with them. Both are 50-minute codes, so bill them once a session reaches 26 minutes.

Crisis psychotherapy has its own codes. 90839 covers the first 30 to 74 minutes. Add 90840 for each extra 30 minutes: one for 75 to 104 minutes, two for 105 to 134. A crisis session under 30 minutes is billed as 90832 or 90834.

On a superbill

Private-pay clients file with their plan using a superbill, and the same rules apply: the code has to match the time. Our superbill generator lists the time range next to each code and makes the PDF. For the full list of fields, read how to make a superbill for therapy.