What Is CPT Code 90837 for Individual Psychotherapy?

Current Procedural Terminology (CPT) codes provide a standardized system for reporting medical services and procedures across the healthcare industry. These codes are essential for healthcare providers to communicate with insurance companies and other payers for accurate billing and reimbursement. CPT code 90837 specifically identifies individual psychotherapy, playing a significant role in documenting and billing for these therapeutic interventions.

Understanding CPT Code 90837

CPT code 90837 represents an individual psychotherapy session typically lasting 60 minutes. It is defined for sessions that involve 53 minutes or more of face-to-face time with the patient. This code is widely used in mental health practices for outpatient psychotherapy services.

Psychotherapy encompasses various therapeutic interventions aimed at alleviating emotional disturbances, modifying maladaptive behaviors, promoting personal growth, and improving problem-solving skills. This can include insight-oriented, behavior-modifying, supportive, or interactive approaches. The time recorded for billing this code must strictly reflect direct therapeutic interaction with the patient, excluding administrative tasks like scheduling, note-taking, or payment collection.

The time-based nature of this code underscores the importance of precise time tracking for compliance.

Key Requirements for Using the Code

The service must be delivered by a licensed mental health professional acting within their scope of practice. This typically includes psychiatrists, psychologists, licensed clinical social workers, and licensed professional counselors.

The interaction between the provider and the patient must primarily be face-to-face, or via telehealth if allowed and documented appropriately. The core of the session should involve direct therapeutic work, focusing on the patient’s mental health concerns. Activities such as report writing, case management, or general administrative duties performed outside the direct session time do not count towards the billable duration.

Medical necessity is a central concept for billing any medical service, including psychotherapy. The service provided must be justified by the patient’s diagnosis and clinical needs. Documentation should clearly demonstrate why a 60-minute session was appropriate and how it contributed to the patient’s treatment goals.

Distinguishing from Other Psychotherapy Codes

CPT code 90837 is one of several codes used for individual psychotherapy, differentiated primarily by session duration. For instance, CPT code 90834 designates individual psychotherapy lasting 45 minutes, applicable for sessions between 38 and 52 minutes. Similarly, CPT code 90832 is used for 30-minute individual psychotherapy sessions, defined as 16 to 37 minutes of direct contact. The choice among these codes depends entirely on the actual face-to-face time spent in therapy.

While 90837 is a standalone code for individual therapy, specific add-on codes exist for particular circumstances. For example, CPT code 90785 can be used for interactive complexity when communication factors complicate the delivery of the service. This add-on code is reported in addition to a primary psychotherapy code like 90837. For crisis psychotherapy, distinct codes such as 90839 (for the first 30-74 minutes of a crisis session) and its add-on 90840 (for additional 30-minute blocks) are used, and these cannot be reported with standard psychotherapy codes like 90837.

It is also important to differentiate individual psychotherapy from other modalities. CPT code 90837 is specifically for individual sessions, meaning the therapeutic focus is on one patient. This contrasts with family therapy codes, such as 90847 (family psychotherapy with the patient present) or 90846 (without the patient present), which focus on family dynamics. Group psychotherapy is billed under codes like 90853.

Documentation for Proper Billing

Accurate and thorough documentation is essential for supporting the use of CPT code 90837. Each session note must include the precise start and end times of the psychotherapy session, or the total duration of face-to-face time. This detail confirms the session met the minimum 53-minute requirement for the 90837 code.

Beyond timing, documentation should clearly describe the specific therapeutic interventions employed during the session. Notes should reflect the patient’s progress or response to treatment and outline the plan for future sessions. This comprehensive record provides the necessary evidence to support the code billed and aligns with compliance standards.