What Is CPT Code 90837 Used For?

Current Procedural Terminology (CPT) codes are standardized alphanumeric codes used across the U.S. healthcare system to describe medical, surgical, and diagnostic services. Developed and maintained by the American Medical Association (AMA), these codes ensure consistent communication and accurate billing between healthcare providers, patients, and insurance companies. Each code represents a specific procedure or service, streamlining the process of claims submission and reimbursement.

The Purpose of CPT Code 90837

CPT Code 90837 is specifically used for individual psychotherapy sessions that involve direct, face-to-face interaction between a patient and a qualified healthcare professional. This code applies to sessions lasting 53 minutes or longer and is a frequently used code in mental health practices due to its extended duration.

The nature of the service covered by 90837 encompasses various therapeutic approaches. These include insight-oriented, behavior-modifying, supportive, and interactive verbal communication techniques. This allows for in-depth therapeutic work, covering complex trauma processing, eye movement desensitization and reprocessing (EMDR) therapy, in-depth cognitive behavioral therapy, or crisis intervention requiring extended time.

Qualified healthcare professionals who provide and bill for this service include psychiatrists, psychologists, licensed clinical social workers (LCSWs), licensed professional counselors (LPCs), and licensed marriage and family therapists (LMFTs). These professionals utilize the code for outpatient services, addressing diagnoses such as depression, anxiety, and post-traumatic stress disorder (PTSD).

Important Considerations for 90837

When utilizing CPT Code 90837, it is important to recognize its specific duration requirements. While 90837 is for sessions lasting 53 minutes or longer, other codes exist for shorter psychotherapy sessions. For instance, CPT Code 90834 is used for sessions lasting between 38 and 52 minutes. Similarly, CPT Code 90832 covers sessions ranging from 16 to 37 minutes.

The service billed under 90837 must always be medically necessary, and this necessity must be thoroughly documented. Proper documentation includes the session’s start and end times, the specific interventions used, the patient’s response to treatment, progress toward treatment goals, and the plan for future sessions. Insurance providers often closely review claims for longer sessions, making accurate and detailed records essential for appropriate reimbursement.

CPT Code 90837 is generally reported once per day per patient, covering the entire face-to-face time spent in the session. This time includes direct patient interaction, evaluation, and treatment planning that occurs during the session.