CPT 90834 and 90837 are both individual psychotherapy codes. The difference is time. Because 90837 pays more, payers watch it closely, so documentation has to support the time billed.
Time thresholds
| Code | Description | Time required |
|---|---|---|
| 90832 | Psychotherapy, 30 minutes | 16–37 minutes |
| 90834 | Psychotherapy, 45 minutes | 38–52 minutes |
| 90837 | Psychotherapy, 60 minutes | 53 minutes or more |
Time means face-to-face psychotherapy time with the patient and/or family. It does not include documentation done after the session, or time spent on a separately billed service.
Why 90837 gets extra scrutiny
Several commercial payers and Medicare contractors use analytics to flag clinicians who bill 90837 for a much higher share of sessions than their peers. Being flagged can lead to record requests, prepayment review or recoupment. Billing 90837 is not a problem in itself when the sessions really are 53+ minutes and the notes show it.
Documentation that holds up
- Record actual start and stop times (or total minutes) in every note
- Explain the clinical reason a longer session was needed
- Keep the treatment plan current and connect it to session content
- Don't use templates that copy the same text into every note
Telehealth
For telehealth sessions, the same time rules apply. Make sure the claim has the correct place of service (often 10 for a patient at home, 02 for a patient elsewhere) and any modifier the payer requires, such as 95. Payer rules vary, so check each contract.
This article is general education, not legal or coding advice for a specific claim. Check current CPT guidance and payer policies.