CPT 90837 Explained: Billing, Reimbursement Rates and Guidelines

Quick Facts — CPT 90837

Short Description	Psychotherapy, 60 minutes with patient and/or family member
Usual Unit Limit	1 unit per date of service (time-based)
Typical Medicare Payment	$167 (PhD/PsyD) / $125 (LPC/LMFT)
Typical Medicaid Payment	$131.16 (LCSW/PsyD/PhD), $104.92 (LPC/LMFT)
Aetna Reimbursement Rate	$115–$165 (Master's-level)
Cigna Reimbursement Rate	$110–$160 (Master's-level)

CPT 90837 is a billing code specifically designed for individual psychotherapy sessions lasting 60 minutes. Often called the “60-minute code”, 90837 is generally used for patients whose mental health needs require a full, in-depth session with a licensed mental health clinician (such as a psychologist, therapist, licensed clinical social worker, or psychiatrist).

What is CPT Code 90837

As per the American Medical Association, 90837 CPT code description is: “Psychotherapy, 60 minutes with patient and/or family member.”

What is CPT Code 90837 used for?

90837 code is used to report an individual therapy session usually lasting 60 minutes (with a minimum window of 53 mins). It is billed when a licensed mental health provider delivers in-person psychotherapy to psychologically and/or emotionally distressed patients for the betterment of their mental health and well-being to change unhealthy behaviors. This code is commonly used for complex mental health conditions that require extended therapeutic time and documented clinical intervention.

90837 Time Requirements: Know the 53-Minute Threshold

Checking session’s length is extremely important and should never be ignored when you’re learning how to bill therapy code 90837. While this is a 60-minute therapy code, the shortest time billed for the 90837 CPT code is 53 minutes. A psychotherapy session must meet the time requirement to use the 90837 CPT code. The sessions that are less than the minimum 53 mins threshold should be charged using a shorter-duration code (e.g., 90834 38-52 minutes).

Understanding CPT 90837 Reimbursement Rates

The reimbursement rate for CPT 90837 is approx. $150 per session, but this can vary depending on insurance company, the provider, location, and the contracted rate. It means there will be no uniform reimbursement rate for all 90837 claims.
Below are some 90837 reimbursement rates for Medicare, Medicaid, Aetna, and Cigna.

Medicaid 90837 Reimbursement Rate

CPT 90837 may have a different Medicaid reimbursement rate depending on provider’s license and credential. In 2025, LCSWs, LICSWs, PsyDs, and PhDs received $131.16 and LPCs, LMFTs, and LMHCs received $104.92. These rates are for 90837 Psychotherapy services and may differ by state and/or by Medicaid program.

Medicare Reimbursement Rate for 90837 (Individual Psychotherapy, 60 Minutes)

The reimbursement amounts for a CPT 90837 may be different depending on the provider’s qualification. The rates offered for 2026 are $167 for LICSWs, PsyDs, and PhDs; and $125 for LPCs, LMFTs, and LMHCs. These rates may change depending upon the Medicare rules and location.

Aetna 90837 Reimbursement Rate

Aetna’s reimbursement rate for CPT 90837 for master’s level providers is estimated to be $115 to $165 in 2026. Actual amounts may be subject to change depending on the provider’s contract, site, or other provider-specific factors.

Cigna 90837 Reimbursement Rate

For Cigna, an estimated reimbursement for master’s-level providers of CPT 90837 is $110 to $160. This reimbursement rate may differ based on provider contract, location and plan.

CPT 90837 and Medicare (Part B) Reimbursement Rate

The CPT 90837 Medicare baseline rate for 2026, non-facility is around $158-$167 based on locality. Medicare covers 80% of Medicare-approved charges (during the Part B deductible) and the patient is responsible for the other 20%. Using this range, Medicare pays 80% which would be about $126.40 to $133.60 per session, prior to adjustments.
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CPT 90837 Documentation Requirements

When billing CPT 90837, your documentation should clearly support the services provided and show why the session was medically necessary. Proper documentation helps support a 90837 claim and shows that the session met the required time, clinical, and billing standards. Some essential requirements are:

Client Information: Patient’s information such as patient’s name, date of service, and clinician’s signature on every page.

Time: Note the actual starting and ending times and the total psychotherapy time (53+ minutes). The time recorded shall only include face-to-face psychotherapy time and shall not include administrative duties (e.g., scheduling, billing, note-writing).

Medical Necessity: Explain why this session is important and what can more be done for patient recovery and betterment.

Diagnosis: Documentation of the need for the 90837 session on that date must clearly include the reasons for the client’s need for such a session (complexity of symptoms, intensity of interventions delivered or clinical factors that necessitate long therapeutic engagement).

Treatment Plan: Demonstrate progression of goals or stabilization of risk across the sessions.

Functional Impairment: Give a brief description of the way that the client’s symptoms are interfering with daily functioning – such things as at work, at home, at school – that may support the clinical need for extended psychotherapy time.

Does using CPT 90837 attract audits?

CPT 90837 does not automatically trigger an audit, but being a code with higher reimbursement, it may receive closer review. Thus, accurate time records, medical necessity, and complete documentation is critical and may save you from penalties if reviewed.

Final Thought:

There are only two things that count when it comes to billing 90837 correctly – time and documentation. Once you reach the 53-minute mark, make notes that justify the prolonged session, and you’ll avoid most denials before they happen. While reimbursement rates continue to fluctuate from year to year, a solid documentation practice will always help your practice in the long term.

Disclaimer:

The information provided in this blog is for general educational and informational purpose only and could not be intended as medical, legal, financial or professional billing advice. Always consult a certified healthcare professional or billing expert for guidance, specific to your situation.