Psytx w pt 60 minutes
CPT code 90837 is used for individual psychotherapy sessions lasting 60 minutes with the patient present. This is one of the most common codes for standard therapy appointments.
This calculator gives a typical-case estimate using standard Medicare modifier rules. Actual payment depends on payer policies, documentation, code-specific CMS status indicators, and locality. Verify before billing.
RVU breakdown
Conversion factor: 32.3465 · Source: CMS MPFS RVU25A · Confidence: High
NCCI bundling edits
Loading bundling edits…
Billing tips
Document exact start and stop times in the medical record for every session
Impact: Prevents denials and downcoding; lack of time documentation is the #1 audit failure for 90837, potentially reducing payment from $154.29 to $99.61 (90834 rate)
Bill 90837 only when face-to-face time is 53-60+ minutes; use 90834 for 38-52 minutes
Impact: Proper time-tier selection prevents upcoding flags; difference between 90834 and 90837 is approximately $55 per session
Do not bill 90837 with E/M codes on same date unless distinct and separately documented service with modifier 25
Impact: Bundling edits will auto-deny combination claims; appeals require clear documentation of medical necessity for both services
Verify telehealth billing rules for each payer; use modifier 95 for telehealth claims
Impact: Telehealth flexibilities vary by payer post-PHE; incorrect modifier use causes $154.29 denial
Include diagnosis code from F-chapter (mental disorders) to support medical necessity
Impact: Non-psychiatric diagnosis codes trigger medical necessity reviews and potential denials of full $154.29 payment
Bill non-facility rate ($154.29) only in office settings; use facility rate ($134.56) in hospital or institution
Impact: Incorrect place of service code creates $19.73 overpayment subject to recoupment
Applicable modifiers
Real billers contribute denial patterns and appeal strategies for this code. Once 5+ reports come in, you’ll see live aggregated data here — the only place this exists, free.
Get the free Revenue Protection Toolkit — the denial triggers, modifier pitfalls, and bundling conflicts that quietly cost you reimbursement. Instant download.
Help build the field knowledge
MedPayIQ gets smarter as billers contribute. If you've had this code denied, share what happened so others learn from it. Anonymous, no patient info.