Individual psychotherapy session with the patient, and family if present, lasting about one hour of face-to-face or telehealth time.
- Medicare
- $167.00
- Work RVU
- 3.78
- Global, days
- Region
- General
Documentation requirements
What must appear in the operative or office note to support the claim.
Source · Editorial brief grounded in 3 cited references ↓
- Total psychotherapy time or start and stop times, at least 53 minutes
- Mental health diagnosis treated
- Therapeutic interventions used during the session
- Patient response and progress toward goals
- Treatment plan updates
- Rendering clinician credential
Applicable modifiers
Modifiers commonly billed with this code.
Source · AMA CPT modifier descriptors · CMS NCCI Policy Manual
What this code covers
Source · Editorial summary grounded in 3 cited references ↓
90837 is a 60-minute psychotherapy session. Under CPT time rules it is reported when the session reaches 53 minutes or more. Shorter sessions drop to 90834 (38 to 52 minutes) or 90832 (16 to 37 minutes). Start and stop times, or total minutes, belong in the note.
Orthopedic surgeons do not bill this code. It comes up in practices that run integrated musculoskeletal programs with a psychologist or licensed clinical social worker on staff, usually for chronic pain, fear of movement after injury, or preparation for spine surgery where depression and catastrophizing predict poor outcomes. Some spine programs require a psychological screen before a spinal cord stimulator trial, though that evaluation often uses different codes.
The therapist's credential and the payer's credentialing list matter. Commercial plans may carve behavioral health out to a separate vendor, which sends claims for 90837 to the wrong payer. Some plans also require prior authorization or cap 60-minute sessions. Telehealth sessions use the place of service and modifier the payer specifies.
RVU & reimbursement
Component RVUs and Medicare national rate. Actual payment varies by GPCI locality.
Source · CMS Physician Fee Schedule, RVU26A · January 2026
Work RVU vs. total RVU
The work RVU (3.78) is the surgeon's own effort — the figure physician pay and productivity targets are built on. The total RVU (5) adds practice overhead and malpractice, and is what drives the Medicare payment below.
| Work RVU | 3.78 |
| Practice expense RVU | 1.2 |
| Malpractice RVU | 0.02 |
| Total RVU | 5 |
| Medicare national rate | $167.00 |
| Global period | days |
Payment by site of service
Medicare pays different rates by setting. HOPD typically pays substantially more than ASC for the same procedure.
Source · CMS OPPS Addendum B·ASC HCPCS payment rates·2026
| Setting | Medicare rate (national) |
|---|---|
Office (PFS non-facility) Procedure performed in physician's office | $167.00 |
HOPD (APC 5823) Hospital outpatient department | $181.34 |
Common denial reasons
The recurring reasons claims for CPT 90837 get rejected.
Source · Editorial brief grounded in CMS NCCI edits, AAOS coding appeals, and cited references ↓
- Session time documented under 53 minutes
- Claim sent to the medical payer when behavioral health is carved out
- Rendering clinician not credentialed with the plan
- Prior authorization or session cap exceeded
- Billed with an E/M by the same provider in place of the correct add-on psychotherapy code
Frequently asked questions
Source · Generated from the editorial pipeline, verified against 3 cited references ↓
01How many minutes is required to bill 90837?
02Can an orthopedic practice bill 90837?
03Can 90837 be billed with an E/M visit?
04Is 90837 covered by telehealth?
Sources & references
Editorial content was developed using the following public sources.
Mira Scribe
Mira Scribe records session length and the interventions discussed, so time-based psychotherapy notes carry the minutes and content a payer checks.
See how Mira captures CPT 90837 documentation