90834 vs 90837: Time Ranges, Rates and Audit Risk (2026)

The difference between 90834 and 90837 is time. 90834 covers 38 to 52 minutes of face-to-face psychotherapy and 90837 covers 53 minutes or more, so you choose the code from the minutes in the note, not the length of the appointment. 90837 pays more because it represents more work, and that higher rate is why Medicare contractors check its documentation closely.

90834 vs 90837 at a glance

Both are individual psychotherapy codes for a session without an evaluation and management (E/M) visit. Either can carry the interactive complexity add-on 90785 when a specific communication factor is documented.

90834 and 90837 time ranges

First Coast's billing article tells providers to "choose the code closest to the actual time," listing 38–52 minutes for 90834 and 53 or more for 90837, and not to report psychotherapy under 16 minutes (A57520). The lines fall at the midpoints between the nominal 45- and 60-minute sessions: 52.5 minutes rounds to 53. The psychotherapy CPT codes guide shows the arithmetic.

Two consequences catch practices out:

• The "therapy hour" is usually 90834. A 60-minute slot with 50 minutes of therapy and 10 minutes for notes and scheduling is a 90834 session.
• There's no partial 90837. At 52 minutes you bill 90834, even if the session felt like an hour.

How much more does 90837 pay than 90834?

These are full physician fee schedule amounts. What a clinician is allowed depends on who bills:

• Psychiatrists and clinical psychologists: 100% of the amount.
• Psychiatric nurse practitioners and physician assistants: 85%.
• Clinical social workers, marriage and family therapists and mental health counselors: 75% (42 CFR 414.53).

The percentage applies to both codes, so the gap shrinks in dollars but not in proportion. To see your locality and your provider type, use Medicare reimbursement by provider type.

Why this matters even if you don't bill Medicare

Medicare's 90834 and 90837 amounts are the benchmark most other prices are set against. Commercial contracts are often negotiated or reviewed as a percentage of Medicare, and EAP and cash-pay rates get compared against the same numbers. A therapist deciding whether to enroll with Medicare, or whether to accept a payer's offer for 90837, starts here. The contract check compares a payer's offer to Medicare for your ZIP.

Documentation that supports 90837

Contractors don't ask for a different kind of note for 90837. They ask for proof of time and medical need, which is easier to miss on a longer session. CGS's 2021 post-payment review of 90832, 90834 and 90837, chosen for "high error rates and/or potential overutilization," checked for documented time, a treatment plan, the session note, periodic summaries and valid signatures.

1. Record the minutes. Start and stop times or total psychotherapy time, for every session (First Coast A57520).
2. Tie the session to the treatment plan. The note should show what was worked on and how it serves the plan's goals.
3. Say why the session ran long. If 53 minutes or more is routine, the treatment plan should explain why the patient needs longer sessions.
4. Keep E/M time out. If a prescriber also managed medication, the visit is an E/M plus an add-on, not 90837. See psychotherapy add-on codes.
5. Sign it. A missing or illegible signature fails review regardless of time.

Sessions over 90 minutes

First Coast allows a prolonged-service code with 90837 when psychotherapy without an E/M visit reaches 90 minutes or more. WPS pays sessions over 90 minutes only when the record shows the face-to-face time and why it was needed (A57480). Those are extended sessions with their own documentation burden, not a way to bill a long day.

90834 and 90837 by telehealth

Both codes are on the Medicare Telehealth Services List, and CMS treats behavioral health telehealth as permanent: there are no geographic or location restrictions, and patients can be at home (CMS Telehealth FAQ, February 26, 2026).

• Place of service: POS 10 when the patient is at home, which Medicare pays at the office (non-facility) rate. POS 02 when the patient is elsewhere, paid at the facility rate.
• Audio-only: permitted for behavioral health to a patient at home. Medicare claims flag it with modifier 93.
• Modifier 95: not how Medicare identifies telehealth on professional claims; many commercial plans still require it. See modifier 95.
• In-person visit: the statutory requirement for an in-person visit before mental health telehealth doesn't take effect until after December 31, 2027.

The time ranges are the same by video as in person. Full rules and dates are in telehealth rules for therapy.

Common 90834 and 90837 denials

• No time in the note. Without start and stop times or total minutes, a reviewer can't tell 90834 from 90837 and may deny both.
• Billing the slot, not the session. The calendar says 60 minutes; the note supports 50.
• 90837 on the same day as crisis codes. 90839 and 90840 stand alone and can't be billed with other psychotherapy that day (WPS A57480).
• 90837 with an E/M visit. Prescribers bill the E/M code plus 90838.
• A provider type that can't bill the code. Under Medicare, psychotherapy is billable by physicians, clinical psychologists, clinical social workers, NPs, CNSs, PAs, nurse-midwives, marriage and family therapists and mental health counselors. Incident-to psychotherapy has to meet every incident-to rule.

Pricing 90834 and 90837 for several clinicians and payers? A fee sheet shows both at your locality, by provider type.

FAQ

What is the difference between 90834 and 90837?

Time. 90834 is 38 to 52 minutes of face-to-face psychotherapy, and 90837 is 53 minutes or more. They cover the same service otherwise.

Can I bill 90837 for a 50-minute session?

No. 50 minutes is in the 90834 range. 90837 starts at 53 minutes of psychotherapy.

Is 90837 billed for 60 minutes?

90837 is built around a 60-minute session, but you can report it from 53 minutes. A full 60 minutes isn't required, and going past 60 doesn't change the code until the session becomes an extended one.

Why does 90837 get audited more?

It pays more than 90834 and only the documented minutes separate them. Contractors have run targeted reviews of the psychotherapy codes because of high error rates.

Does 90837 pay more on telehealth?

No. The rate depends on place of service: POS 10 (patient at home) pays the same office rate as an in-person session, and POS 02 pays the facility rate.

Should I bill 90837 for every session?

Only when the session ran 53 minutes or more and the note supports it. If most sessions are a standard 50-minute hour, most of them are 90834.

Keep reading

• Mental health billing: every behavioral health code family, payment and telehealth rule in one place.
• 90832 vs 90834: the 37/38-minute line for shorter sessions.
• Psychotherapy add-on codes: 90836 and 90838 when a prescriber also bills an E/M visit.
• Behavioral health fee schedule: 90834, 90837 and every related code for your ZIP as a CSV or PDF.

Sources: First Coast Billing and Coding Article A57520, Psychiatric Diagnostic Evaluation and Psychotherapy Services (revision effective Jan 1, 2025); WPS Billing and Coding Article A57480, Psychiatry and Psychology Services (revision effective Jan 1, 2026); CGS, Service Specific Post-Payment Review of Psychotherapy (April 26, 2021); CMS Telehealth FAQ (updated Feb 26, 2026); CMS MLN1986542, Medicare & Mental Health Coverage (March 2026); 42 CFR 414.53. Verified October 7, 2026.