Billing Codes for Therapy: Psychotherapy Time Ranges (2026)

The billing code for a therapy session depends on face-to-face psychotherapy time: 90832 for 16 to 37 minutes, 90834 for 38 to 52 minutes and 90837 for 53 minutes or more. Sessions under 16 minutes are not reportable as psychotherapy, and prescribers who also manage medication in the same visit bill an E/M code plus an add-on (90833, 90836 or 90838) instead.

Psychotherapy billing codes by session length

Three codes cover individual psychotherapy with the patient when no medical evaluation and management happens in the same visit. Each is named for a typical session (about 30, 45 and 60 minutes), but you report the actual time.

Where 16, 38 and 53 come from

The general midpoint convention for timed services is that a unit of time counts once you are past its midpoint. Apply that to the three nominal session lengths and the boundaries fall out:

• A 30-minute code is earned once you pass 15 minutes, so the floor is 16 minutes.
• Between the 30- and 45-minute codes the midpoint is 37.5 minutes, so 38 minutes moves you to 90834.
• Between the 45- and 60-minute codes the midpoint is 52.5 minutes, so 53 minutes moves you to 90837.

Medicare contractors publish the same ranges. First Coast's billing article for psychotherapy instructs providers to choose the code closest to the actual time: 16–37 minutes for 90832 and 90833, 38–52 minutes for 90834 and 90836, and 53 minutes or more for 90837 and 90838. Psychotherapy lasting less than 16 minutes is not reportable.

The midpoint convention is not universal. For office E/M visits, CMS says the full time must be met and the midpoint convention for certain timed services does not apply (Claims Processing Manual, ch. 12, §30.6.1). Don't carry psychotherapy rounding into E/M time.

90834 vs 90837

90837 is the most-searched therapy code because the step up from 90834 is large. The comparison below uses the live national office rates:

The decision is purely about minutes. Three practical rules keep it clean:

1. Count face-to-face psychotherapy only. Scheduling, billing talk and writing the note afterward don't count.
2. Stop at 52 or go past 53. A 50-minute "therapy hour" is a 90834 session. If clinical need justifies a 60-minute session, document why.
3. Past 90 minutes, add documentation. First Coast allows a prolonged-service code with 90837 when psychotherapy without an E/M reaches 90 minutes or more, and WPS pays sessions over 90 minutes only when the record supports the face-to-face time and the need for it.

Diagnostic evaluation: 90791 and 90792

The intake visit isn't psychotherapy. 90791 is the psychiatric diagnostic evaluation; 90792 is the same evaluation with medical services added, so it's the prescriber's version (psychiatrists, psychiatric nurse practitioners, physician assistants). Psychologists, clinical social workers and counselors report 90791.

Neither code is timed. How often you can repeat one is set by your Medicare contractor. WPS, for example, expects one evaluation at the onset of an illness, repeated by the same provider only after an extended break in treatment (about six months), an inpatient psychiatric admission or a significant change in mental status.

Psychotherapy with an E/M visit: 90833, 90836, 90838

When a prescriber manages medication and provides psychotherapy in the same visit, bill the office or hospital E/M code plus a psychotherapy add-on that uses the same 16–37, 38–52 and 53+ ranges:

Contractor guidance is consistent on how the two parts fit together (WPS A57480, First Coast A57520):

• The two services must be significant and separately identifiable. A separate diagnosis isn't required.
• Choose the E/M level by medical decision making. Time can't be used to pick the E/M level when you bill a psychotherapy add-on.
• Psychotherapy minutes exclude the time spent on the E/M work. Document both.
• Prolonged-service codes can't be added when you bill a psychotherapy add-on.

Interactive complexity: 90785

90785 is an add-on for communication factors that make the session harder to deliver, such as a caregiver whose involvement complicates the visit or a young child who needs play equipment to communicate. It is not a "difficult session" upcharge.

It can go with 90791, 90792, the psychotherapy codes, the E/M add-ons and group psychotherapy 90853. WPS bars it with crisis codes and with an E/M visit when no psychotherapy is billed. With timed codes, the note must show the time spent on the interactive work and the specific factor involved.

Psychotherapy for crisis: 90839 and 90840

90839 covers the first 60 minutes of crisis psychotherapy and 90840 each additional 30 minutes. Time doesn't need to be continuous, but you must give the patient your full attention for the whole period, and the patient must be present for all or part of it.

Outside the office in a non-facility setting (the patient's home, for example), Medicare uses HCPCS G0017 and G0018 instead. CMS pays those at 150% of the non-facility fee schedule amount for crisis services.

Family and group psychotherapy: 90846, 90847, 90853

• 90846: family psychotherapy without the patient present. In the CMS file it carries a restricted-coverage status, so check your contractor's policy before relying on it.
• 90847: family psychotherapy with the patient present.
• 90853: group psychotherapy, billed per patient in the group.

Family sessions are covered only when the purpose is treating the Medicare patient's condition, not the family members' problems. They can't be used for taking a family history or for routine updates with facility staff. For group therapy, contractors add their own limits: Novitas expects groups of no more than 10 people and sessions of at least 45 to 60 minutes, and WPS allows one 90853 per day unless the patient joined a separate, distinct group session.

How to pick the code for a session

1. Was it a crisis? Use 90839, plus 90840 for each additional half hour, and nothing else from the psychotherapy family that day.
2. Was there an E/M visit by the same prescriber? Bill the E/M by medical decision making plus 90833, 90836 or 90838 for the psychotherapy minutes alone.
3. Otherwise, count the face-to-face minutes. 16–37 is 90832, 38–52 is 90834, 53 or more is 90837.
4. Add 90785 only if a specific communication factor is documented.
5. Check who and where. CMS lists physicians, clinical psychologists, clinical social workers, clinical nurse specialists, nurse practitioners, physician assistants, certified nurse-midwives, marriage and family therapists and mental health counselors as eligible for Medicare mental health services. Incident-to psychotherapy must meet every incident-to rule, and the person doing it must be licensed in the state to provide psychotherapy.

Building a fee sheet for a whole practice? Check every code at your locality at once instead of one page at a time.

FAQ

What is the billing code for a therapy session?

For individual psychotherapy without an E/M visit: 90832 (16–37 minutes), 90834 (38–52 minutes) or 90837 (53 minutes or more). The first visit is usually 90791, and a prescriber who also manages medication bills an E/M code plus 90833, 90836 or 90838.

What are the billing codes for psychotherapy in 2026?

The core family on the 2026 fee schedule: 90791 and 90792 for evaluation, 90832/90834/90837 for individual therapy, 90833/90836/90838 as E/M add-ons, 90785 for interactive complexity, 90839/90840 for crisis, 90846/90847 for family and 90853 for group. Medicare pays crisis services outside the office through G0017 and G0018. What changes each year is the rate, shown live above.

Is 90837 a valid billing code?

Yes. 90837 is an active code on the 2026 Medicare Physician Fee Schedule with national payment, as the rate comparison above shows.

What is the billing code for a 60-minute therapy session?

90837, as long as at least 53 minutes were face-to-face psychotherapy. If the session ran 38–52 minutes of actual therapy, it's 90834, even in a one-hour slot.

What is the time range for 90834?

38 to 52 minutes of psychotherapy. Under 38 minutes the session is 90832; at 53 minutes it becomes 90837.

Can 90837 be billed for a 50-minute session?

No. 50 minutes falls in the 90834 range. 90837 starts at 53 minutes.

What is the difference between 90791 and 90837?

90791 is the diagnostic evaluation at the start of care: assessment, history and a treatment plan. 90837 is a psychotherapy session of 53 minutes or more. They describe different services and are not billed for the same encounter.

Can a therapist bill 90837 and 90785 together?

Yes, when a documented communication factor complicated the session. The note must name the factor and the time spent on it.

Can psychotherapy be billed with an E/M visit?

Yes, using the add-on codes 90833, 90836 or 90838 with the E/M code. Each service must be separately identifiable, and the psychotherapy minutes can't include E/M time.

Keep reading

• The 8-minute rule calculator covers 15-minute timed therapy codes, which use a different rounding rule than psychotherapy.
• Incident-to billing explains when therapy by a supervised clinician can be billed under the supervising practitioner.
• Modifier 25 vs 59 for separately identifiable visits on procedure days.
• What is an RVU? explains the work, practice expense and malpractice values behind every rate on this page.
• Codes in this guide: 90785 90791 90792 90832 90833 90834 90836 90837 90838 90839 90840 90846 90847 90853 G0017

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); Novitas LCD L35101, Psychiatric Codes; CMS, Psychotherapy for Crisis (modified Feb 25, 2026); Medicare Claims Processing Manual, Pub. 100-04, ch. 12, §30.6.1. Verified October 6, 2026.