90837 or 90834: How to Choose the Right Psychotherapy Code
Choosing 90837 or 90834 comes down to one thing: the face-to-face minutes you document. CPT code 90834 covers 38 to 52 minutes. CPT code 90837 covers 53 minutes or more. Neither code is “better” on its own, because payment for each one is set by the payer’s fee schedule. This guide shows how to pick 90837 or 90834, what Medicare says about time, and what the note must show. It is written for psychotherapists and for psychiatrists.
For the full reference, see our individual psychotherapy guide.
90837 or 90834: the time ranges
| Code | Service | Time range |
|---|---|---|
| 90832 | Psychotherapy, patient and/or family member | 16–37 minutes |
| 90834 | Psychotherapy, patient and/or family member | 38–52 minutes |
| 90837 | Psychotherapy, patient and/or family member | 53 minutes or more |
The AMA descriptors list 45 minutes as the typical time for 90834 and 60 minutes for 90837. Bill by the minute ranges above, not the typical times. Contractor article A57520 (First Coast, rev. 1/1/2025) quotes the 90832 range (Article A57520). There is no 46–52 minute tier and no separate code for 75 or 90 minutes.
How to choose between 90837 or 90834
- Record the start time and the end time of the face-to-face session.
- Subtract any time that was not psychotherapy with the patient, such as scheduling or paperwork.
- Match the total to the table: 38–52 minutes is 90834, and 53 minutes or more is 90837.
- If the total is 16–37 minutes, the code is 90832.
A 50-minute session is 90834. A 53-minute session is 90837. Do not round up to reach a code. The note has to support the code you bill.
Does 90837 or 90834 pay more?
Payment depends on the payer. Medicare, each Medicaid program and each commercial plan publish their own rates, and those rates change. We do not quote a dollar figure here, because a fixed number would be out of date for most readers. Ask each payer for its current fee schedule, and check whether it limits how often you can bill 90837.
Billing the longer code is only correct when the session was long enough. Payers compare the time in your note with the code on the claim.
What Medicare says about time and long sessions
CMS says “Psychotherapy services (CPT codes 90832-90838) are time-based codes. Start and stop times or total times must be documented for CPT codes 90832, 90834, and 90837” (CMS Coverage Database, Article A57480, WPS, rev. 1/1/2026). The same article says a session over 90 minutes is paid only if the record shows the face-to-face time and the medical necessity for the extra time.
What to document for either code
- Date of service, start time and end time
- The focus of the session and the treatment goal it supports
- Why the session ran as long as it did, for sessions of 53 minutes or more
- Interventions used, the patient’s response and the plan
See documentation requirements for the full list.
When neither code fits
- Crisis session: CMS says not to bill crisis codes with 90832–90838. See the crisis psychotherapy guide.
- Intake: use 90791 or 90792. See the CPT code 90791 guide.
- Family session without the patient: use 90846. See the CPT code 90846 guide.
- Psychiatrists billing an E/M service the same day: use a psychotherapy add-on code. See the add-on codes guide and the E/M guide.
For one code at a time, read CPT code 90834 and CPT code 90837. The CPT & E/M code guide covers the other code families. These are Medicare rules. Private payers and state Medicaid programs set their own limits, and these vary by state.
Frequently asked questions about 90837 or 90834
Which is correct for a 50-minute session, 90837 or 90834?
90834. That code covers 38 to 52 minutes. A session of 53 minutes or more is 90837.
Does 90837 pay more than 90834?
It depends on the payer’s fee schedule. Ask each payer for its current rates rather than relying on a general figure.
Do I have to document the time for 90837 or 90834?
Yes. Start and stop times or total times must be documented for 90832, 90834 and 90837.
Is there a code for sessions over 90 minutes?
No. CPT code 90837 covers 53 minutes or more. Over 90 minutes, the record has to show the face-to-face time and the medical necessity for the extra time.
Where this applies
MCM South supports psychotherapists and psychiatrists in Georgia, Massachusetts, Connecticut, Texas, Florida, New York, Colorado, Tennessee, North Carolina and Illinois. Payer rules differ by state. Get a free quote or schedule a consultation.
For quick reference only: verify against the current AMA CPT manual and each payer’s policy before billing. Operational billing guidance, not legal advice. Current as of last search (sources checked 9/29/26).
