Billing Reference
90834 vs 90837: the 53-minute line
The difference between 90834 and 90837 is documented psychotherapy time: 38 to 52 minutes bills 90834, and 53 minutes or more bills 90837. Both are individual psychotherapy codes, and under CMS guidance the code follows the time you document, not the length of the scheduled slot. The side-by-side below comes straight from the CMS-sourced notes on each code.
Side by Side
The two codes, next to each other
90834
Individual psychotherapy, 38 to 52 minutes
The standard individual psychotherapy session.
- CMS time rule: 38 to 52 minutes of psychotherapy.
- Document start and stop times or the total time spent.
- Time is counted face to face with the patient, and the patient is present for all or some of the service.
- Beyond the clock, the record shows the therapeutic techniques used and a periodic summary of goals, progress, and the updated treatment plan.
90837
Individual psychotherapy, 53 minutes or more
The extended individual psychotherapy session.
- CMS time rule: 53 minutes or more of psychotherapy.
- Document start and stop times or the total time spent.
- A prolonged-service code may be reportable at 90 minutes or more when the visit is not billed with an evaluation and management service.
How to decide, session by session
Document the time first, then let the code follow it. Record start and stop times or the total time spent for every session. If the documented psychotherapy time lands between 38 and 52 minutes, the session is 90834. At 53 minutes or more, it is 90837.
The scheduled slot does not decide anything. An hour on the calendar with 48 documented minutes of psychotherapy is a 90834 session, and a 45-minute slot that runs to 55 documented minutes is 90837. Sessions under 38 minutes drop to 90832, and psychotherapy under 16 minutes is not billable at all.
Common Questions
90834 vs 90837 questions therapists ask
What is the difference between 90834 and 90837?
Session time. 90834 covers 38 to 52 minutes of psychotherapy and 90837 covers 53 minutes or more. The code follows the documented psychotherapy time, not the scheduled slot, so record start and stop times or total time for every session.
Which code do I bill for a 45-minute session?
90834. A typical 45-minute session falls inside the 38 to 52 minute bracket. A typical 60-minute session, with 53 minutes or more of psychotherapy, is 90837.
Do I code by the scheduled appointment length or the actual time?
The actual documented psychotherapy time. An appointment booked as an hour that includes 48 minutes of psychotherapy is billed as 90834. Document start and stop times or the total time so the code choice is defensible.
What if the session was under 38 minutes?
Then neither code applies. 90832 covers 16 to 37 minutes of psychotherapy, and under CMS guidance psychotherapy of less than 16 minutes is not billable at all.
Why are there no reimbursement rates on this page?
Reimbursement varies by payer, locality, and year, so a single national number would be wrong for most readers. Check your payer contracts for your actual rates, or the CMS Physician Fee Schedule lookup tool for Medicare amounts in your locality.
Keep Going
Related codes and tools
The code is the easy part. The note has to hold up too.
Time-based codes only survive an audit when the documentation behind them does. Generate a structured progress note in SOAP, DAP, BIRP, GIRP, PIRP, or Narrative format from a short session summary. Free, no account required.
Generate a Free Progress NoteBefore you bill from this page
This is an informational tool, not billing, legal, or clinical advice. You are responsible for selecting the correct codes for your services and for verifying coverage, code definitions, and documentation requirements against your payer contracts and the current code set.
CPT is a registered trademark of the American Medical Association. This page does not reproduce the CPT code set or its official descriptors. Every description here is a plain-English summary written by Reframe Practice and checked against the CMS public billing documents linked above.