Did You Get a 90837 Letter?
By Barbara Griswold, LMFT (posted August 5, 2020, updated March 6, 2022)
- The session length must be 53 minutes or longer. If the session starts late or ends early, you may have to use a 90834 code (38-52 minutes) or 90832 code (16 – 37 minutes). Insurers will expect to see that you have done so on occasion. They will also expect your start and stop times to believably vary from one session to the next to reflect real life.
- In each progress note, you must document the actual start/end times of the therapy portion of the session to back up your billing. Do not include time spent waiting, scheduling, communicating with others, or documenting
- It can be used only for individual sessions, or when family comes into a session to serve as informants for ongoing individual treatment. When a 90837 is used for a family visit, the client must be present for all or most of the session. This code should not be used for ongoing couples or family treatment.
- While it may not be required, it’s a good idea to document in those cases you feel there is a reason you feel the need for sessions longer than 52 minutes (if the case is complex, you are working with more severe diagnoses, you are doing EMDR or trauma work, or some treatment that may take longer than routine talk therapy).
- All sessions must meet a plan’s medical necessity criteria, meaning you only bill insurance when a client has a diagnosis (usually more than a Z code), when the treatment is not aimed solely at personal growth, is deemed necessary and not just desired, and aimed at least in part on reduction of a mental health symptom, such as anxiety or depression (for more on Medical Necessity, see my other articles on this topic– click here).