Did You Get a 90837 Letter?
By Barbara Griswold, LMFT (updated July 30, 2022)
- I understand the session length must be 53 minutes or longer. If the session starts late or ends early, a 90834 code (38-52 minutes) or 90832 code (16 – 37 minutes) must be used.
- In each progress note, the actual start/end times of the therapy portion of the session has been documented to back up my billing. I understand this does not include time spent waiting, scheduling, communicating with others, or documenting the session or writing reports.
- I know 90837 may 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. I know this code should not be used for ongoing couples or family treatment.
- I document all sessions according to the health plan’s documentation criteria, including capturing the date of service, length of session (start/end time), client problems and symptoms presented, therapeutic maneuvers utilized, diagnosis, progress or lack of progress to the goals, updates to the treatment plan if necessary, and my signature (electronic or written).
- I know all sessions must meet the health plan’s medical necessity criteria– that insurance can only be billed when a client has a diagnosis (usually more than a DSM-5 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.
Please let me know if I can provide any other information.
[Your License and License #]
[Your Tax ID and Your NPI]
[Your Phone Number]”