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I've written a lot of articles over the years about Medicare. So I thought it would be helpful to put together this page to answer some of your questions about Medicare. I'll try to update it regularly, posting the most up-to-date information. I am not a Medicare...
While I have always emphasized the importance of putting all your client’s diagnoses on a claim – even the Z codes – this may be more important than you realize. Although found in the DSM-5-TR, Z codes are typically not billable as primary or standalone diagnoses,...
Well… it seems many of you had some strong reactions to my previous article on 45 minute sessions. That article was actually the second of two. The first article looked at Aetna’s decision to reimburse 60-minute sessions (CPT 90837) at the same rate as 45-minute...
UPDATED AUGUST 7, 2026 There has been a great deal of confusion about billing for psychotherapy sessions that last longer than 60 minutes. How should they be coded? Will health insurance plans cover these longer sessions? Must the therapist get...
For many therapists, the 60-minute session is standard. This is particularly true if you provide time-sensitive techniques like EMDR or Somatic Therapy, or if you work with complex cases, trauma, families, and couples. But many clinicians have begun to wonder whether...
(Post updated June 12th and July 13, 2026 -- see updates in red at end of post) Feeling a little déjà vu? Yes—another health plan has found a new way to lower clinician reimbursement rates. This time, it’s insurance giant Aetna. The company has rolled out new rate...
One of the biggest concerns I hear from therapists surrounds audits and the use of the CPT code 90837. This billing code is used for individual therapy sessions 53 minutes and above. So, what’s the concern? As documentation expert Beth Rontal of in her blog, "the...
While the U.S. is pretty polarized these days, I think we can all agree on one thing: Our health insurance system is broken. For starters, why must a client have a diagnosable mental illness to be covered, while normal life stressors and preventive treatment aren't...
Every day, therapists contact me with their sad stories about some nightmare they are going through with an insurance plan. Sometimes the health plan audited their records, and found coding and billing mistakes, or just poor documentation. Sometimes the plan wants...
90791 is one of the most frequently-billed CPT codes. Used by psychotherapists, it's billed for the initial intake appointment for each new client at the start of therapy. In certain cases, it can also be used later in treatment. Most therapists probably feel very...