The most commonly used CPT code for therapy is 90837, which covers individual psychotherapy sessions of 53 minutes or more. For shorter sessions, clinicians use 90834 (38–52 minutes) or 90832 (16–37 minutes). Selecting the correct CPT code for therapy depends on session type, time, and whether the visit involves medical evaluation and management services.
Disclaimer: This article is for informational purposes only and does not constitute billing or legal advice. Always verify current payer-specific requirements, as policies change frequently.
What Is a CPT Code for Therapy?
A CPT (Current Procedural Terminology) code is a standardized numeric code used to describe a clinical service for billing purposes. Maintained by the American Medical Association, CPT codes tell payers — including Medicare, Medicaid, and private insurers — exactly what service was rendered, so the claim can be processed and reimbursed.
The Core Individual Psychotherapy CPT Codes: 90832, 90834, and 90837
These three codes cover the majority of outpatient individual therapy sessions. The primary differentiator is time — specifically, the face-to-face minutes spent in psychotherapy with the client.
| CPT Code | Session Time | Common Use |
|---|---|---|
| 90832 | 16–37 minutes | Brief check-ins, crisis follow-ups, or medication management add-ons |
| 90834 | 38–52 minutes | Standard 45-minute sessions |
| 90837 | 53+ minutes | Full 60-minute therapy sessions |
A 45-minute therapy session is typically billed under 90834, not 90837. Many clinicians default to 90837 regardless of session length, which is a common — and auditable — billing error. Time must be documented in the progress note to support whichever code is submitted.
What Documentation Does 90837 Require?
To support a 90837 claim, your progress note should include the session start and end time (or total face-to-face minutes), the presenting problem and client’s current status, specific psychotherapy interventions used, the client’s response to those interventions, and a plan or next steps. Without documented session time and clinical content, a 90837 claim is difficult to defend in an audit. If you want to understand what reviewers look for, this overview of therapy chart audits walks through the process in detail.
Add-On Psychotherapy Codes: 90833, 90836, and 90838
These codes are not standalone — they are billed alongside an Evaluation and Management (E/M) service when a prescribing clinician (typically a psychiatrist or psychiatric nurse practitioner) conducts both a medical visit and psychotherapy in the same session.
- 90833 — Psychotherapy add-on to E/M, 16–37 minutes of psychotherapy time
- 90836 — Psychotherapy add-on to E/M, 38–52 minutes of psychotherapy time
- 90838 — Psychotherapy add-on to E/M, 53+ minutes of psychotherapy time
These codes require documentation that clearly separates the medical decision-making component from the psychotherapy component. CMS documentation guidelines for E/M services outline what each component must contain. Non-prescribing therapists do not use these codes.
Group and Family Therapy Billing Codes
Group Therapy: CPT 90853
CPT 90853 covers group psychotherapy (other than multiple-family group). It is billed per patient per session. There is no specific time threshold, but the session must involve therapeutic interaction among group members facilitated by the clinician — not just psychoeducation. Each client needs their own note documenting their participation, response, and progress. For guidance on structuring those notes, see how to write a group therapy progress note.
Family Therapy: CPT 90847 and 90846
- 90847 — Family psychotherapy with the patient present
- 90846 — Family psychotherapy without the patient present
Both codes require documentation of who was present, the focus of the session, interventions used, and the family’s response. The distinction between 90847 and 90846 must be reflected clearly in the note — payers do scrutinize this.
Telehealth Therapy CPT Codes and Current Modifier Rules
The same psychotherapy CPT codes (90832, 90834, 90837, 90853, 90847, 90846) apply to telehealth sessions. What changes is how you indicate the service was delivered remotely.
After the COVID-19 Public Health Emergency ended in May 2023, telehealth billing rules shifted. For Medicare, the key current guidance includes:
- Modifier 95 — Indicates a synchronous telehealth service (audio and video)
- Place of Service (POS) 02 — Telehealth provided other than in the patient’s home
- POS 10 — Telehealth provided in the patient’s home
- Modifier GT — Still used by some payers; confirm with your specific payer
Many telehealth billing extensions were made permanent or extended through 2024 and beyond under subsequent legislation, but CMS telehealth billing guidance should be checked regularly as policies continue to evolve. Private payer rules vary — always confirm modifier requirements with each insurer or your billing team. For a practical walkthrough of telehealth documentation, see how to write a telehealth therapy note.
Per-Code Documentation: What a Compliant Note Looks Like
The code you bill should be reflected in the note you write. Here is what that looks like in practice:
90834 (38–52 minutes): A note for a standard 45-minute session should document session start/end time or total minutes, the client’s presenting concerns that day, at least one specific intervention (e.g., cognitive restructuring, motivational interviewing), the client’s in-session response, and a brief plan. A vague note that says “discussed coping skills” without clinical detail does not adequately support this code.
90837 (53+ minutes): Same elements as 90834, but the documented time must reflect 53 minutes or more of face-to-face psychotherapy. If your note says “45-minute session” and you bill 90837, that is a mismatch a payer or auditor will flag.
90853 (group therapy): Each client’s individual note should identify the group topic or theme, describe that specific client’s participation and response, and connect the session to their treatment goals. A single generic note copied across all group members is a red flag in audits.
Pairing your CPT codes with accurate ICD-10-CM diagnosis codes is equally important — payers expect the diagnosis to support the service billed.
Common Billing Mistakes That Trigger Claim Denials
Most therapy billing errors are documentation problems, not coding problems. The code selection was right — the note just did not support it.
- Billing 90837 for a 45-minute session. If session time is not documented or the note reflects less than 53 minutes, the claim does not support the code.
- Missing session time in the note. Payers increasingly require documented start and end times or total face-to-face minutes for time-based codes.
- Generic intervention language. “Provided supportive therapy” is not sufficient. Name the modality and describe how it was applied.
- Copying notes across sessions. Clone or copy-forward notes with no session-specific content are a primary audit trigger.
Supervisee billing adds another layer of complexity. Whether a supervisee can bill under their own NPI or must bill under the supervising clinician’s National Provider Identifier depends on licensure type, state regulations, and individual payer contracts. Incident-to billing rules under Medicare are particularly specific. Consult your compliance officer or billing specialist before establishing your supervisee billing workflow — the rules are not uniform across payers or states.
Using a CPT worksheet in session can help clinicians track the information needed to support accurate code selection before writing the note.
If you want to understand how payers evaluate these elements during a review, what happens in a therapy chart audit covers the process step by step.
How to Select the Right CPT Code: A Quick Decision Framework
Before submitting a claim, run through these questions:
- What type of service was this — individual, group, or family therapy?
- Was the patient present for a family session (90847) or not (90846)?
- For individual therapy: how many face-to-face psychotherapy minutes are documented?
- Was this a telehealth session? If so, which modifier does this payer require?
- Is there a prescribing clinician involved who conducted both an E/M and psychotherapy? If yes, consider add-on codes 90833, 90836, or 90838.
The answer to question three determines whether you bill 90832, 90834, or 90837. Document the time first — then select the code. Selecting the code first and hoping the note supports it is how billing errors happen.
If your practice uses a group therapy model, a group therapy treatment plan template can help ensure each client’s treatment goals are documented in a way that supports ongoing group billing.
Frequently Asked Questions About Therapy CPT Codes
What CPT code do I use for a 45-minute therapy session?
A 45-minute individual therapy session is billed under CPT code 90834, which covers psychotherapy lasting 38 to 52 minutes. CPT 90837 requires at least 53 minutes of documented face-to-face psychotherapy time and should not be used for a standard 45-minute session.
What is the difference between CPT 90832, 90834, and 90837?
All three are individual psychotherapy codes differentiated by time. CPT 90832 covers 16–37 minutes, 90834 covers 38–52 minutes, and 90837 covers 53 minutes or more. The session time must be documented in the progress note to support whichever code is billed.
How do I bill telehealth therapy sessions after the public health emergency ended?
Use the same psychotherapy CPT codes (90832, 90834, 90837, etc.) with the appropriate telehealth modifier. For Medicare, Modifier 95 indicates a synchronous telehealth service; POS 02 is used when the patient is not at home, and POS 10 when they are. Private payer requirements vary — confirm modifier and place-of-service rules with each insurer.
What documentation is required to support CPT code 90837?
A compliant 90837 note should include documented session time (start/end or total face-to-face minutes of 53+), the presenting problem, specific psychotherapy interventions used, the client’s response to those interventions, and a plan for next steps. Missing or vague documentation is the most common reason 90837 claims are denied or flagged in audits.
Can a supervisee bill therapy CPT codes under a supervising clinician?
It depends. Supervisee billing rules vary by licensure type, state law, and payer contract. Under Medicare’s incident-to rules, specific conditions must be met for a supervisee’s services to be billed under a supervising provider’s NPI. Many commercial payers have their own credentialing and supervision requirements. Consult a billing specialist or compliance officer before billing supervisee services.
What are the most common reasons therapy CPT codes get denied?
The most frequent denial triggers include mismatched session time and billed code (e.g., billing 90837 for a 45-minute session), missing or vague intervention documentation, lack of documented session start/end times, and copy-forward notes with no session-specific content. Diagnosis codes that do not align with the service billed also generate denials.
How do add-on psychotherapy codes 90833, 90836, and 90838 work?
These codes are billed alongside an Evaluation and Management (E/M) code when a prescribing clinician provides both a medical visit and psychotherapy in the same session. CPT 90833 covers 16–37 minutes of psychotherapy, 90836 covers 38–52 minutes, and 90838 covers 53+ minutes. The note must separately document the E/M component and the psychotherapy component. Non-prescribing therapists do not use these codes.
What CPT codes are used for family therapy with and without the patient present?
CPT 90847 is used for family psychotherapy when the patient is present. CPT 90846 is used when the family session occurs without the patient. Both codes require documentation of who attended, the session focus, interventions used, and the family’s response. The distinction must be clearly reflected in the note.
Getting Documentation Right Before You Bill
Billing errors in therapy practices are rarely the result of intentional miscoding. They happen because documentation is rushed, vague, or completed hours after the session ends — and the note does not capture the detail needed to support the code submitted.
Writing structured, time-stamped notes that include specific interventions and client responses is the most reliable way to reduce claim denials and be prepared if a payer requests records. If you are looking for a faster way to produce that level of documentation consistently, AutoNotes generates structured, editable progress note drafts built around the clinical elements each code requires — giving you a starting point that reflects real session content rather than a blank page at 9 PM.
Try AutoNotes free and see how structured note drafts can support more accurate billing from session one.
