What is the 2026 reimbursement for CPT 90837?

The national average payment for 90837 in 2026 is approximately $167.00 (Non-Facility). It is protected from the 2.5% efficiency cuts applied to other codes.

How many minutes are required for CPT 90837?

To bill 90837, the face-to-face time with the patient must be at least 53 minutes. If the session is between 38 and 52 minutes, you must bill 90834 instead.

Can I bill 90837 if the session is conducted over the phone?

Yes. CMS has permanently approved 'audio-only' delivery for 90837 in behavioral health contexts. You should append Modifier FQ to the claim.

Does 90837 require an in-person visit?

For telehealth patients, CMS recommends an in-person visit every 12 months, but this is a guideline with flexibility based on patient clinical circumstances and geographic access.

BehavioralBase2026 Compliant

CPT 90837

2026 Billing Guide

Psychotherapy 60 min

Reimbursement

$167.00

Threshold

60m

2026 Status

Active

What is CPT Code 90837?

CPT 90837 is defined as: Individual psychotherapy with the patient, lasting for a duration of 60 minutes. This extended session is intended for patients with complex clinical needs or those requiring high-intensity therapeutic interventions. It involves a deeper exploration of psychological distress and maladaptive patterns, utilizing advanced therapeutic techniques to foster significant clinical progress.

This code is primarily used for Behavioral services. It falls under the category of Medicine / Psychiatry and is valid for the 2026 calendar year according to the CMS Physician Fee Schedule.

2026 RVU Components

Relative Value Units (Non-Facility)

Standard Formula Applied

Work RVU

2.7

Physician Effort

PE (Non-Fac)

2.2

Practice Expense

Malpractice

0.1

Risk Factor

Total RVU

Note: [(Work RVU * Work GPCI) + (PE RVU * PE GPCI) + (MP RVU * MP GPCI)] * Conversion Factor

2026 CMS Policy Intelligence

efficiency shield

Strategically exempt from the -2.5% efficiency adjustment. CMS values the longitudinal relationship in behavioral health and has protected the Work RVU of 90837 to maintain provider participation.

audio only permanent

Behavioral health services like 90837 have obtained permanent 'audio-only' status, a significant regulatory win for rural and underserved access in 2026.

conversion factor

Utilizes the 2026 Non-QP rate of $33.40.

Administrative Framework

Place of Service

11 (Office)02 (Telehealth - Synchronous)10 (Telehealth - Patient Home)

NCCI Exclusions

Do not bill with:907919079290832 9083490839

Key Modifiers

25Significant, separately identifiable E/M service by the same physician on the same day. Used if medication management or a physical evaluation is performed alongside psychotherapy.

95Synchronous telemedicine service rendered via real-time interactive audio and video telecommunications system.

Operational Requirements

time threshold

Coded as 60 minutes, but the actual face-to-face time with the patient must be at least 53 minutes. There is no maximum limit, but documentation must justify extended durations.

telehealth eligibility

Permanent authorization for audio-only delivery for behavioral health when video is not technically feasible or patient-preferred.

documentation of complexity

Due to the higher reimbursement of 90837, documentation should reflect the clinical complexity or the specific intensive work that justifies a 60-minute session over a 45-minute session.

frequency limits

While not strictly limited, daily or very frequent use of 90837 is subject to medical necessity review.

Compliance Checklist

Detailed time tracking (cumulative for the month).

Specific clinical decision-making documentation.

Electronic care plan availability and access log.

Audit Defense

No specific audit defense elements defined.

2026 Update

Exempt from the mandatory -2.5% efficiency cut. Audio-only (Modifier FQ) is permanently allowed.

Common Clinical Scenarios

No clinical examples provided.

Target Specialties & Utilization

PsychiatryClinical PsychologyLCSWLMFT

Typical Clinical Indications (ICD-10)

F43.10 (Post-traumatic stress disorder, unspecified)F33.1 (Major depressive disorder, recurrent, moderate)F60.3 (Borderline personality disorder)

Frequently Asked Questions

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Official Data Provider: CMS Physician Fee Schedule (2026)