If you bill CPT 90837 for 60-minute sessions, you may have noticed more denials and reviews. Insurers increasingly expect documentation that justifies the longer session.
Why 90837 is flagged
Payers compare your 90837 usage to peers. When most sessions are billed at the longest code, it can trigger audits or pre-payment review.
What to document
- Exact start and stop times (53+ minutes).
- Symptom severity, risk factors or complexity that required extra time.
- Interventions used and the client's response.
- How the session ties to treatment-plan goals.
Practical tips
- Don't default to 90837. Bill the time you actually spent.
- Review your mix of 90834 and 90837 quarterly.
- Keep treatment plans current and specific.