CPT90837

Psychotherapy (60 min) Cost

Psytx w pt 60 minutes

$317Hospital outpatient total2026 Medicare, physician + facility
Hospital payments are wage-adjusted by locality, so the ZIP changes the numbers.
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National Medicare physician rate (2026)

Medicare (Hospital)
$135.27
Facility physician fee
Private plan est.
$217–$334
~130–200% of Medicare
Cash / self-pay est.
$134–$251
~80–150% of Medicare

What the whole procedure costs

The rate above is the physician’s fee on its own. The facility bills separately, and for most procedures the facility is the larger half of the bill. These are 2026 national Medicare amounts.

Physician fee alone
$135
Only 43% of the hospital total

Medicare may pay the facility separately for this code or package it into another service on the same day, so treat the facility share as an upper bound. Medicare allowed amounts are not what an uninsured patient is charged, and not a quote. Private plans typically allow more.

Get the rate for your ZIP

CMS adjusts this CPT by locality. A five-digit ZIP is enough — no account, no insurance card.

What psychotherapy (60 min) costs at hospitals near you

Everything above is a national average. The hospital you pick in your area moves the bill more than anything else you control.

Locked

Rates for your ZIP, 5 named hospitals with CMS ratings, the add-on codes, and the scheduler script.

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What these numbers are

Every figure on this page is a 2026 Medicare allowed amount: the physician line comes from the Physician Fee Schedule adjusted by geographic practice-cost indices, and the facility totals come from the CMS hospital outpatient (OPPS) and ambulatory surgery centre rates. None of them is a hospital chargemaster price, your insurer's contracted rate, or a quote. Anesthesia, pathology, imaging reads and follow-up care are billed under their own codes when they apply, and an inpatient stay is paid a different way again. For this code the office and hospital physician lines differ by $31.73.

How CMS prices CPT 90837

CMS descriptionPsytx w pt 60 minutes
Work RVU3.78
Practice expense RVU (office)1.20
Practice expense RVU (hospital)0.25
Malpractice RVU0.02
Conversion factor$33.4009

Work is about 76% of the office total RVU; practice expense is about 24%. Localities with a high PE GPCI move this code more when practice expense is a large share.

Office vs hospital for this code

Office (non-facility) physician rate: $167.00. Hospital (facility) physician rate: $135.27.

Medicare patients typically owe 20% of the allowed amount after the Part B deductible — about $33 for the office physician fee, before any Medigap coverage. That coinsurance does not include a hospital facility fee.

Labeled private-plan and cash ranges on this page are arithmetic multiples of Medicare, not negotiated quotes. Ask the billing office for the CPT code, the site of service, and a good-faith estimate.

What Is Psychotherapy (60 min)?

This is an extended individual psychotherapy session of about 60 minutes, used when clinical work benefits from more time, such as trauma-focused therapies like EMDR or prolonged exposure, complex cases, or clients who simply progress better with longer sessions. The experience is the same as any therapy session, just longer, in office or via telehealth. Many private-practice therapists use this as their default session length.

What Affects the Cost

  • The 60-minute code both charges and reimburses more than the 45-minute 90834, so session length is itself a cost decision.
  • Some insurers scrutinize routine use of the longer code and effectively pressure therapists toward 45-minute billing, affecting what is offered in network.
  • Trauma protocols that clinically require longer sessions can lock you into the higher per-session rate for an extended course.
  • Cash rates for 60-minute sessions in major metropolitan areas run well above national averages.
  • Weekly frequency at the higher session rate compounds fastest of the common therapy configurations.

How It Is Billed

CPT 90837 applies to sessions of 53 minutes or more; the actual session length in the record must support the code, and payers occasionally audit heavy 90837 billers. It bills per session, cannot combine with 90834 on the same day, and telehealth sessions bill the same code with a location modifier. If insurers request treatment plans to justify continued extended sessions, that review process can interrupt reimbursement, though parity rules constrain how restrictive it can be.

Insurance & Coverage Notes

Coverage mirrors other psychotherapy: in-network copay or coinsurance per session, parity protections against arbitrary limits, and broad telehealth acceptance. The practical wrinkle unique to this code is payer friction: some plans reimburse 90837 only modestly above 90834 or ask therapists to justify the longer length, which influences whether in-network clinicians offer full-hour sessions at all. If out of network, your reimbursement depends on the plan's allowed amount for this specific code, worth asking your insurer for in advance.

Questions to Ask Before Booking

  • 1.Do you bill 45 or 60 minute sessions, and how does that change my cost per visit?
  • 2.Does my treatment approach genuinely need the longer session, or would 45 minutes serve?
  • 3.What is my plan's allowed amount for 90837 out of network?
  • 4.Has my insurer ever pushed back on your 60-minute billing, and what happens to my sessions if it does?
  • 5.Is telehealth billed at the same rate as in-person for the hour session?

Psychotherapy (60 min) (CPT 90837): questions

The 2026 national Medicare physician rate for CPT 90837 is $167.00 in an office and $135.27 in a hospital. Enter a ZIP code to apply the geographic adjustment for your locality.

Medicare uses a different practice-expense RVU in a facility. For CPT 90837 that produces an office rate of $167.00 and a hospital physician rate of $135.27 (a $31.73 gap). The hospital’s own facility charge is extra and often larger than this entire physician line.

This is an extended individual psychotherapy session of about 60 minutes, used when clinical work benefits from more time, such as trauma-focused therapies like EMDR or prolonged exposure, complex cases, or clients who simply progress better with longer sessions. The experience is the same as any therapy session, just longer, in office or via telehealth. Many private-practice therapists use this as their default session length. CMS bills it as “Psytx w pt 60 minutes.”

Not on its own. $167.00 is the physician allowed amount. Medicare also pays the facility, which takes the total to about $317 in a hospital outpatient department. Anesthesia, pathology and imaging interpretation billed under other codes are separate again. Private-plan allowed amounts are often higher than Medicare; your deductible and coinsurance still apply.

For cash-pay surgery shopping, use this CPT as the Medicare floor when you compare written quotes. How cash-price shopping works.

Data source: 2026 Medicare Physician Fee Schedule (CMS PPRRVU26B, released March 2026). Conversion factor: $33.4009. Prices shown are Medicare allowed amounts for the physician service and may not match what you are billed. Private insurance and self-pay ranges, when shown, are labeled estimates (typical multiples of Medicare), not quotes. This site is an independent cost tool, not medical advice.