90837 with Medicare: what the policy says
The short answerYes. Medicare covers 90837, a current telehealth code. The First Coast billing article says to report it for 53 or more minutes and document start and stop times or total time. Computed from 2026 RVUs, the national non-facility amount is about $167.00; CSWs, MFTs and MHCs get 75% of that.
By Javier Alvarez · Updated · 2 min read
1 row: Medicare. Public policy, not the member's benefits.
Medicare
Original Medicare (Part B) · All states
| 90785 | Listed [1] |
|---|---|
| 90791 | Listed [1] |
| 90832 | Listed [1] |
| 90834 | Listed [1] |
| 90837 | Listed [1] |
| 90846 | Listed (covered when medically reasonable and necessary with patient treatment as the primary purpose; PFS status indicator R (restricted coverage)) [1][2] |
| 90847 | Listed [1] |
| 90853 | Listed [1] |
| Other codes | Crisis psychotherapy 90839 and 90840 are on the CMS list of commonly used mental health codes and are marked as codes CPs, CSWs, MFTs and MHCs can bill. CPs, CSWs, MFTs and MHCs can bill the general behavioral health integration code G0323 when they personally perform the services. [1] |
| Telehealth POS | Use POS 02 when the patient is not at home and POS 10 when the patient is at home. Telehealth to the patient's home is paid at the non-facility rate. [3] |
| Telehealth rules | Behavioral health telehealth has no geographic or place-of-service restriction and the patient may be at home. Through December 31, 2027 audio-only is allowed at home; from January 1, 2028 audio-only behavioral health at home is allowed when the practitioner can use video but the patient cannot or does not consent to video. After December 31, 2027 an in-person visit is required within 6 months before the first home mental health telehealth service and then within 12 months of each one, with limited exceptions; patients who began mental health telehealth by December 31, 2027 count as established and need only the 12-month visit. [3][1] |
| Visit limits | Services billed by MFTs and MHCs are not paid under their benefit category when a hospital outpatient department or CMHC provides them in a partial hospitalization or intensive outpatient program. Services to SNF residents are excluded from consolidated billing, so include the SNF's Medicare provider number. [1] |
| Who can bill | Clinical psychologists, clinical social workers, MFTs and mental health counselors (including certified alcohol and drug counselors) are eligible professionals. MFTs and MHCs need a master's or doctoral degree that qualifies for state licensure or certification, a state license or certification, and at least 2 years or 3,000 hours of post-master's supervised clinical experience. Since January 1, 2024 they may enroll and bill Medicare independently. [1] |
| Payment | CSWs, MFTs and MHCs must accept assignment and are paid 75% of the PFS amount for clinical psychologists. Computed from the RVU26D October 2026 file (non-facility total RVUs x 33.4009 conversion factor, national, before geographic adjustment): about $167.00 for 90837, $113.90 for 90834, $85.84 for 90832, $173.35 for 90791, $109.55 for 90847 and $30.39 for 90853, before the 75% rate. [1][2] |
| Medicare rules | MFTs and MHCs enroll with PECOS or the paper CMS-855I, are limited screening risk, and pay no application fee. A separate CMS-855I is needed in each state where services are rendered. Medicaid enrollment does not enroll you in Medicare. [4] |
- CMS: MLN Medicare & Mental Health Coverage, MLN1986542 (March 2026), checked October 30, 2026
- CMS: PFS Relative Value Files, RVU26D (zip updated 08-26-2026, file PPRRVU2026_Oct_nonQPP), checked October 30, 2026
- CMS: Telehealth FAQ (updated 10/8/26), checked October 30, 2026
- CMS: Provider Enrollment FAQs for Marriage and Family Therapists and Mental Health Counselors (May 2024), checked October 30, 2026
What Medicare's policy says about 90837
90837 is the CPT code for psychotherapy, 60 minutes with patient. At Medicare it is listed: named in the payer's public policy. Each line below is from the cited text:
- Where it is listed. 90837 is on the CMS list of commonly used mental health codes and is marked as a current telehealth code. (CMS, checked October 30, 2026)
- Billed with. Per the First Coast article, a prolonged service code can be reported with 90837 only if the psychotherapy, not performed with an E/M service, is 90 minutes or longer with direct patient contact. Interactive complexity 90785 may be billed with 90837; with time-based codes the documentation must show the time spent on interactive complexity. (CMS Medicare Coverage Database, checked October 30, 2026)
- When it pays. A First Coast Service Options billing article (Florida, Puerto Rico, US Virgin Islands) says to choose the code closest to the actual time: 53 or more minutes for 90837 and 90838, 38 to 52 for 90834, 16 to 37 for 90832. Do not report psychotherapy under 16 minutes. (CMS Medicare Coverage Database, checked October 30, 2026)
- Units. The First Coast article says start and stop times or total times must be documented for 90832, 90834 and 90837. (CMS Medicare Coverage Database, checked October 30, 2026)
- Telehealth. 90837 is a current Medicare telehealth code. Medicare covers behavioral and mental health telehealth to the patient's home on a permanent basis; use POS 10 for the home. After December 31, 2027 the in-person visit rules in the Medicare row apply. (CMS, checked October 30, 2026; CMS, checked October 30, 2026)
- Payment. 2026 PFS (RVU26D October file): work RVU 3.78, non-facility practice expense 1.20, malpractice 0.02, non-facility total 5.00. Computed from these RVUs at the 33.4009 conversion factor: about $167.00 national, before geographic adjustment. CSWs, MFTs and MHCs are paid 75% of the clinical psychologist amount (computed: about $125.25). (CMS, checked October 30, 2026; CMS, checked October 30, 2026)
90837 at other payers
- 90837 with Illinois Medicaid (HFS), LPHA fee schedule: listed.
- 90837 with New York Medicaid (fee-for-service): listed.
The rest of Medicare's psychotherapy rules
The Medicare row has its codes, telehealth rule, limits and authorization, each with its source. Before the claim goes out, compare it with the row in the table above.