CPT code 90832 represents the shortest individual psychotherapy session that qualifies for insurance reimbursement. While it is used less frequently than its longer counterparts (90834 and 90837), understanding when and how to bill 90832 correctly can help you capture revenue for legitimate brief therapy sessions, medication check-ins with psychotherapy, and crisis interventions.
This comprehensive guide covers everything you need to know about CPT 90832: time requirements, appropriate clinical scenarios, documentation standards, reimbursement rates, and strategies to avoid common billing pitfalls.
What Is CPT 90832?
CPT 90832 is the billing code for individual psychotherapy sessions lasting 16-37 minutes of face-to-face time with the patient. The American Medical Association defines this code as:
"Psychotherapy, 30 minutes with patient when performed with an evaluation and management service."
Note: When billed alone (not with E/M), the descriptor is simply "Psychotherapy, 30 minutes with patient."
The "30 minutes" in the code description refers to the midpoint of the time range. The actual billable range spans from 16 minutes at the minimum to 37 minutes at the maximum. Sessions shorter than 16 minutes do not qualify for 90832, and sessions of 38 minutes or longer should be billed as 90834.
Key Facts About 90832
- Time Range: 16-37 minutes of face-to-face psychotherapy
- Session Type: Individual therapy only (not group or family)
- Frequency: Accounts for approximately 15% of outpatient psychotherapy claims
- Add-on Option: Can be billed with E/M codes when psychotherapy is provided during a medication management visit
- Supervision: Billable by licensed psychologists, clinical social workers, licensed professional counselors, and other qualified mental health professionals
Understanding the 16-37 Minute Time Range
Time-based billing is the foundation of psychotherapy CPT codes. For 90832, the time counted is strictly face-to-face psychotherapy time with the patient. This creates specific boundaries you must understand:
Time That Counts
- Direct therapeutic conversation with patient
- Psychotherapy interventions (CBT, DBT, etc.)
- Crisis intervention counseling
- Processing and insight work
- Treatment planning discussions with patient
- Psychoeducation delivered directly to patient
Time That Does Not Count
- Chart review before the session
- Documentation after the session
- Phone calls with other providers
- Waiting for patient to arrive
- Administrative tasks (scheduling, billing)
- Travel time for home visits
Important Time Boundaries
If your session runs 15 minutes or less, you cannot bill 90832. If your session runs 38 minutes or more, you should bill 90834 instead. Accurate time tracking is essential to avoid upcoding or downcoding violations.
Time Thresholds at a Glance
| CPT Code | Time Range | Midpoint |
|---|---|---|
| 90832 | 16-37 minutes | 30 minutes |
| 90834 | 38-52 minutes | 45 minutes |
| 90837 | 53+ minutes | 60 minutes |
Medicare vs Commercial Reimbursement Rates
Reimbursement for 90832 varies significantly based on payer, geographic location, and provider credentials. Here is what you can typically expect:
2024-2025 Medicare Rates
Medicare rates for 90832 are based on the Physician Fee Schedule and adjusted by geographic locality. The national average for 2024:
Commercial Insurance Rates
Commercial payers typically reimburse 110-140% of Medicare rates, though this varies widely:
- Blue Cross Blue Shield: $75-95 average
- Aetna: $70-90 average
- United Healthcare: $72-88 average
- Cigna: $68-85 average
Rate Negotiation Tip
If your contracted rates for 90832 are below Medicare, consider renegotiating. Many practices overlook this code during contract negotiations because it is used less frequently. A 10% increase on 90832 may seem small, but it adds up across your patient population.
When Is CPT 90832 Appropriate?
Not every short therapy session should be billed as 90832. This code is designed for specific clinical scenarios where brief psychotherapy is therapeutically appropriate. Here are the most common legitimate uses:
Appropriate Uses for 90832
- ✓ Brief supportive therapy for stable patients in maintenance phase
- ✓ Psychotherapy add-on during medication management visits
- ✓ Crisis intervention when brief stabilization is needed
- ✓ Follow-up sessions after intensive treatment
- ✓ Sessions shortened due to patient factors (fatigue, medical condition)
- ✓ Targeted skill reinforcement for specific coping strategies
When NOT to Use 90832
- ✗ Routinely scheduling 30-minute sessions to see more patients
- ✗ When patient needs exceed what can be addressed in 30 minutes
- ✗ Initial evaluations (use 90791 instead)
- ✗ Complex trauma processing that requires longer sessions
- ✗ Sessions that consistently run 38+ minutes
- ✗ Attempting to bill for phone calls or portal messages
Clinical Scenarios Where 90832 Makes Sense
Scenario 1: Medication Management with Brief Therapy
A psychiatrist sees a patient for medication review (billed as E/M code 99213 or 99214) and also provides 20 minutes of supportive psychotherapy addressing medication adherence and coping strategies. The 90832 is billed as an add-on to the E/M service.
Scenario 2: Stable Maintenance Patient
A patient who has completed active treatment for depression is in the maintenance phase. They come in monthly for 25-minute check-ins focusing on relapse prevention. This is appropriate use of 90832.
Scenario 3: Crisis Bridge Session
A patient calls in crisis between regular appointments. The therapist fits in a 30-minute session to provide stabilization and safety planning until their next full session. This is a legitimate 90832.
Required Documentation Elements
Proper documentation is your defense against audits and denials. For 90832, your notes must support both the medical necessity of the service and the time billed.
90832 Documentation Checklist
Sample Documentation Language
"Patient seen for 28 minutes of individual psychotherapy (start time: 2:00 PM, stop time: 2:28 PM). This brief session format is clinically appropriate given the patient's stable presentation and maintenance phase of treatment. Utilized supportive therapy techniques focusing on reinforcement of coping strategies for work-related stressors. Patient demonstrated improved insight and reported successful use of grounding techniques since last session. Will continue monthly 30-minute maintenance sessions. Next appointment scheduled for [date]."
Common Modifiers for 90832
Modifiers can affect reimbursement and provide important information to payers. Here are the modifiers most commonly used with 90832:
| Modifier | Description | When to Use |
|---|---|---|
| -95 | Synchronous telemedicine service | Video telehealth sessions |
| -GT | Via interactive audio/video | Alternative telehealth modifier (payer-dependent) |
| -HO | Masters level provider | LCSW, LPC, or equivalent |
| -52 | Reduced services | Session ended early (use rarely) |
| -59 | Distinct procedural service | When billing with E/M on same day |
Payer-Specific Restrictions
Some insurance payers have specific policies around 90832 that can affect coverage and reimbursement. Being aware of these helps prevent unexpected denials.
Common Payer Restrictions
- Medicare: May require documentation explaining why a shorter session was clinically appropriate if billed frequently
- Medicaid (varies by state): Some states do not cover 90832 at all, or limit it to specific diagnoses
- Blue Cross: Some plans require prior authorization if 90832 is billed more than 4 times in 30 days
- United Healthcare: May request clinical documentation if 90832 represents more than 30% of your claims for a patient
- Managed Care Plans: Often have lower reimbursement and may steer toward 90834 as the standard
Pro Tip: Check Payer Policies
Before routinely scheduling 30-minute sessions, verify coverage with each major payer in your practice. Some commercial plans have moved away from covering 90832 entirely, expecting 90834 as the minimum session length.
Common Denial Reasons and Prevention
Understanding why 90832 claims get denied helps you prevent these issues before they occur:
Missing or Inadequate Time Documentation
Prevention: Always document start time, stop time, and total face-to-face minutes. Use your EHR's time-tracking features.
Frequency Limits Exceeded
Prevention: Know payer-specific frequency limits. If you need to see a patient more often, obtain prior authorization.
Medical Necessity Not Established
Prevention: Document why the brief session length is clinically appropriate. Link interventions to treatment goals.
Incorrect Modifier Usage
Prevention: Use appropriate modifiers for telehealth and provider type. Check payer-specific modifier requirements.
Bundling Issues with E/M Codes
Prevention: When billing 90832 with E/M, ensure the psychotherapy was distinct and separately identifiable. Use modifier -59 appropriately.
90832 vs 90834 vs 90837: Decision Guide
Choosing the correct psychotherapy code is straightforward once you understand the time boundaries. Here is how to decide:
| Factor | 90832 | 90834 | 90837 |
|---|---|---|---|
| Time Range | 16-37 min | 38-52 min | 53+ min |
| Medicare Rate | ~$68 | ~$102 | ~$152 |
| Best For | Maintenance, add-on to E/M | Standard sessions | Complex cases, trauma |
| Payer Acceptance | Variable | Universally accepted | May require justification |
| Audit Risk | Higher (if used frequently) | Lower | Moderate |
The Golden Rule
Bill for the time you actually spent providing psychotherapy. Never extend sessions just to bill a higher code, and never shorten documentation of actual time to fit a lower code. Let clinical needs drive session length, then bill accurately.
Real-World Billing Scenarios
Let us walk through some common situations where 90832 billing questions arise:
Scenario A: Psychiatrist Medication Visit + Therapy
Situation: Dr. Smith sees a patient for a 30-minute appointment. She spends 10 minutes on medication review and adjustment (E/M), then 20 minutes providing supportive psychotherapy addressing the patient's anxiety about work.
Correct Billing: 99213 (or 99214, depending on complexity) + 90832
Key Point: The psychotherapy time (20 minutes) falls within the 90832 range (16-37 minutes). The E/M and psychotherapy are distinct services.
Scenario B: Session Ends Early
Situation: A therapist schedules a 45-minute session, but the patient becomes too fatigued to continue after 25 minutes due to their medical condition.
Correct Billing: 90832 (the session fell within the 16-37 minute range)
Key Point: Document the clinical reason for the shortened session. Do not bill for time that did not occur.
Scenario C: Telehealth Brief Session
Situation: A therapist provides a 30-minute video telehealth session for a stable patient in the maintenance phase.
Correct Billing: 90832-95 (or 90832-GT, depending on payer)
Key Point: Add the appropriate telehealth modifier. Also include place of service code 02 (telehealth) or 10 (telehealth in patient home).
Frequently Asked Questions
Can I bill 90832 for a phone session? ▼
It depends on the payer. Medicare allows 90832 for audio-only telehealth with the -93 modifier in certain circumstances. Commercial payers vary widely. Many require video capability for psychotherapy billing. Always verify payer-specific telehealth policies before billing phone sessions.
How often can I bill 90832 for the same patient? ▼
There is no universal limit, but frequent 90832 billing may trigger audits. If you are consistently seeing a patient for 30-minute sessions, document why this session length is clinically appropriate. Some payers have specific frequency limits, such as no more than 4 sessions per month at this code level.
What if my session runs exactly 38 minutes? ▼
At exactly 38 minutes, you should bill 90834, not 90832. The time ranges are strict: 90832 covers 16-37 minutes, and 90834 begins at 38 minutes. There is no overlap or rounding. Bill the code that matches your documented time.
Can interns or trainees bill 90832? ▼
This depends on state regulations and payer policies. In most cases, services provided by trainees must be billed under a supervising provider's credentials. Medicare has specific "incident to" rules. Commercial payers vary. Always verify credentialing requirements before billing for trainee services.
Is 90832 covered for children and adolescents? ▼
Yes, 90832 can be used for patients of any age when individual psychotherapy is provided. However, brief sessions may be less clinically appropriate for younger patients who need more time to engage. Some payers may question frequent use of 90832 for child/adolescent patients.
What diagnoses support 90832 billing? ▼
Any mental health diagnosis that requires psychotherapy can support 90832 billing. Common diagnoses include F32.x (Major Depressive Disorder), F41.x (Anxiety Disorders), F43.x (Adjustment Disorders), and F90.x (ADHD). The diagnosis must support medical necessity for psychotherapy services.
Can I bill 90832 and 90837 on the same day? ▼
Generally no. The psychotherapy codes (90832, 90834, 90837) represent time-based services that should not be billed together for the same patient on the same day. If you provide 60+ minutes of psychotherapy, bill 90837 for the total time. The only exception is when billing 90832 as an add-on to E/M services.
Key Takeaways
Master CPT 90832 Billing
CPT 90832 serves an important role in your billing toolkit, particularly for maintenance patients, medication management add-ons, and situations where brief therapeutic interventions are clinically appropriate. By understanding the time requirements, documentation standards, and payer expectations, you can bill this code confidently and avoid common pitfalls.
Remember: accurate billing starts with accurate time tracking. Make it a habit to document your session times precisely, and the correct CPT code will follow naturally.
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TheraFocus Team
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The TheraFocus team is dedicated to empowering therapy practices with cutting-edge technology, expert guidance, and actionable insights on practice management, compliance, and clinical excellence.