Every therapy session begins with listening, but when it comes to billing, the clock is also ticking.

In behavioral healthcare, what happens between the first “hello” and the final reflection is not just clinically valuable, but also determines how providers are reimbursed. In fact, behind each patient interaction lies a billing framework built on minutes and modifiers. That’s where time-based CPT codes come into play. These codes are the silent translators that turn your care into compensation. Using the right time-based code from a 30-minute one-on-one therapy session to urgent crisis interventions ensures your services are accurately represented and financially supported.

This blog examines how these codes function and why timing is crucial in offshore medical billing and coding services in India.

Why Timing Matters in Behavioral Health Billing

Time-based CPT codes enable accurate billing by aligning reimbursement with the actual time spent in psychotherapy. Whether it is a 30-minute session (CPT 90832), a 45-minute session (CPT 90834), or a full 60-minute session (CPT 90837), these codes enable mental health professionals—including psychologists, psychiatrists, social workers, and nurses—to clearly document and bill services based on the actual session length.

For instance, 90837 (60-minute therapy) is the most commonly billed CPT code in the United States which highlights the preference for deeper, more comprehensive sessions. These codes ensure that providers are fairly reimbursed while helping insurance companies confirm the legitimacy of services. However, if session times are not properly documented or the incorrect CPT code is selected, it can lead to denied claims, audits, or lost revenue. To avoid these issues, it is essential to record precise start and end times of the sessions, apply the correct time-based code, and stay informed about the latest billing and coding guidelines in behavioral health.

Different Time-Based CPT Codes Used

The following is a list of all major time-based CPT codes used in behavioral health, categorized by the type of service and including their corresponding time ranges:

Individual Psychotherapy

• 90832 – Psychotherapy, 30 minutes

Billable for sessions lasting between 16 to 37 minutes

• 90834 – Psychotherapy, 45 minutes

Billable for sessions lasting between 38 to 52 minutes

• 90837 – Psychotherapy, 60 minutes

Billable for sessions lasting 53 minutes or longer

Family Psychotherapy

• 90846 – Family psychotherapy without the patient present, 50 minutes

Minimum billable time: 26 minutes

• 90847 – Family psychotherapy with the patient present, 50 minutes

Minimum billable time: 26 minutes

Group Psychotherapy

• 90849 – Multiple-family group psychotherapy

(Time ranges may vary by payer requirements)

• 90853 – Group psychotherapy (non-family group)

(Time-based, typically 45–60 minutes)

Psychotherapy for Crisis Situations

• 90839 – Psychotherapy for crisis, first 60 minutes

Used for urgent, life-threatening or complex crisis intervention

• 90840 – Each additional 30 minutes of crisis psychotherapy

Used as an add-on to 90839 for longer sessions

Telehealth Psychotherapy

• 90834-95 – Psychotherapy, 45 minutes via telehealth
• 90837-95 – Psychotherapy, 60 minutes via telehealth

(Modifier 95 is added to indicate the session was conducted via telehealth)

Additional Related Codes Used in Behavioral Health

• 90791 – Psychiatric diagnostic evaluation

(Time-based but typically used for initial assessments)

• 97803 – Medical nutrition therapy – re-assessment and intervention, each 15 minutes

(Commonly used when dealing with comorbid conditions like eating disorders)

• 99214 – Evaluation and management, moderate complexity

(Used when behavioral health providers perform medical evaluations alongside therapy)

How to Ensure Accuracy in Time-Based Behavioral Health Billing

When it comes to billing for therapy sessions, every minute counts. Even a small mistake in documenting time or selecting the correct code can lead to huge problems. The following tips will help you stay compliant and confident when billing for behavioral health services:

●       Record Actual Session Start and Stop Times

It is always recommended to document the precise start and end times of each psychotherapy session in the clinical notes. This helps the providers to ensure the billed time aligns with your records, which is a fundamental requirement during insurance audits.

●       Match Code to Time Range

You should refer to the CPT manual or updated payer guidelines to verify that your billed CPT code matches the actual session duration:

• 90832: 16–37 minutes
• 90834: 38–52 minutes
• 90837: 53 minutes or more

Do remember that billing outside these ranges can result in claim denials.

●       Use Modifiers for Telehealth

When conducting sessions via telehealth, always append the Modifier 95 to indicate the virtual nature of the service. Some payers also require the appropriate place of service (POS) code for telehealth (e.g., POS 10 or POS 02).

●       Avoid Billing for Sessions Under 16 Minutes

Do not bill any psychotherapy codes if the session lasted less than 16 minutes. Such brief interactions are considered non-billable by most insurers and may trigger audits if submitted.

●       Use Add-On Codes When Necessary

Don’t forget to use 90840 in addition to 90839 for crisis sessions longer than 60 minutes. These two codes must be used together to reflect prolonged, intensive care during behavioural health emergencies accurately.

Additional Tip: Outsource to Offshore Behavioral Health Billing Services

Many behavioral health practices choose outsourcing medical billing and coding services providers in India to reduce errors, save time, and increase claim acceptance rates. These companies are experts in CPT code updates, insurance guidelines, and documentation requirements. They also help in tracking underpayments, managing denials, and ensuring compliance with Medicare and commercial payer rules.

At the heart of smart billing strategies, Info Hub Consultancy Services stands out as a reliable offshore partner customized for behavioral health practices. More than just managing codes and claims, our team delivers a seamless bridge between clinical work and financial outcomes. Are you ready to scale without getting bogged down in paperwork? Info Hub Consultancy Services offers clarity, control, and confidence in every claim submitted.

FAQs

1. Can two sessions on the same day be billed separately?

If clinically necessary and properly documented, multiple sessions on the same day can be billed.

2. Are there differences in reimbursement rates for in-person versus telehealth CPT codes?

Sometimes, Medicare often pays equally, but private payers may vary in reimbursement.

3. What is the difference between time-based and event-based CPT codes?

Time-based codes are billed based on session duration, whereas event-based codes reflect the service type regardless of the duration.

4. Can missed appointments be billed with CPT codes?

CPT codes only apply to services actually rendered; missed sessions are not reimbursable.

5. Can time spent writing notes be included in session time?

Only face-to-face or real-time virtual patient interaction counts toward billable time.

6. Are CPT codes different for child versus adult therapy?

Time-based psychotherapy CPT codes are the same regardless of patient age.

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