Mastering New Billing Codes For Extended Therapy Sessions

Therapy practice is continually evolving in response to billing code changes that impact how lengthy therapy sessions are coded and paid for. Mastering New Billing Codes for Extended Therapy Sessions involves becoming acquainted with current instructions from CPT for coding and documentation purposes.

It was common practice for therapists to use the prolonged service code when adding extra therapy time. This has changed, however, calling for some revision to existing processes.

Understanding these updates can help practices:

• Improve billing accuracy
• Reduce claim denials
• Support appropriate reimbursement
• Strengthen documentation
• Maintain compliance standards

Providers who are proactive manage to enhance patient experience and financial stability.

Removal of CPT Codes 99354 and 99355

The change that had the greatest effect on the billing process was the removal of codes 99354 and 99355 from use in most outpatient prolonged services visits. This is how clinics billed for their extended services to patients.

The elimination of these codes caused confusion for therapists who often booked longer sessions. Practices had to check insurance rules, train teams again, and fix billing systems.

Key implications included:

• Changes to prolonged service reporting
• Revisions to coding workflows
• Updated payer expectations
• Increased focus on psychotherapy-specific codes
• Greater importance of detailed documentation

Practices that don’t update their coding methods risk late payments, denied claims, and lawsuits.

Why 99354 and 99355 Mattered for Therapists Billing Extended Sessions

Before their removal, extended service codes allowed therapists to charge for longer sessions with patients who required extra care. These visits helped with complex emotional support, urgent cases, or detailed therapy plans.

The availability of these codes ensured fair pay for extended visits. Without them, providers had to adjust their scheduling and billing practices.

These codes mattered because they:

• Reflected additional provider time
• Supported reimbursement for extended care
• Recognized patient complexity
• Improved revenue opportunities
• Encouraged accurate reporting of services

Today, providers must understand billing choices and correct therapy codes to ensure claims are accurate and payments arrive fast.

Financial and Clinical Impact on Mental Health Practices

Billing changes don’t just impact paperwork. These determine how employees will be hired, scheduling, and operations in general throughout the organization.

From an economic standpoint, errors in coding decrease payments received and increase denials. From a patient care perspective, there may be changes in visit planning based on payer requirements without decreasing patient needs.

Potential impacts include:

• Reduced revenue from incorrect billing
• Increased administrative burden
• More frequent documentation reviews
• Scheduling adjustments
• Additional staff education needs
• Greater emphasis on compliance

Practices that act fast on industry changes keep things running smoothly and provide good care.

How to Bill Extended Therapy Sessions in 2025

Providers billing for longer therapy sessions must track time correctly, follow payer rules, and keep clear records.

The extended therapy session CPT codes have adopted the use of psychotherapy codes that apply to extended visits, and not the previous method of prolonged service codes.

Best practices include:

• Verify payer-specific policies
• Document total treatment time
• Record clinical necessity
• Support treatment goals clearly
• Review telehealth requirements
• Audit claims regularly

Knowing the correct billing code for therapy sessions minimizes confusion.

Those looking for the correct coding for the 90-minute therapy session need to be careful with assumptions and ensure that their payers allow payment using current codes for psychotherapy sessions.

Medicare Reimbursement Rate for CPT 90834 (2024–2025)

CPT 90834 is a top choice for therapy billing. It covers a standard 45-minute session with a patient.

For providers serving Medicare patients, payment rates vary by area and year. Stay informed—review Medicare’s current rules regularly.

Important considerations include:

• Local reimbursement variations
• Documentation requirements
• Medical necessity standards
• Telehealth billing updates
• Annual fee schedule changes

Most practitioners use 90834 in relation to CPT codes for therapy sessions; however, its use is limited to instances where the documentation supports meeting the minimum time requirement.

Comprehension of the appropriate CPT code for psychotherapy promotes compliance and accurate reimbursement.

CPT Code 90837 — Billing 60-Minute and Longer Therapy Sessions

CPT 90837 covers a full hour of one-on-one therapy. More clinics now use it for longer treatment plans.

Your documentation must show why this time was needed and how it helped the patient. Track time right and list what you did during the session.

Best practices for using 90837 include:

• Record session duration accurately
• Document clinical complexity
• Support the treatment necessity
• Confirm payer acceptance
• Maintain complete patient records
• Review audit preparedness

The CPT code used for extended psychotherapy sessions, commonly referred to by healthcare practitioners, is CPT 90837.

The behavioral health practitioner should always be up to date with the individual therapy billing codes, individual therapy codes, and the various codes for psychotherapy sessions. 

These new billing CPT codes allow for easier adaptation within the practice despite changes within the industry and minimize liability from lengthy therapy sessions.

Conclusion

To master new billing codes for extended therapy, it will require time, proper documentation, and understanding how the insurance company thinks. This is because the old codes that were used for long visits no longer exist.

With appropriate billing techniques, reimbursement regulations, and record-keeping practices, mental health practitioners will be able to increase their number of successful claims and sustain their income. Staying current at this time will help make it possible to adjust to future changes in billing without sacrificing patient care.

Frequently Asked Questions

1. What CPT code replaced 99354 and 99355 for extended therapy sessions?

Substitution for psychotherapy has its own unique code. In general, professionals utilize the codes of psychotherapy 90837 provided they have all necessary documents to do so.

2. Can I bill two units of CPT 90834 for a 90-minute therapy session?

Coding two units of 90834 is not acceptable in most cases. It should be done following payer guidelines and making use of the psychotherapy codes that match the services provided.

3. What is the difference between CPT 90834 and CPT 90837 for therapy billing?

The CPT code 90834 includes 45 minutes of therapy, while the CPT code 90837 includes 60 minutes of therapy provided that there is proper documentation.

4. What documentation is required to bill extended therapy sessions?

Documentations need to cover treatment duration, treatment necessity, interventions done, patient reaction, treatment objectives, and signatures of providers.

5. How do I bill extended therapy sessions via telehealth in 2026?

It should be kept in mind that physicians must ensure compliance with payer requirements and may need to include modifiers along with documenting the necessity of the service provided.

ALSO READ – Importance of Medical Documentation and Diagnosis Coding in Mental Health Billing