What insurance policy changes affect CPT 90837?

There are 15 tracked policy changes affecting CPT 90837, including updates from Nebraska Medicaid, Maryland Medicaid, CareSource. Each change may modify coverage criteria, reimbursement rates, or prior-authorization requirements.

Which payers have updated policy for CPT 90837?

Payers that have issued tracked updates for CPT 90837 include: Nebraska Medicaid, Maryland Medicaid, CareSource, SC Medicaid - SCDHHS, Aetna, Harvard Pilgrim Health Care, MassHealth, Wisconsin Medicaid (ForwardHealth), New Jersey Medicaid, SelectHealth, Wisconsin ForwardHealth, Blue Cross of Idaho.

How do I get notified when CPT 90837 policy changes?

Create a free account at PolicyChanges.app and save a search filtered to CPT 90837. You will receive a daily digest email whenever a new policy change references this code.

Why do payers change policies for CPT 90837?

Payers revise policies for individual billing codes to align with updated clinical guidelines, CMS rule changes, fraud and abuse prevention measures, or network cost-management goals. Changes can affect medical necessity criteria, place-of-service restrictions, bundling rules, or whether a code requires prior authorization.

90837 — A therapy session between a patient and mental health professional lasting about an hour.: Insurance Policy Changes

90837 Insurance Policy Changes

CPT 90837, in plain terms, covers A therapy session between a patient and mental health professional lasting about an hour. CPT 90837 is referenced in 15 tracked payer policy changes from Nebraska Medicaid, Maryland Medicaid, and 10 other payers. For billers and coders, staying current on payer-specific coverage criteria, reimbursement rules, and prior-authorization requirements for CPT 90837 is critical to clean claim submission. Each entry below links to the full policy analysis with effective dates and action steps.

High impact

Claims Submission Information for Expanded School-Based ServicesMay 15, 2026: This Update has been revised since its original publication. Revised information appears in red text on pages 1, 2, and 4.

Wisconsin Medicaid (ForwardHealth)·Effective Aug 11, 2025

Effective August 11, 2025, Wisconsin schools can now submit claims for expanded school-based services including mental health, therapy, audiology, nursing, physician, and dental services using new procedure codes. Modifiers are no longer required on school-based services claims (though providers may still include them). The policy has been recently revised with updates noted in red text on pages 1, 2, and 4.

90837 Insurance Policy Changes

Billing changes and clarifications for Crisis Intervention Mental Health and Social Detoxification services

PT 66-26: Federally Qualified Health Center and Rural Health Center Coding Guidelines

[Georgia] CareSource Policy and Prior Authorization changes

Rehabilitative Behavioral Health and Substance Use Services Rate Increases

Eye Movement Desensitization and Reprocessing (EMDR) Therapy (CPB 0583, reviewed 2025-09-09)

Billing updates for mental health centers

Managed Care Entity Bulletin 135: Mental Health Center Policy Updates

Claims Submission Information for Expanded School-Based ServicesMay 15, 2026: This Update has been revised since its original publication. Revised information appears in red text on pages 1, 2, and 4.

[Georgia] Prior Authorization Requirement Update

[Georgia] Clarification on Behavioral Health Outpatient Therapy Codes

Medicaid Alert MA-2025-01

February 2026

ForwardHealth Update 2025-33: ForwardHealth Enhances Behavioral Health Treatment With More Options for Continuing Care and Concurrent Services

MAPAP111 - Billing Requirements for Federally Qualified Health Centers (FQHCs) - Updated language CCM, VCS, CoCM, and telehealth

MAPAP113 - Billing Requirements for Rural Health Centers (RHCs) - Revised exclusions added