What insurance policy changes affect CPT 90837?

There are 14 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, Harvard Pilgrim Health Care, MassHealth, New Jersey Medicaid, SelectHealth, Wisconsin ForwardHealth, Blue Cross of Idaho, Alaska Medicaid.

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 14 tracked payer policy changes from Nebraska Medicaid, Maryland Medicaid, and 9 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.

Medium impact

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

Blue Cross of Idaho·Effective Aug 1, 2025

Blue Cross of Idaho updated FQHC billing requirements for Medicare Advantage patients, removing MMCP/IMP billing requirements and clarifying language for Chronic Care Management (CCM), Virtual Communication Services (VCS), Psychiatric Collaborative Care Model (CoCM), and telehealth services. FQHCs must continue using specific revenue codes and HCPCS codes for qualifying services under the CMS Prospective Payment System.

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

Billing updates for mental health centers

Managed Care Entity Bulletin 135: Mental Health Center Policy Updates

[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

Tribal FQHC FAQs Updated