Why a 90837 (53+ minute therapy session) is more effective than a 90834 (38-52 minute therapy session) for the client

longer therapy sessions

Mental health is a crucial aspect of our lives, and therapy is a powerful tool for individuals looking to improve and maintain their well-being. However, with the growing number of different types of therapies available, the options for billing and payment have become increasingly diverse.

It’s especially challenging when it comes to the duration of the session. It turns out that time plays a critical role in the effectiveness of therapy. Still, clients often find it hard to decide between 53+ minute (90837) and 38–52 minute (90834) therapy sessions, which is mainly due to different billing options that were created by health insurance companies.

Since 90837 is a longer session than 90834, usually it’s billed at a higher rate. This higher rate reflects the additional time and resources required to provide a longer therapy session. However, clients may not always be aware of the benefits of longer therapy sessions and choose shorter 38–52 minute sessions in an effort to reduce costs. Unfortunately, this can result in less effective therapy that requires more sessions, ultimately costing more than originally anticipated.

In this article, we will delve into these two CPT codes and explain why we believe that 53+ minute therapy sessions (90837) are more effective than shorter sessions (90834). By the end of this article, it will become clear why longer therapy sessions can lead to more positive outcomes for clients.

Typical Length of Counseling Sessions

Some people or health insurance representatives may believe that a typical counseling session usually lasts for about 30-45 minutes. But the truth is that when it comes to counseling, there’s no such thing as a “typical length.” Instead, a counseling session can vary depending on the type of therapy, the needs of the client, and the goals of the treatment.

It’s true that some short-term therapies, such as solution-focused or cognitive-behavioral therapies, may be modeled on an idea that they only require a few sessions of around 30-45 minutes each. On the other hand, longer-term therapies, such as psychoanalytic or psychodynamic therapies, (and EMDR therapy) may require sessions of 50–60 minutes or longer. Furthermore, often couples counseling requires longer sessions, such as 85 minutes for the first three sessions, to allow for an in-depth exploration of the relationship issues and the development of a treatment plan.

In either case, the duration of the therapy session is a critical factor in determining its effectiveness and should be tailored to meet the specific needs of each client. Generally, longer therapy sessions allow for the development of a stronger therapeutic relationship and a deeper exploration of the client’s life situation, stressor, symptoms, and issues, which can lead to more meaningful and long-lasting change.

90837 vs 90834: Benefits of 53+ Minute Therapy Sessions

Clinical social workers and professional counselors use Current Procedural Terminology (CPT) codes to describe the types of performed procedures during therapy sessions for reimbursement purposes. These codes are standardized by the Health Insurance Portability and Accountability Act (HIPAA) for simplifying the process of describing psychotherapy services and other health treatments for healthcare professionals.

90837 and 90834 are two of the most commonly used CPT codes for reporting individual psychotherapy services. The codes help therapists and insurance companies accurately determine the cost of each therapy session based on the amount of time and resources required to provide the treatment.

  • 90837 is a CPT code for individual psychotherapy sessions that are 53 minutes or longer in duration.
  • 90834 is a CPT code for an individual session that lasts between 38 and 52 minutes, often considered a standard psychotherapy session.

Therefore, both 90834 and 90837 are standardized codes, designed for psychotherapy services. While therapies that last for a shorter time usually require more sessions, studies show that the frequency of therapy isn’t related to more favorable outcomes. Instead, in a 2017 study, the number of sessions wasn’t related to therapeutic gains (Evans et al., 2017).

On the other hand, sessions that last longer than 53 minutes are accompanied by plenty of benefits for both clients and therapists, including an opportunity to build a stronger therapeutic alliance and a sense of continuity and stability.

Why Are Longer Therapy Sessions More Effective?

While longer therapy sessions can provide numerous benefits, you might be concerned about the time and cost of longer sessions. However, you should know that longer therapy sessions such as 90837 allow for a more in-depth and comprehensive exploration of your issues.

Still, if you’re wondering why you should choose longer therapies that cost more, take a look at some of the benefits of 53+ minute sessions:

  • The ability to build a stronger therapeutic alliance

Did you know that the therapeutic relationship is directly related to treatment outcomes? Well, studies prove that developing and maintaining a strong therapeutic alliance leads to more effective results (Cronin et al., 2014).

A therapeutic alliance is a relationship between the therapist and the client, and it is a crucial factor in determining the success of therapy. Longer therapy sessions provide more time for the therapist and the client to get to know each other, establish trust, and work together to achieve the client’s goals. When clients experience the affective bond and collaborative nature of the relationship with a therapist, they feel heard, understood, and supported. As a result, the client is more likely to feel comfortable sharing their thoughts and feelings and to be more engaged in the therapy process (Norcross, 2010).

  • More time for clients to process and integrate insights

The therapeutic process often involves exploring difficult emotions and experiences, and it can take time for clients to fully process and understand these experiences. During a longer therapy session, the client has more time to reflect on what has been discussed, ask questions, and explore their thoughts and feelings in greater depth.

This increased understanding can help to build the client’s confidence and resilience, and it can also help them feel more empowered and in control of their lives.

  • More time to address complex or long-standing mental health issues

Mental health problems can be complex and deeply rooted, and they often require more time and attention to resolve.

In comparison, shorter therapy sessions of 38-52 minutes may not provide enough time to delve deeply into these issues and make progress in resolving them. The limited time frame can result in a surface-level treatment approach, where only the symptoms are addressed and not the underlying causes.

On the other hand, longer therapy sessions allow for a more comprehensive and in-depth examination of mental health problems. This additional time allows the client and therapist to work together to identify the root causes and develop a tailored treatment plan that addresses these issues. Ultimately, this leads to a more effective and lasting resolution of mental health problems.

Negative Effects of Time Limits on Psychotherapy

Imagine sitting down with your therapist, ready to delve into the depths of your emotions and experiences. But after 52 minutes, your therapist reminds you that your time is up and stops listening to you. How would you be able to express yourself and resolve your complex issue?

While therapists don’t actually set timers for 38-52-minute or other types of sessions, time limits do affect the effectiveness of psychotherapy, making it harder to build rapport, feel heard, and create a sense of comfort.

A 2019 study published in Psychologica Belgica proves that time limits in therapy can impact therapy processes in complex ways. In particular, time limits exert pressure and can lead to a more directive approach from the therapist. These limitations can hinder the formation of a strong therapeutic alliance and hinder clients from processing and integrating insights, leading to less effective treatment outcomes (De Geest & Meganck, 2019).

Needless to say, when clients don’t feel heard or understood, they may be less likely to engage in therapy, leading to lower treatment outcomes. Therefore, time limits can lead to a lack of progress in treatment and a longer time frame for achieving therapeutic goals. On the other hand, clients receiving psychotherapy with predetermined time limits emphasized the significance of clear communication from the therapist regarding the therapy’s timeframes, while still allowing for personalized adjustments to therapy (Stige et al., 2021).

Final Thoughts: Choose 90837 for the Best Outcome

As you can see, 53+ minute sessions allow for more time for clients to process and integrate insights, practice therapeutic interventions, build a stronger therapeutic alliance, and address complex or long-standing mental health issues.

So, if you’re still hesitant to commit to a longer session, remind yourself that the investment in a longer session can pay off in the long run, as it can lead to more effective treatment and improved outcomes.

At Health for Life Counseling, we believe in the power of longer therapy sessions and are dedicated to providing the best possible care to our clients. Our licensed counselors will work with you to determine the session length that best meets your needs and provides the support you need to achieve your goals.

Reach out to us at our offices in Grand Rapids, MI, or Ada, MI, or talk to us online (telehealth for the State of Michigan only) and let us support you on your journey to wellness and a more balanced life.

Learn more about the Trauma-Informed Counseling Center of Grand Rapids

Learn more about Counseling and Therapy services at Health for Life Counseling Grand Rapids

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