JotPsych Notes: from the Medical Group Management Association conference

90837 would pay social workers and counselors $139 nationally under Medicare's proposal

The 2027 amount comes before Medicare adjusts it for each area and includes the patient's coinsurance. Each note must show a session of 53 minutes or more.

Nate Peereboom
Co-founder, JotPsych

Your social workers and counselors bill hour-long Medicare sessions as 90837. Medicare proposes a higher amount for that code in 2027. You can lose the 90837 payment in an audit when a note doesn't show how long the session ran.

Medicare's proposed 2027 allowed amount for 90837 billed by a social worker, counselor, or marriage and family therapist

$139

per session, national, before the adjustment for each area

Medicare's 2027 proposed rule addendum and its mental health coverage booklet, March 2026. The patient's 20 percent coinsurance is part of the allowed amount.

Medicare allows your social workers, counselors, and marriage and family therapists 75 percent of the fee schedule amount. Psychologists would get the full amount, a national $185 per 90837 in 2027, coinsurance included. Check your 90837 notes now.

Four steps to put the minutes on your 90837 notes

Find your Medicare contractor's billing article. The compliance tips from the Centers for Medicare & Medicaid Services (CMS) send you to your Medicare Administrative Contractor's article in the Medicare Coverage Database. Look for the article's rule on session time.
Pull ten of your Medicare notes billed as 90837. Take them from last month. Include notes from more than one of your therapists.
Check each note for the minutes your contractor's article asks for. First Coast Service Options, the contractor for Florida, Puerto Rico, and the U.S. Virgin Islands, writes in its article: "Start and stop times or total times must be documented."
Add a time line to your note template. Ask each therapist to fill in the start and stop times before signing the note.

One 55-minute therapy session billed as 90837, documented two ways

an illustration, not a measurement

Note A

Psychotherapy, 90837

Start 2:00 PM, end 2:55 PM

Total time: 55 minutes

Note B

Psychotherapy, 90837

Start and end: not in the note

Total time: not in the note

90837 needs a session of 53 minutes or more. Both notes bill 90837 for the same session, and an auditor can confirm the time only from Note A.

The proposal also cuts every clinician's 2027 conversion factor, the dollar amount Medicare multiplies by each code's relative value units. The Medical Group Management Association's government affairs staff flagged the cut.

Therapy codes rise anyway. CMS's proposed rule expects "a significant positive impact on clinical psychologists and clinical social workers." Compared with CMS's 2026 rate file, your social workers, counselors, and marriage and family therapists gain on all three psychotherapy codes in the 2027 proposal.

Medicare's allowed amount for three psychotherapy codes billed by a social worker, counselor, or marriage and family therapist, 2026 and proposed 2027

dollars per session, national, before the adjustment for each area; CMS rate files

Allowed amounts, office setting

CodeMinutes20262027

9083216 to 37$64$71

9083438 to 52$85$94

9083753 or more$125$139

The 2027 amounts are proposed.

CMS's 2026 rate file and its proposed 2027 addendum, at 75 percent of the fee schedule amount, coinsurance included. Of the three codes, 90837 rises the most.

CMS sets the final 2027 rates before November 1, as federal law requires. You'll be paid the final rates from January 1, 2027.

JotPsych's Time in room stamps the recording's start and end on the note, so start recording when the session starts. You can correct a late start in the note's Session Details before you sign.

See JotPsych

Sources:

Madison Hynes, MPP, and James Haynes, JD, associate directors of government affairs at the Medical Group Management Association (MGMA), “MGMA Government Affairs: 2026 Washington Update”, MGMA 2026 Annual Conference, San Antonio, September 27, 2026. Slide 8, “Cuts to Conversion Factors.”
Centers for Medicare & Medicaid Services, 2027 Physician Fee Schedule proposed rule (CMS-1848-P), 91 Federal Register 43842, July 16, 2026: the specialty impact at 44248.
CMS, 2026 National Physician Fee Schedule Relative Value File, October release (RVU26D), with the 2026 conversion factor of $33.4009 for clinicians outside advanced payment models.
CMS, Addendum B to the 2027 Physician Fee Schedule proposed rule, updated July 21, 2026, with the proposed 2027 conversion factor of $32.8409 from the rule at 44241.
CMS, Medicare & Mental Health Coverage (MLN1986542), March 2026: the payment for each type of clinician, pages 13 to 24; read October 2, 2026.
CMS, Medicare Provider Compliance Tips: Outpatient Psychiatric Care, page last modified February 11, 2026; read October 2, 2026.
First Coast Service Options, Billing and Coding: Psychiatric Diagnostic Evaluation and Psychotherapy Services (A57520), the billing article for Florida, Puerto Rico, and the U.S. Virgin Islands, revision effective January 1, 2025, Medicare Coverage Database; read October 2, 2026.
United States Code, title 42, section 1395w-4 (Social Security Act section 1848), subsection (b)(1): the fee schedule is set before November 1 of the year before.