CPT code 90838 designates an add-on psychotherapy service performed in conjunction with an evaluation and management (E/M) visit, typically lasting a minimum of 53 minutes. Nationally, the code captures extended psychotherapy delivered during the same session as a medical evaluation, and it is relevant to ambulatory behavioral health and primary care integration models where mental health treatment is provided alongside medical care. Payers commonly covering or recognizing this code include Aetna, Blue Cross Blue Shield, Cigna, UnitedHealthcare, and Medicare.

This publication explains the clinical context for use of 90838, the service setting and purpose, and the operational implications for billing when psychotherapy extends the E/M encounter. Readers will find concise benchmarks on typical use, descriptions of payer coverage patterns, and a summary of policy considerations affecting documentation and claims submission. The report also outlines what to expect when selecting 90838 as an add-on service in outpatient and office-based psychiatry and behavioral health visits, and highlights common documentation elements necessary to support the extended psychotherapy time. Data not available in the input are noted where applicable.