CPT 90837 + ICD-10 F84.0: Autistic disorder
Psychotherapy, 60 minutes billed with Autistic disorder — documentation requirements, denial reasons, modifiers, and reimbursement context.
Compatibility Notes
Used for 60-minute psychotherapy sessions with ASD patients targeting co-occurring anxiety, depression, or social functioning. F84.0 represents Level 3 ASD (previously classic autism). Therapy may focus on cognitive, emotional, or behavioral challenges rather than ASD core features. Most commercial plans cover ASD psychotherapy; ABA services require separate billing.
Documentation Required
- ✓Session start and stop times confirming 53+ minutes
- ✓ASD diagnosis with clinical basis for 60-minute psychotherapy
- ✓Psychotherapy treatment targets distinguished from ABA goals
- ✓Coordination with ABA provider or other ASD specialists noted if applicable
- ✓Safety screen for self-injurious behaviors
Common Denial Reasons
- ✗ABA-type interventions billed under psychotherapy code
- ✗Scope of practice concern if provider lacks ASD-specific training
- ✗Session time below 53 minutes
Applicable Modifiers
Reimbursement Notes
OON UCR $130-$210. ASD therapy coverage varies by state mandate. Distinguish psychotherapy from ABA in all documentation.
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