The following undersigned licensed mental health providers seek policy protections and stated commitments from legislative leaders and from health insurance policy makers to standardize 90837 coded 53-minute psychotherapy sessions (one hour) to prevent a reduction in quality of care through the increased restrictions of provider reimbursement of 45-minute sessions due to expectations of additional documentation required for 53 minutes, leading to potential elimination of 53 minute sessions in the future. Maintaining coverage for 53‑minute sessions is not an added benefit—it is the clinically necessary standard for safe, effective, and cost‑efficient mental healthcare in today’s environment.

Mental health clinicians across the United States have observed a significant shift in client presentation over the past decade. Research spotligh the rise in algorithm-driven social media, increased digital overstimulation and time spent online, and reduced in‑person connections as contributors to widespread  presentation of heightened emotional reactivity or its opposite, decreased emotional awareness, all with greater difficulty in nervous system and emotional regulation. Today, clients require more time at the beginning of sessions to settle, regulate, and transition from digital pace to therapeutic pace, from starting points of emotional and physical restlessness, or the opposite- numb, shutdown, and difficulty identifying and expressing emotional states. 

The necessity for 53 minute sessions is the standard, NOT the exception. We expect legislation and insurance company leadership to stand behind the evidence and stand behind the recommendations of clinical providers who do the work ahead of profit-driven goals driving decisions which negatively impact our ability to provide effective mental health care.