A common question from new clients – how long is a therapy session? The counseling “hour” (as many people call it) can look different from therapist to therapist and client to client. There are several factors that go into how long a therapy appointment lasts.
The most commonly used time frame for most psychologists is 45-50 minutes. This seems weird to many patients, and I’m often asked, “so why do I only get 45 minutes?” or “Why don’t I get the whole hour?” There are a few reasons. First, if you’re using insurance, this is the standard length of therapy that insurance reimburses for (known as a 90834). The code actually ranges from 38-52 minutes, so any session that falls into that time frame is billed in that way.
Beyond insurance, there are a few more reasons a therapist might use the 45-50 minute therapy hour. First, it gives us a chance to do our notes and paperwork between clients (while the session is fresh in our minds) and run to the bathroom (just being honest here!). Second, this gives us a bit of leeway – if a client has a last-minute question or drops a bombshell, we can still wrap up the session and get to our next client on time. This is a bit more difficult with a 60 minute session.
Speaking of 60 minute sessions (known as a 90837 to insurance companies), some therapists prefer to use the full hour. For processed based therapy like EMDR, Exposure and Response Prevention or Prolonged Exposure, a 60 minute hour is important. This gives the client time to engage in the therapy and process their experience with the psychologist or therapist. Some insurance companies discourage the use of the 60 minute hour (because they have to pay more). Because of this, some therapists shy away from this session length because of increased scrutiny from insurance companies.
Some therapists, often couples therapists, will do a 90 minute therapy appointment. This is used in situations where insurance coverage is not an issue (as most companies don’t reimburse beyond an hour), and can be much more expensive than a typical 45-50 minute session. However, some people find this more helpful than shorter sessions, particularly for in-depth work.
Thirty minute sessions are also available (known as a 90832). There are a variety of reasons a therapist might do a shorter session – a quick check-in is common. For self-pay clients, a 30-minute counseling appointment can make therapy more affordable, particularly during the maintenance stage of therapy.
Regardless of the length of therapy sessions, this is an important expectation to communicate with your therapist. During your first appointment, part of the informed consent, your therapist should tell you their policies. If they forget, don’t hesitate to ask! In addition, advocate for yourself if you need longer or shorter sessions (or sessions more or less often). You may need additional authorizations from your insurance company for longer sessions.