EMDR Session Notes: Templates, CPT Codes & Documentation
What to chart for each EMDR session, which CPT code applies, and how to document Phase 3–6 reprocessing so the record holds up to an audit.
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Every EMDR session note needs six elements: the issue worked on, the intervention (which phase and protocol), a measurable response (SUD, VOC, window of tolerance, observations), medical necessity tied to the diagnosis, the plan for next session, and the time and CPT code. EMDR has no dedicated CPT code, so it is billed by face-to-face time with standard psychotherapy codes.
What every EMDR session note needs
Insurance auditors, EMDRIA consultants, and your future self all need the same six elements in every note: presenting issue worked on, intervention used (which EMDR phase, what protocol), measurable response (SUD, VOC, window status, behavioural observation), medical necessity tied to the diagnosis, plan for next session, and your time and CPT code. Miss any of these and the note is weaker than the work was.
CPT code selection for EMDR
EMDR has no dedicated CPT code. Bill by face-to-face time using the standard psychotherapy codes:
90832 — psychotherapy, 16–37 minutes. Rarely used for EMDR; not enough time for full Phase 3–4 work.
90834 — psychotherapy, 38–52 minutes. Standard for Phase 1, Phase 2 resourcing, and Phase 8 re-evaluation sessions.
90837 — psychotherapy, ≥53 minutes. The right code for active reprocessing sessions (Phase 3–6). EMDR commonly runs 60–90 minutes; document the start and end times.
90847 — family/conjoint psychotherapy with patient present. For attachment-focused or family-system EMDR.
90839 / +90840 — psychotherapy for crisis (60+ min, with add-on per 30 min). Only when the session was driven by acute crisis, not because reprocessing ran long.
Never bill 90837 'because EMDR' — bill it because the face-to-face time exceeded 53 minutes and the medical record reflects it. Pad the chart with a literal time-in / time-out.
Phase → what to document
Minimum chart elements per phase. Used in EMDRIA consultation reviews and most payer audits.
| Phase | Required documentation | Common CPT |
|---|---|---|
| 1 — History | Trauma history obtained, DES-II / PCL-5 / PHQ-9 scores, screening for contraindications (suicidality, substance use, dissociation), informed consent for EMDR signed. | 90834 |
| 2 — Preparation | Stop signal practised, dual-attention rehearsed, Calm Place / Container installed with BLS, RDI figures, modality choice (eye movements / tactile / auditory) and rationale. | 90834 |
| 3 — Assessment | Target memory, Image (worst part), Negative Cognition, Positive Cognition, baseline VOC (1–7), baseline SUD (0–10), Emotion, Body location. | 90837 (with 4) |
| 4 — Desensitization | BLS modality and approximate sets, content of reports each set (themes only, never granular memory detail), interweaves used and why, SUD at close, window-of-tolerance status, any abreaction or grounding used. | 90837 |
| 5 — Installation | Positive Cognition affirmed or revised, VOC at start and close, BLS sets to install, residual SUD if present. | 90837 |
| 6 — Body Scan | Body scan result (clear / residual sensation / location), additional BLS if residual, status at close. | 90837 |
| 7 — Closure | Closure method used (Calm Place / Container / debrief), what client takes home, between-session log assigned, safety check, time-in/time-out. | 90834 or 90837 |
| 8 — Re-evaluation | Re-check SUD on previous target, VOC, treatment effects since last session, what surfaced between sessions, plan for next target. | 90834 |
SOAP template adapted for EMDR
Subjective: client's report of the week, current symptoms, anything that surfaced since last session. Two to four sentences.
Objective: behavioural observations (affect, eye contact, window-of-tolerance status at arrival), measures administered (PCL-5 every 4 weeks, PHQ-9 monthly).
Assessment: link today's work to the treatment plan and the diagnosis. 'Continued reprocessing of target #2 (age 7 medical procedure) per TSP; consistent with PTSD diagnosis and treatment goal of reduced intrusive imagery.'
Plan: next target or next phase, homework, when to re-administer outcome measures. Date and sign.
Pair the SOAP with phase-specific data: SUD trajectory, VOC trajectory, BLS modality, interweaves used. The body of the note records the EMDR-specific clinical work; SOAP gives auditors the structure they expect.
DAP template (shorter alternative)
Data: observed behaviour, client-reported symptoms, today's intervention with EMDR phase, SUD/VOC at start and close, window-of-tolerance status. The factual record.
Assessment: clinical interpretation — was the target reprocessed, did processing stall, did the window narrow? Tie to the diagnosis and treatment plan.
Plan: next session focus, homework, re-administration of measures, any consultation or supervision sought. Faster than SOAP; good for high-volume clinicians.
What NOT to put in a session note
Avoid granular trauma narrative. Document the target as 'age 7 medical procedure, NC: I'm not safe' — not a paragraph reconstructing what happened. The narrative belongs in case formulation, not the visit note. Granular detail in visit notes creates risk in legal discovery, raises re-traumatization concerns if the chart is released to the client, and is medically unnecessary for billing.
Audit-ready example: a full Phase 4 note
Time-in 14:02, time-out 15:31. CPT 90837. Dx: F43.10 PTSD.
S: Client reports lower nightmare frequency this week (2x vs 5x), continued avoidance of driving past hospital. No SI/HI.
O: Arrived inside window of tolerance, oriented, affect congruent. PCL-5 administered: 38 (down from 47 at intake).
A: Continued reprocessing of TSP target #2 (age 7 medical procedure) per treatment plan. Phase 3 re-established: NC 'I'm not safe', PC 'I am safe now', baseline VOC 3, SUD 7, emotion fear, body throat/chest. Phase 4 with eye-movement BLS, ~24 sets, client reported associative chain (hospital → mother's face → present-day relief). Cognitive interweave at set 17 (responsibility — 'whose job was it to keep you safe?') reduced stuck loop. Window remained intact; brief grounding pause at set 12 for mild hyperarousal, resolved. Close SUD 2, VOC 5. Body scan clear except mild throat tightness. Phase 7 closure with Calm Place.
P: Continue target #2 next session (SUD not fully cleared). Re-administer PCL-5 in 2 weeks. Between-session log assigned.
Clinician signature, date, license.
Free bilateral stimulation tool
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Frequently asked questions
Only if the face-to-face time exceeded 53 minutes and the chart documents start and end times. Phase 1 and Phase 8 sessions typically run shorter and bill 90834. Pattern-billing 90837 without time documentation is a common audit risk.
Minimum necessary. Target identifier (age, theme), NC/PC, SUD/VOC trajectory, intervention type. The client's reported associations should be summarised thematically ('processed maternal abandonment material'), not narratively. Detailed narrative belongs in a separate case formulation document.
No. One note per session, but the note should identify which phase(s) the session covered. A common Phase 3 + 4 + 5 + 6 + 7 reprocessing session is documented in a single 90837 note with all the phase markers.
Add the telehealth modifier per your payer (95, GT, or place-of-service 02/10) and document the platform used, the client's location, and consent for telehealth EMDR specifically. Document BLS modality (most telehealth EMDR uses self-tapping or audio BLS).
References
3 sources · peer-reviewed and clinical texts
- 1American Medical Association. (2024). CPT 2024 Professional Edition. AMA.
- 2EMDR International Association. (2023). Professional Standards & Training Guidelines.
- 3Shapiro, F. (2018). Eye Movement Desensitization and Reprocessing (EMDR) Therapy: Basic Principles, Protocols, and Procedures (3rd ed.). Guilford Press.
Free PDFs for this topic
Progress note structured around the 8-phase EMDR model — medical-necessity language, interventions, measures, risk and plan.
A fictional completed DAP note for an EMDR Phase 4 session, a blank DAP template, and an EMDR documentation checklist.
Working clinician log for live Phase 4–6 reprocessing — BLS sets, SUD trajectory, interweaves, Installation, Body Scan, and closure on one sheet per target.
Tools & resources
The structured data that anchors every reprocessing note.
Closure documentation that auditors expect.
Printable EMDR-specific progress note template.
Companion log clients fill between sessions.
EMDR Assist — the in-session companion built for therapists.
Related reading
Your therapist gathers your history and maps out the memories that will become reprocessing targets.
You learn the EMDR procedure and build internal resources (Safe Place, Container) before any reprocessing begins.
The target memory is activated and measured: image, negative cognition, positive cognition, SUD and VOC.
Sets of bilateral stimulation reprocess the target memory until distress (SUD) drops to 0.
The positive belief is paired with the memory and strengthened with BLS until the VOC reaches 7.
You scan your body for any residual tension or sensation tied to the memory, and clear it with BLS.