Crisis psychotherapy is not just a "long therapy session." It is an urgent service for patients in high distress (e.g., suicidal ideation, severe agitation). These codes (90839, +90840) have specific time and documentation requirements that differ from standard therapy.
The Crisis Codes Explained
CPT 90839 (Crisis psychotherapy, first 60 minutes):
- This is the base code for the first 60 minutes of crisis psychotherapy.
- You must provide at least 30 minutes of service to bill this code.
CPT +90840 (Crisis psychotherapy, each additional 30 minutes):
- This is an add-on code for each additional 30 minutes of crisis care beyond the first 60.
- Use this for services 75 minutes or longer (75 mins = 90839 + 90840).
Documentation Requirements
- The Crisis: Your note must clearly state the crisis (e.g., "Patient reports active suicidal ideation with a plan," "severe panic attack," "unable to ensure own safety").
- Start/Stop Times: This is mandatory. You cannot just bill "total time." You must document, for example, "Crisis session from 2:05 PM to 3:20 PM."
- Intervention: Must describe the intervention (e.g., "safety planning, means restriction, mobilized family support, coordinated with ER").
90839 vs. 90837 (Standard 60-min)
"Do not bill 90837 (60 min therapy) for a crisis. 90839 reimburses higher because it reflects a higher intensity of service. A 75-minute crisis session is billed as 90839 (x1) for the first 60 mins and +90840 (x1) for the next 15 mins."
