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)