CPT Code 90840: Add-On for Extended Crisis Psychotherapy

CPT code +90840 is an add-on code used when a crisis psychotherapy session exceeds 74 minutes. It allows providers to be properly reimbursed for the additional time and intensity involved in managing psychiatric emergencies.

In this guide, we’ll cover:

• What CPT +90840 is
• When and how to use it
• Documentation tips
• Reimbursement rates
• Billing scenarios

What is CPT Code +90840?

CPT +90840 bills for each additional 30 minutes of psychotherapy for a patient in crisis, following the initial 60-minute session billed under CPT 90839.

Important: +90840 cannot be billed on its own. It must be used in conjunction with 90839.

Billing Thresholds:

• 90839: 30–74 minutes
• 90839 + 90840: 75–104 minutes
• 90839 + 2 units of 90840: 105–134 minutes
• And so on...

When to Use CPT Code +90840

Use +90840 when:

• A patient is experiencing a psychiatric emergency (e.g., suicidal ideation, panic attack, trauma)
• The crisis session lasts more than 74 minutes
• You provide continuous psychotherapy focused on immediate stabilization

This code captures the additional clinical time spent in extended crisis intervention.

Documentation Requirements

To support billing 90840, your documentation should include:

• Start and stop times or total duration of the session
• Description of the ongoing crisis
• Interventions provided during the extended time
• Patient response
• Any changes in risk level or safety plan
• Coordination with emergency services, if applicable

Each add-on unit of 90840 must be clearly supported by 30 full minutes of additional, medically necessary crisis care.

Who Can Bill +90840?

+90840 may be billed by:

• Psychiatrists
• Psychiatric NPs
• Psychologists
• Licensed Clinical Social Workers (LCSWs)
• Licensed Professional Counselors (LPCs)

Always confirm payer and state-level billing rules for your license type.

Reimbursement Rates

Typical Medicare reimbursement for +90840 ranges from $65 to $80 per additional 30-minute increment. Commercial payers may offer higher rates depending on acuity and provider type.

Improper use or vague documentation can lead to denials or audits—make sure the crisis nature is clearly established.

Common Billing Errors to Avoid

• Billing 90840 without 90839
• Overestimating session time (don’t round up)
• Insufficient documentation of extended crisis work
• Using 90840 for routine follow-ups (only valid in crisis scenarios)

Final Thoughts

CPT +90840 ensures you’re compensated for the time-intensive care required in extended psychiatric crises. When combined with CPT 90839 and supported by strong documentation, it enables providers to deliver responsive, high-acuity treatment—without underbilling.