CPT Code 90839: Crisis Psychotherapy Billing Guide
CPT code 90839 is used to bill for psychotherapy provided during a psychiatric crisis. It’s reserved for urgent situations that require immediate attention and extended, focused care. Correct use of this code ensures appropriate reimbursement for high-intensity clinical work.
In this article, we’ll cover:
What CPT 90839 includes
When to use it
Documentation requirements
Who can bill it
Reimbursement and add-on codes
Common billing pitfalls
What is CPT Code 90839?
CPT 90839 is used for 60 minutes of psychotherapy for a patient in crisis. It reflects the need for immediate clinical intervention to stabilize emotional or behavioral functioning due to a life-threatening or severely distressing event.
These sessions typically include:
Rapid assessment
Crisis intervention techniques
Supportive counseling and safety planning
Coordination of care (e.g., contacting family, crisis lines, or emergency services)
This is not routine therapy — 90839 is meant for acute psychological crises that require focused, extended care.
When to Use CPT Code 90839
Use 90839 when:
The patient is experiencing a psychiatric emergency
The session lasts 30–74 minutes
Immediate clinical attention is necessary to reduce risk (e.g., self-harm, suicidality, severe panic)
Appropriate situations might include:
Suicidal ideation with active plan
Panic attacks requiring de-escalation
Emotional collapse following traumatic news or events
Risk of harm to others or self
Add-On Code: 90840
If the crisis session exceeds 74 minutes, you can add CPT code 90840, which bills for each additional 30 minutes of crisis psychotherapy.
90839 = first 30–74 minutes
90840 = each additional 30-minute increment (must be ≥75 minutes total)
Example: A 90-minute session would be billed as 90839 + 90840.
Documentation Requirements
You must clearly document:
Duration of the session
Nature of the crisis
Clinical interventions used
Risk assessment (e.g., harm to self/others, functional impairment)
Coordination of care (e.g., safety plan, referrals, emergency response)
Auditors look for detailed notes proving the session was truly crisis-oriented—not routine psychotherapy.
Who Can Bill CPT 90839?
CPT 90839 can be billed by:
Psychologists
Licensed clinical social workers (LCSWs)
Licensed professional counselors (LPCs)
Psychiatrists or psychiatric nurse practitioners
Check state scope-of-practice laws and payer policies for your specific license.
Reimbursement for 90839
Medicare typically reimburses around $130–$160 for 90839. Commercial insurers may reimburse more, particularly if 90840 is added for extended crisis sessions.
Note: Reimbursement reflects the intensity and urgency of the care—not just duration.
Common Billing Errors to Avoid
Using 90839 for routine therapy (instead, use 90832/90834/90837)
Lack of documented crisis — vague notes won’t support the code
Not specifying duration or omitting risk assessment
Forgetting to add 90840 when sessions exceed 74 minutes
Final Thoughts
CPT 90839 allows providers to be reimbursed fairly for high-acuity clinical situations. Proper use, supported by strong documentation, ensures compliance and captures the full value of crisis care.
