ARTICLE

Behavioral Health

Author:
Brellium

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.

Automate clinical & payor compliance

Automate clinical & payor compliance

Automate clinical & payor compliance