Billing Reference
CPT codes 90839 and 90840: psychotherapy for crisis
CPT code 90839 is the base code for psychotherapy for a patient in crisis, and CPT code 90840 is the add-on reported with it for each additional block of crisis time. The two codes are one time-based service: report the total face-to-face time spent with the patient, family, or both on that date, even when that time is not continuous. Per the short descriptors in the CMS Physician Fee Schedule look-up tool, 90839 covers the initial 60 minutes and 90840 each additional 30 minutes. Neither code is ever billed with the diagnostic evaluation codes 90791 or 90792.
Part of CPT Codes for Therapists, the plain-English lookup verified against public CMS billing guidance.
What CPT code 90839 covers
Psychotherapy for crisis. Urgent crisis psychotherapy. A time-based service.
90839 is not a longer version of a regular session. It is urgent psychotherapy for a patient in crisis, and CMS guidance treats it that way: the clinician must devote full attention to the patient, which rules out providing services to any other patient during the same period, and the patient must be present for all or some of the service.
The add-on is where the structure matters. 90840 never appears on a claim by itself: it rides on 90839 and follows the same crisis rules. When a crisis encounter runs long, 90839 is reported once for the initial block of time and 90840 is added for each additional block. Per the CMS short descriptors, the initial 60 minutes fall under 90839 and each additional 30 minutes under 90840.
The clock is the total, not one continuous stretch. The time that counts is the total face-to-face time with the patient, family, or both on that date, even if it is not continuous. Document that total, and make sure the record shows that the crisis guidelines in the related coverage policy were followed. For crisis psychotherapy furnished in non-facility places of service other than the office, CMS lists the separate HCPCS codes G0017 and G0018.
The Rules
Time rule and documentation for 90839
Paraphrased from public CMS billing guidance, with the source documents linked below the notes.
- Report the total face-to-face time with the patient and or family, even if that time is not continuous.
- Per the short descriptors in the CMS Physician Fee Schedule look-up tool, 90839 covers the initial 60 minutes of crisis psychotherapy and the add-on 90840 covers each additional 30 minutes.
- The clinician must devote full attention to the patient and cannot provide services to any other patient during the same period.
- The patient must be present for all or some of the service.
- The record must show the total face-to-face time and that the crisis guidelines in the related coverage policy were followed.
- Never billed with 90791 or 90792.
- CMS lists separate HCPCS codes, G0017 and G0018, for crisis psychotherapy furnished in non-facility places of service other than the office.
The add-on code: 90840
- Follows the same crisis rules as 90839: total face-to-face time, full attention, patient present for all or some of the service.
- Never billed with 90791 or 90792.
The Boundaries
90839 next to its neighboring codes
90839 vs 90840: one base code, one add-on
They are two halves of one service. 90839 is reported once for the initial block of crisis psychotherapy time, and 90840 is reported alongside it for each additional block; it is never reported alone. Both follow the same rules: total face-to-face time on that date even when not continuous, full attention to the patient, and the patient present for all or some of the service.
90839 and the intake evaluation never mix
CMS guidance draws a hard line: the crisis codes 90839 and 90840 are never billed with the diagnostic evaluation codes 90791 or 90792. If the encounter is a diagnostic evaluation, bill the evaluation. If it is crisis psychotherapy, bill 90839 and add 90840 as the time requires.
A long session is not automatically a crisis session
Length alone does not move a session onto the crisis codes. A 60-minute session that runs as planned is 90837, individual psychotherapy of 53 minutes or more. The crisis codes describe urgent work with a patient in crisis and carry their own rules, including full attention to the patient and total face-to-face time reported for the date.
Common Questions
Questions therapists ask about 90839
Can 90840 be billed without 90839?
No. 90840 is an add-on code. It is reported only with 90839 and follows the same crisis rules as the base code: total face-to-face time, full attention to the patient, and the patient present for all or some of the service.
Does crisis psychotherapy time have to be continuous?
No. CMS guidance says to report the total duration of face-to-face time spent with the patient, family, or both on that date, even if that time is not continuous. What matters is that the record shows the total.
How do the minutes split between 90839 and 90840?
Per the short descriptors in the CMS Physician Fee Schedule look-up tool, 90839 covers the initial 60 minutes of crisis psychotherapy and 90840 covers each additional 30 minutes. Confirm the current code set definitions with your payer before billing.
Can 90839 be billed with 90791 or 90792?
No. CMS guidance states the crisis psychotherapy codes are never billed with the diagnostic evaluation codes 90791 and 90792. If the visit is a diagnostic evaluation, bill the evaluation code instead.
What documentation do the crisis codes require?
The record must show the total face-to-face time with the patient, family, or both on that date, and that the crisis guidelines in the related coverage policy were followed. The service also carries two conditions worth charting against: the clinician devotes full attention to the patient, with no services to any other patient during the same period, and the patient is present for all or some of the service.
What if the crisis session happens outside the office?
CMS lists separate HCPCS codes, G0017 and G0018, for crisis psychotherapy furnished in non-facility places of service other than the office. Verify with your payer which codes apply to your setting.
Why are there no reimbursement rates on this page?
Reimbursement varies by payer, locality, and year, so a single national number would be wrong for most readers. Check your payer contracts for your actual rates, or the CMS Physician Fee Schedule lookup tool for Medicare amounts in your locality.
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This is an informational tool, not billing, legal, or clinical advice. You are responsible for selecting the correct codes for your services and for verifying coverage, code definitions, and documentation requirements against your payer contracts and the current code set.
CPT is a registered trademark of the American Medical Association. This page does not reproduce the CPT code set or its official descriptors. Every description here is a plain-English summary written by Reframe Practice and checked against the CMS public billing documents linked above.