The CPT (Current Procedural Terminology) code for crisis psychotherapy applies when a clinician provides immediate support to stabilize a patient with acute emotional or behavioral symptoms. These crisis sessions differ from routine therapy because they focus on safety and urgent response.
Clinicians such as Anat Joseph, LCSW, PsyA, a psychoanalyst in NYC, may use these codes when care meets medical necessity during crisis situations.
Key Takeaways
- Crisis psychotherapy CPT codes apply only when a patient is in high distress and needs immediate, medically necessary care beyond routine psychotherapy.
- CPT code 90839 covers the first 60 minutes of crisis psychotherapy, while CPT code 90840 is an add-on code used only when crisis care extends beyond that time.
- Accurate time tracking and detailed documentation are required to support reimbursement rates and reduce audit risk.
- Crisis codes cannot be billed with standard psychotherapy codes on the same date, and 90840 must always follow 90839.
- Clear differences between crisis psychotherapy and extended therapy support correct code use and compliance.
What Is the CPT Code for Psychotherapy for Crisis?
Psychotherapy for crisis is billed using time-based CPT codes. These codes apply when a patient shows high distress and needs immediate care, such as during panic attacks or acute anxiety. The crisis psychotherapy CPT code reflects the urgency and clinical complexity of the situation. It is not based solely on diagnosis.
Unlike routine therapy, including approaches such asmodern psychoanalysis, crisis psychotherapy focuses on fast stabilization. The clinician assesses risk, documents the crisis history, and provides crisis interventions during the same therapy session.
These services must meet medical necessity under psychotherapy codes. Accurate timing and notes are required.
CPT Codes Used for Crisis Psychotherapy
Crisis psychotherapy is billed using two CPT codes: 90839 and 90840. These codes are based on the total minutes of crisis therapy in one therapy session. Clinicians must track time carefully. Crisis codes should not replace standard psychotherapy codes.
90839 CPT Code Description
CPT code psychotherapy for crisis, first 60 minutes
The cpt code 90839 description applies to the first 60 minutes of psychotherapy for crisis. It is used for direct, face-to-face crisis care, including risk review and focused intervention. To bill 90839, at least 30 minutes of crisis care must occur. Shorter sessions do not qualify.
This code is used when routine therapy is not enough. The clinician documents symptoms, the crisis situation, and actions taken. Clear notes help support reimbursement rates. Poor documentation increases denial risk.
90840 CPT Code Description
CPT code psychotherapy for crisis, 90 minutes
The cpt code 90840 description applies when crisis psychotherapy goes beyond the first hour. It represents an additional 30 minutes of crisis therapy, billed under 90839. Because 90840 is an add-on code, the minutes of crisis therapy must exceed 74. It cannot be billed alone.
This code is used when crisis situations require extended stabilization. Examples include prolonged de-escalation or repeated safety checks.
The phrase crisis psychotherapy cpt code, additional 30 minutes, reflects this role. Accurate time tracking is essential when using cpt codes 90839 and 90840.
Time Rules for Crisis Psychotherapy CPT Codes
Time rules are central to crisis billing. Clinicians must document total face-to-face minutes spent on crisis interventions. The therapy session must focus on crisis care, not general discussion. If time rules are not met, crisis codes should not be used.
Only direct clinical time counts toward these codes. Administrative tasks do not apply. When sessions are conducted via telehealth, modifier 95 may apply. Clear timing supports accurate reimbursement rates.
90839 CPT Code Time Frame
The 90839 CPT code time frame usually covers sessions lasting 30 to 74 minutes. Sessions under 30 minutes do not qualify. Sessions over 74 minutes may be billed under 90840. Start and end times should be recorded clearly.
If symptoms settle quickly, standard psychotherapy codes may be more appropriate. Decisions should reflect high distress and clinical need. Correct timing reduces audit risk.
Crisis Psychotherapy vs Standard Psychotherapy
Standard psychotherapy focuses on long-term emotional patterns and broader goals of psychotherapy. Crisis psychotherapy focuses on immediate stabilization and safety. Crisis sessions aim to reduce risk and restore short-term function. These differences justify separate billing rules.
Using crisis codes without a true crisis may result in denials. Code choice depends on medical necessity and urgency. Clinicians must explain why crisis care was required. Documentation should make this clear.
90837 CPT Code vs Crisis Codes
90837 CPT code description
The 90837 CPT code description applies to planned 60-minute therapy sessions. It does not require crisis-level risk or urgent intervention. This makes it different from crisis codes. Using the wrong code can trigger reviews.
Key differences include:
- 90837 is planned, non-emergency therapy
- Crisis codes require immediate risk assessment and stabilization
- Crisis sessions must show an urgent need beyond the session length
CPT Code for Crisis Counseling and Intervention
Crisis counseling provides immediate support during crisis situations. The CPT code for crisis counseling reflects structured clinical care, not informal support. Crisis interventions may include grounding, safety checks, and symptom control. These actions must be documented.
Crisis counseling is appropriate for patients whose symptoms impair safety or judgment. Notes should explain what was done and why. Clear documentation supports medical necessity.
CPT Code for Mental Health Crisis Care
Mental health crisis care includes psychotherapy during acute emotional episodes. The CPT code for mental health crisis care applies in outpatient and telehealth settings. Services must meet urgency and documentation standards. Crisis codes are not diagnosis-specific.
Patients with panic attacks or severe anxiety may qualify. The clinician decides based on presentation and risk. Careful assessment supports ethical billing.
Related CPT Codes Used in Crisis Sessions
Related CPT codes may be used during crisis sessions in limited and specific situations. These include CPT code 90785 for interactive complexity and CPT code G0018 for certain care coordination services.
These codes do not represent crisis psychotherapy itself and must meet separate criteria when used alongside crisis care. Using them incorrectly or without proper documentation may lead to claim denials.
What Is CPT Code 90785 Used For?
Interactive complexity in crisis sessions
CPT code 90785 reports interactive complexity during psychotherapy. This may involve third parties or communication barriers. It does not replace crisis codes. Documentation must explain why complexity was present.
What Is CPT Code G0018?
How G0018 differs from crisis psychotherapy codes
CPT code G0018 relates to care management services. It is not a psychotherapy for a crisis code. It should not replace crisis psychotherapy CPT codes. Understanding this difference avoids errors.
Documentation and Billing Rules for Crisis CPT Codes
CMS-Defined Criteria for Crisis Psychotherapy
Crisis psychotherapy must involve an urgent mental health situation. Care includes risk assessment, crisis interventions, and planning next steps.
Session length alone does not establish medical necessity; psychotherapy codes must reflect the severity and urgency of the condition. Notes should explain why routine therapy was not enough.
Documentation is required for crisis sessions. Notes should describe the history of a crisis, symptoms, and interventions. Time must be recorded clearly. These details support compliance.
Crisis codes receive close payer review. Frequent crisis sessions may lead to audits. Clear notes support reimbursement rates and reduce risk.
Billing rules often limit crisis codes to a single use per day. Crisis codes cannot be billed with standard psychotherapy codes on the same date. Accurate records protect billing integrity.
Common Coding and Billing Mistakes
Common errors include billing crisis codes without enough time or detail. Another mistake is using crisis codes for routine therapy. Confusion about 90840 is an add-on code, and minutes of crisis therapy also cause denials. These issues increase audit risk.
Claims are often denied when these rules are missed:
- Billing crisis codes with standard psychotherapy codes on the same date
- Billing 90840 without billing 90839 first
- Billing crisis codes for sessions under 30 minutes
Careful documentation and time tracking reduce billing problems. Correct coding protects clinical and compliance standards.
