Crisis Psychotherapy: CPT 90839 and +90840
What CMS.gov says these codes are, who can furnish them, what they cannot be billed with, and how to document the time. Checked against CMS.gov on 9/29/26.
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Crisis Psychotherapy at a glance
This page covers crisis psychotherapy for mental health billing: what the codes cover, how payers apply them, and what to document. Psychotherapists and psychiatrists both use these codes, so the sections below call out differences where they matter. Payer rules vary, so confirm current requirements with the payer before you bill.
What CMS.gov says these codes are
Quotes are copied from CMS.gov pages. Each quote names its source. Contractor articles are written by Medicare Administrative Contractors (MACs), the companies that process Medicare claims for a region, and apply to their own region.
CMS.gov definition
“urgent assessment and history of a crisis state, a mental status exam, and a disposition”
90839: “Psychotherapy for crisis; first 60 minutes”
90840: “Each additional 30 minutes” (use with 90839)
“The psychotherapy for crisis CPT/HCPCS codes 90839, 90840, G0017, and G0018 are time-based codes” … “The patient must be present for all or some of the service.”
Who, where and what not to bill with
CMS lists these practitioners: physicians (MDs and DOs), clinical psychologists, clinical social workers, clinical nurse specialists, nurse practitioners, physician assistants, certified nurse-midwives, marriage and family therapists, and mental health counselors.
CMS lists these places: hospitals, skilled nursing facilities, physician offices and patient homes, and by telehealth when requirements are met.
CMS says not to bill crisis codes with diagnostic evaluation codes (90791, 90792) or other psychiatric and psychotherapy procedure codes (90785–90899, 90832–90838).
Time range and documentation
Every timed code needs the date of service and the start and end time of the service.
| Code | Service | Time range | Document |
|---|---|---|---|
| 90839 | Psychotherapy for crisis, first 60 minutesRange is CPT-defined. The CMS page says 'first 60 minutes' - use the CPT range for the claim and verify with the payer. | 30–74 minutes | Date of service + start and end time Documentation rules |
| +90840 | Psychotherapy for crisis, each additional 30 minutes (add-on)Add-on: only with 90839. Record start and end time of the whole crisis service. | Use at 75+ minutes total | Date of service + start and end time Documentation rules |
| G0017 / G0018 | Psychotherapy for crisis in an applicable site of service (Medicare)Medicare-only HCPCS codes. Confirm the 'applicable site of service' rule before billing. | Time-based - confirm on CMS | Date of service + start and end time Documentation rules |
How often and with what?
- Not billed with 90791, 90792, 90785–90899 or 90832, 90833, 90834, 90836, 90837, 90838.
Source: CMS, Psychotherapy for Crisis (page modified 02/25/2026) - Time on the date of service can be non-continuous.
Source: CMS, Psychotherapy for Crisis (page modified 02/25/2026) - For non-facility sites, CMS pays G0017 and G0018 at 150% of the fee schedule amount.
Source: CMS, Psychotherapy for Crisis (page modified 02/25/2026)
These are Medicare rules. Private payers and state Medicaid programs set their own; ask each payer. Full list: frequency and documentation rules.
Psychotherapists and psychiatrists
Psychotherapists
Bill 90839 for the first crisis block and +90840 for each additional 30 minutes once the service reaches 75 minutes (CPT).
Psychiatrists
Same codes. Do not bill an E/M or psychotherapy add-on for the same crisis time.
Frequently asked questions
What is the time range for 90839?
CPT defines 90839 as 30–74 minutes, and +90840 is added for each additional 30 minutes once the service reaches 75 minutes. CMS describes 90839 as the “first 60 minutes.” Because the wording differs, confirm the threshold with each payer before billing.
Who can bill crisis psychotherapy to Medicare?
CMS lists physicians, clinical psychologists, clinical social workers, clinical nurse specialists, nurse practitioners, physician assistants, certified nurse-midwives, marriage and family therapists, and mental health counselors.
What can't be billed with 90839 and +90840?
CMS says crisis codes are not billed with 90791, 90792, 90785–90899 or 90832–90838. Interactive complexity (+90785) is therefore not added to a crisis service.
Does the crisis time have to be continuous?
No. CMS says the service can be billed even when the time spent on the date of service is not continuous. Record the start and end time of each block.
More CPT code guides
CMS.gov sources
- CMS Coverage Database, Article A57520 (First Coast, rev. 1/1/2025)
- CMS, Psychotherapy for Crisis (page modified 02/25/2026)
Current as of last search (9/29/26). Reconfirm before publishing. For quick reference only: verify against the current AMA CPT manual and each payer's policy before billing. Operational billing guidance, not legal advice.
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