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.