Question 1

What qualifies as a crisis for billing CPT code 90839?

Accepted Answer

A crisis qualifying for CPT code 90839 typically involves a life-threatening or complex situation requiring immediate attention for a patient in high distress. This may include acute suicidal ideation, severe panic attacks, or trauma responses that significantly impair functioning or pose safety risks.

Question 2

How do you bill for a 90-minute crisis therapy session in 2025?

Accepted Answer

For a 90-minute crisis therapy session in 2025, you would bill CPT code 90839 for the first 74 minutes, plus one unit of add-on code 90840 for the additional time. The total reimbursement would be approximately $221.25 ($148.47 for 90839 + $72.78 for 90840) under Medicare rates.

Question 3

What documentation is required when billing for crisis therapy?

Accepted Answer

When billing for crisis therapy, your documentation should include a detailed crisis assessment, mental status examination, specific interventions used, safety planning elements, and precise start and stop times or total face-to-face duration. It's crucial to clearly justify why the situation required immediate, high-intensity intervention.

Question 4

Can you bill both crisis codes and standard therapy codes on the same day?

Accepted Answer

No, you cannot bill both crisis codes (90839/90840) and standard therapy codes (90832, 90834, 90837) on the same day. Crisis codes are designed to be used exclusively for emergency situations and cannot be combined with routine therapy services.

Question 5

How does reimbursement for crisis therapy compare to standard therapy sessions?

Accepted Answer

Crisis therapy reimbursement is typically higher than standard therapy sessions. For instance, Medicare pays 150% of the standard fee schedule amount for crisis services provided in non-facility settings. In 2025, CPT code 90839 reimburses at $148.47, which is slightly higher than the rate for a 60-minute standard therapy session (90837).