How to Bill Crisis Psychotherapy With 90839 and 90840
Crisis psychotherapy billing uses 90839 for the first 60 minutes of crisis care and add-on 90840 for each additional 30 minutes. The codes apply only when the patient’s problem is urgent and either life-threatening or highly complex. This guide covers the crisis definition, time rules, Medicare’s G0017 and G0018 codes, what cannot be billed alongside, documentation and common errors.
Crisis codes follow different rules from routine therapy, which our mental health billing services guide covers in full.
| Key takeaways 90839 covers 30 to 74 minutes of crisis care; 90840 adds each further 30-minute block.Crisis time on one date can be added up even when it is not continuous.Crisis codes are not billed with other psychiatric codes such as 90785 to 90899.Medicare uses G0017 and G0018, paid at 150%, at applicable non-office sites. |
What counts as crisis psychotherapy
The AMA CPT code set defines psychotherapy for crisis as urgent care for a patient in high distress. The Noridian mental health billing page describes the presenting problem as life-threatening to the patient or others, or complex enough to need immediate attention.
The service has four parts: an urgent assessment and history of the crisis, a mental status exam, psychotherapy, and work to mobilize resources, restore safety and limit psychological trauma. A difficult routine session is not a crisis; the urgency has to be real and documented.
Time rules for 90839 and 90840
Crisis codes follow the CPT time rule: a code is reported once the midpoint of its time is passed. That gives these ranges for total crisis time on one date.
| Total crisis time | What to report |
| Under 30 minutes | Not a crisis code; report the psychotherapy code that fits the time |
| 30 to 74 minutes | 90839, one unit |
| 75 to 104 minutes | 90839 plus one unit of 90840 |
| 105 to 134 minutes | 90839 plus two units of 90840 |
According to the CMS psychotherapy for crisis page, the time does not have to be continuous on the date of service. If a clinician spends 40 minutes in the morning and 45 more that afternoon, the 85 minutes support 90839 plus one unit of 90840. Some payers cap 90840 units, so check each payer’s policy.
Medicare crisis codes by setting: G0017 and G0018
Medicare pays crisis services furnished at an applicable site of service, meaning a non-facility location other than the office, at 150% of the fee schedule amount. Those visits are billed with HCPCS G0017 for the first 60 minutes and G0018 for each additional 30 minutes instead of 90839 and 90840.
CMS lists physicians, clinical psychologists, clinical social workers, nurse practitioners, clinical nurse specialists, physician assistants, certified nurse-midwives, marriage and family therapists and mental health counselors as practitioners who can furnish these services. Some can also bill crisis services provided by auxiliary staff, such as peer support specialists, incident to their care under general supervision.
Medicare also lists 90839 and 90840 as telehealth services. Place of service and modifier rules differ by payer, and our comparison of telehealth modifiers 95 and GT explains them. Commercial plans and Medicaid set their own crisis rules, so check each payer’s manual.
What not to bill with crisis codes
CMS says not to report crisis codes with psychiatric services 90785 to 90899. That rules out other psychotherapy codes, the interactive complexity add-on and diagnostic evaluations on the same date. Noridian adds that crisis psychotherapy is billed only once per day.
Bundled pairs like these are a frequent source of denials, as our guide to NCCI bundling edits and fixes explains.
Documentation that supports a crisis claim
A crisis note must show why the situation was urgent and what you did about it. Use the checklist below.
Sample (fictional data): Morgan Ellis arrives at the clinic with active suicidal thoughts and a plan. The clinical social worker assesses risk, completes a mental status exam, uses de-escalation and safety planning, contacts a family member and arranges same-day psychiatric follow-up. Total time is 80 minutes. Claim: 90839 plus one unit of 90840, place of service 11. Replace the patient, clinician, events and minutes with your own case details.
Common crisis billing mistakes
| Mistake | Fix and prevention |
| Crisis code for a routine but hard session | Document the urgent, high-distress problem that made it a crisis |
| Billing 90839 for under 30 minutes | Report the psychotherapy code that fits the actual time |
| Adding 90832 to 90838 or 90785 on the same date | Leave other psychiatric codes off crisis claims |
| Office codes used for a home crisis visit | Use G0017 and G0018 for Medicare at applicable non-office sites |
| No total time in the note | Record start and stop times or total minutes for the date |
| Missing disposition | Document the safety plan, referrals and follow-up arranged |
Weak urgency documentation tends to come back as a CO-50 medical necessity denial, so the note matters as much as the code.
Frequently asked questions
When should I bill 90839 instead of 90837?
Bill 90839 only when the patient’s problem is urgent and life-threatening or complex enough to need immediate attention, and the note shows an urgent assessment, mental status exam, psychotherapy and steps to restore safety. A long routine session is still 90837, even when it is emotionally difficult.
How many minutes do I need to bill 90840?
90840 starts once total crisis time reaches 75 minutes, because the first 60 minutes belong to 90839 and the add-on needs more than half of its 30-minute block. At 105 minutes you can report a second unit. Some payers limit 90840 units per day.
Can crisis time be split across the day?
Yes. CMS says the time for psychotherapy for crisis does not need to be continuous on the date of service. Add the face-to-face crisis minutes from each contact that day and document each block, then report the codes that match the total.
What are G0017 and G0018?
They are Medicare HCPCS codes for crisis psychotherapy furnished at an applicable non-office site where the non-facility rate applies, such as a patient’s home. G0017 covers the first 60 minutes and G0018 each additional 30 minutes, and Medicare pays them at 150% of the fee schedule amount.
Can therapists like LCSWs and MFTs bill crisis codes?
Yes. CMS lists clinical social workers, clinical psychologists, marriage and family therapists and mental health counselors among the practitioners who can furnish crisis psychotherapy. They must be enrolled with the payer, and commercial plans may set their own rules, so check each contract.
Final Considerations
Crisis psychotherapy billing rewards precise notes: a clear crisis, total minutes for the date and the right code for the setting. Keep other psychiatric codes off the same claim and follow each payer’s limits. For Medicare’s wider behavioral health rules, see our therapist’s guide to CMS behavioral health directives.
If you want crisis claims checked before submission, our medical billing and coding services assign a dedicated agent to your practice, or you can send our team a message to start.
Sources: AMA CPT code set; CMS, Psychotherapy for Crisis; Noridian Medicare, Mental Health billing guidance; CMS, Medicare Mental Health (MLN1986542). This article is general information, not legal advice. Confirm current rules with each payer.