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Psychotherapy for crisis is a critical mental health service designed to provide immediate clinical attention to patients experiencing acute psychological distress. Medicare recognizes the importance of these services and provides reimbursement under CPT codes 90839 and +90840.
These services are intended for situations where a patient presents with life-threatening, complex mental health issues requiring urgent intervention. Appropriate clinical management in such scenarios includes:
- Urgent assessment and review of the presenting crisis
- Mental status examination to evaluate current psychological functioning
- Disposition planning to determine the immediate next steps and ensure patient safety
The purpose of psychotherapy for crisis is not routine psychotherapy, but rather to stabilize an acute situation, mitigate risk, and initiate an appropriate care trajectory often within a limited, high-intensity timeframe.
Crisis Psychotherapy CPT® Codes
90839 is used for the first 60 minutes of psychotherapy for a patient in crisis, and +90840 is an add-on code for each additional 30 minutes. These codes do not have CPT® limitations on place of service and are typically provided in an outpatient or office setting, or an emergency department.
CPT® describes the service as:
“Psychotherapy for crisis is an urgent assessment and history of a crisis state, a mental status exam, and the treatment includes psychotherapy, mobilization of resources to defuse the crisis and restore safety, and implementation of psychotherapeutic interventions to minimize the potential for psychological trauma. The presenting problem is typically life-threatening or complex and requires immediate attention to a patient in high distress.”
This definition highlights that crisis psychotherapy involves immediate, focused intervention for patients in severe distress, addressing both safety and psychological stabilization.
CPT® specifies that these codes are used to report the total duration of face-to-face time with the patient and/or family. The time does not have to be continuous, but the clinician must be fully focused on the patient during the interaction. The patient must be present for all or part of the session. According to CPT® editorial guidance, only face-to-face time with the patient or family member should be counted when reporting these services.
Key Points for Reporting Psychotherapy for Crisis
- These codes can be reported by psychiatrists, nurse practitioners, physician assistants, social workers, psychologists, and other licensed mental health providers.
- They are time-based codes; document the duration in the medical record, counting only face-to-face time with the patient and/or family member.
- If a patient requests an urgent appointment but is not in crisis, use a standard psychotherapy code instead.
- Report these codes only when the patient’s condition and treatment meet the criteria for crisis psychotherapy as defined by CPT®.
HCPCS Codes for Psychotherapy for Patients in Crisis
The Consolidated Appropriations Act required CMS to establish HCPCS codes for psychotherapy for patients in crisis outside a traditional office or facility setting. These codes are intended for outreach workers and crisis teams who provide care in patients’ homes, homeless shelters, or even on the street. The fee levels are set at 150% of CPT® codes 90839 and 90840, reflecting the increased cost and complexity of providing care to patients who may lack stable housing.
Who Can Perform These Services?
Physician Fee Schedule Final Rule describes the use of “auxiliary personnel” under supervision:
“…as any individual who is acting under the supervision of a physician (or other practitioner), regardless of whether the individual is an employee, leased employee, or independent contractor of the physician (or other practitioner) or of the same entity that employs or contracts with the physician (or other practitioner), …”
CMS does not define specific types of personnel included under auxiliary personnel in the regulations. These services can be provided by crisis teams caring for patients without permanent housing.
HCPCS Codes for Crisis Psychotherapy
- G0017 – Psychotherapy for crisis furnished in an applicable site of service, first 60 minutes
- G0018 – Each additional 30 minutes
Why MindCare is the Right Choice for Mental Health Billing?
MindCare offers deep specialization in mental health billing, making us a trusted partner for providers offering high-acuity services, such as psychotherapy for crises. We understand the urgency and complexity involved in crisis care and, more importantly, how to ensure it’s accurately documented, billed, and reimbursed. Our team stays current with evolving CMS guidelines and payer requirements, ensuring your claims accurately reflect the actual value of the care you deliver.
Behavioral health professionals choose MindCare because we go beyond basic billing and financial management. We collaborate with clinicians and their teams to align clinical documentation with compliance standards, reduce denials, and protect revenue. Whether services are provided in-office, through outreach teams, or in non-traditional settings, MindCare provides the billing clarity and consistency you need.
Let us handle the technical details so you can focus on delivering critical mental health care without interruption.