CPT Code 90839: Crisis Therapy Billing Guide [+Reimbursement Rates]

CPT Code 90839 is a procedure code for licensed mental health providers rendering crisis therapy or psychotherapy for crisis.

Our 90839 billing and coding guide will teach you how to bill for crisis therapy sessions, explain the timeline for 90839 billing, license requirements, and how to bill for extended crisis therapy and telehealth crisis therapy as well.

We’ll also teach you about add-on CPT Code 90840 for each additional 30 minutes beyond the first 90 minutes of crisis therapy treatment (how to bill +90840).

If you’d rather skip all of this and get help, consider hiring our mental health insurance billing service (our rates fit your practice size).  If you’re brave, read on.

CPT Code 90839 Definition

90839 is defined as Psychotherapy for crisis, first 60 minute.

Along with add-on code 90840 it falls into a subgroup of crisis psychotherapy procedure codes.

cpt code 90839

CPT Code 90839 License Level Requirements:

Therapy for crisis can be billed by:

  • Licensed Clinical Social Workers (LCSW)
  • Licensed Professional Counselors (LPC)
  • Licensed Marriage Family Therapist (LMFT)
  • Clinical Psychologists (PsyD PhD)
  • Psychiatrists (MD)

90839 Time Requirement

90839 is a crisis procedure code but also has a time requirement. If the session falls short of the 60 minute time requirement you can bill a routine procedure code, such as 90834 or 90832 depending on the time elapsed.

Make sure to document the time spent to ensure you can bill this code.

CPT Code 90839 Time Length:  60-90 Minutes

How do you bill more than 90 minutes of crisis therapy? Use Add-on code 90840.

CPT Code 90840 Description:

90840 Add-On service code describes an billing an additional 30 minutes of crisis therapy services rendered after the first 90 minutes of treatment.

CPT Code 90840 Time Length:

Each additional 30 minutes of crisis psychotherapy after the first 90 minutes of services.

CPT Code 90840 Reimbursement Rate:

2020 Medicare 90840 Reimbursement Rate:  $70.74

(Source)

CPT Code 90839 Billing Checklist:

  • Telehealth Session?
    • Use POS 02 + 95 or GT Telehealth Modifier
  • Over 90 Minutes?
    • Use +90840
  • After Hours?
    • Use 99050 or 99051

CPT Code 90839 Guide

CPT Code 90839 Reimbursement

CPT Code 90839 typically pays slightly more than CPT code 90837 for a 60 minute individual psychotherapy session.  90840 pays a similar rate per time period, about half of what 90839 allows.

Medicare has published CPT Code 90839 Reimbursement Rates for 2020 as:

CPT Code 90839 – Therapy for Crisis – Medicare Reimbursement: $147.61

— 60 to 90 minute session for crisis therapy services

CPT Code 90840 – Extended Therapy for Crisis – Medicare Reimbursement: $70.74

— Over 90 minute crisis therapy session

CPT Code 99050 – Services provided in the office at times other than regularly scheduled office hours, or days when the office is normally closed

Not Covered by Medicare.  This code is for commercial insurance companies and may be approved on a case by case basis. 

CPT Code 99051 – Services provided in the office during regularly scheduled evening, weekend, or holiday office hours.

Not Covered by Medicare.  This code is for commercial insurance companies and may be approved on a case by case basis.

Crisis Therapy Billing Recommendations

We know many providers are not perfectly billing their crisis therapy sessions.  If you would like help doing so, reach out to our mental health insurance billing service for assistance.

CPT Code 90839 Billing Recommendations:

  1. Use the appropriate diagnosis and add multiple diagnoses.
  2. Use specified diagnoses (instead of general Dx).
  3. Perform services for 2 hours and bill 90839 + 90840
  4. If your services are performed out of normal business hours, use add-on CPT code 99050.  If they’re during scheduled holiday, weekend, or evening hours use CPT addon code 99051.
  5. Crisis sessions are not scheduled so perform an authorization phone call within 24 business hours after the session has been performed.  (We do this for you.)

90839 vs 90840 for an Extended Crisis Session

90840 is an add-on code that can be billed for longer crisis sessions. In order to bill 90840, the session must be 30 minutes longer (90 minutes in this case).

If you are going to bill CPT code 90840, use 90839 as the primary CPT code.  Your billing will look like 90839 +90840.

After Hours Crisis Therapy Billing Guide

Make sure to code all your claims accurately.

Question:  Did you perform crisis therapy outside of normal business hours?  Make sure to add CPT Code 99050.

If you’re performing crisis therapy during a holiday, weekend, or evening hours that are scheduled, use CPT Code 99051.

Crisis therapy sessions are never known about before the fact, obviously; they are performed in crisis.

Telehealth Crisis Therapy Recommendations

In 2020, telehealth therapy has become the norm.  Ensure you are billing crisis via telehealth with the appropriate place of service codes and modifiers.

Use Place of Service code 02 and Telehealth CPT Code Modifiers 95 or GT, depending on the insurance company and it’s guidelines.  Your billing service will take care of this for you.

90839 Requirements & Documentation

The situation must require prompt attention to a highly distressed patient. This means it is especially important to document the medical necessity of the situation. Make sure to document the risk, any referrals to other services, and communication with other contacts.

Does 90839 Require Authorization?

Billing 90839

Usually CPT code 90839 does not require prior authorization. Due to the nature of a crisis psychotherapy session, it’s often simply not practical to call the insurance and ask if they’ll pay for this code. Unfortunately, not all insurance companies will reimburse this, Medicare in particular is known for not reimbursing crisis codes. There may also be limits to the amount of times it can  be bill within a certain time period.

In these cases, it is still a good idea to call the insurance company to determine if it is better to bill 90839 or for a routine service, i.e. 90837. Our billing service can do this for you.

How Do I Bill CPT 90839?

Just like other CPT codes, it should go in the 24(c) location of a CMS 1500. If applicable, 90840 should be billed on the same claim.