Psychotherapy for Crisis
Medicare pays for psychotherapy for crisis (currently billed using CPT codes 90839 and 90840). These services help reduce a patient’s mental health crisis through an urgent assessment and history of a crisis state, a mental status exam, and a disposition (or what happens next for the patient). Psychotherapy for crisis services are appropriate for patients in high distress with life-threatening, complex problems that require immediate attention.
- What’s Covered?
Medicare pays for psychotherapy for crisis under the Physician Fee Schedule. Services include:
- Providing an urgent assessment and history of a crisis state
- Performing a mental status exam and psychotherapy
- Mobilizing resources to defuse the crisis and restore safety
- Using interventions to minimize the potential for psychological trauma
- Who Can Furnish Psychotherapy for Crisis Services?
Physicians and some non-physician practitioners can personally furnish services for the diagnosis and treatment of mental illnesses. These practitioners include:
- Physicians (MDs and DOs)
- Clinical psychologists (CPs)
- Clinical social workers (CSWs)
- Clinical nurse specialists (CNSs)
- Nurse practitioners (NPs)
- Physician assistants (PAs)
- Certified nurse-midwives (CNMs)
- Marriage and Family Therapists (MFTs)
- Mental Health Counselors (MHCs)
In addition to physicians, some of these types of practitioners may also bill for outpatient psychiatric services and supplies provided by auxiliary personnel (like a peer support specialist) incident to their professional services under their general supervision. Services provided incident to the services of a physician, CP, CNS, NP, PA, or CNM must comply with state law and meet all applicable requirements.
- Where Can I Currently Furnish Psychotherapy for Crisis Services?
You can furnish the services described by CPT codes 90839 and 90840 in facility or non-facility locations, including, but not limited to:
- Hospitals
- Skilled nursing facilities
- Physician’s offices
- Patient’s homes
You can also furnish these services via telehealth (PDF) if you meet all requirements.
- How Do I Bill for Psychotherapy for Crisis?
Use these CPT codes to report the time you spend with the patient furnishing psychotherapy for crisis services, even if the time spent on the date of service isn’t continuous.
CPT Code Description 90839 Psychotherapy for crisis; first 60 minutes 90840 Each additional 30 minutes
Use in conjunction with 90839
Use HCPCS codes G0017 and G0018 to bill for services furnished in an applicable site of service (any place of service at which the non-facility rate for psychotherapy for crisis services applies, other than the office setting). Payment for these psychotherapy for crisis services is equal to 150% of the fee schedule amount for services furnished in non-facility sites of service.
Don’t bill psychotherapy for crisis codes with these codes:
- 90791 (Psychiatric diagnostic evaluation)
- 90792 (Psychiatric diagnostic evaluation with medical services)
- 90785-90899 (Psychiatric services and procedures)
- 90832-90838 (Psychotherapy services and procedures)
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