2025 CPT code 90839
(Active) Effective Date: N/A Revision Date: N/A Psychiatry - Psychiatry Services and Procedures Medicine Feed
Psychotherapy for crisis; first 30-74 minutes.
Modifiers may be applicable depending on the circumstances of service delivery.Consult the CPT manual and payer-specific guidelines for applicable modifiers.
Medical necessity is established when a patient presents with a life-threatening or complex mental health crisis requiring immediate intervention.The situation should be documented as requiring urgent and intensive psychological care to mitigate immediate risks to the patient's safety and well-being.
The clinical responsibility involves providing direct psychotherapy to a patient in crisis, performing a thorough assessment, developing a safety plan, mobilizing resources, and implementing crisis intervention strategies. This typically requires a qualified mental health professional (physician or other qualified healthcare professional).
In simple words: This code is for a mental health professional's first session helping someone in a serious mental health crisis. The session is for 30 to 74 minutes and helps the person feel safer and more stable.
This CPT code reports psychotherapy services for a patient in crisis, specifically covering the initial 30-74 minutes of face-to-face time with the patient and/or family.The session includes an urgent assessment, history of the crisis, mental status exam, disposition planning,psychotherapy interventions to minimize potential psychological trauma, and resource mobilization to restore safety. The provider must dedicate their full attention to the patient during this time.Code 90839 is used only once per date, even if the time is not continuous.
Example 1: A patient presents to the emergency room with suicidal ideation and acute distress. The psychiatrist provides 60 minutes of crisis psychotherapy, utilizing techniques to stabilize the patient, de-escalate the immediate crisis, and develop a safety plan for discharge., A patient experiencing a severe panic attack following a traumatic event calls their therapist. The therapist provides 45 minutes of telehealth crisis psychotherapy to address the immediate symptoms and reduce the patient's distress level. The therapist collaborates with the patient to identify coping strategies and develops a plan for follow-up care., A patient is admitted to an inpatient psychiatric unit following a psychotic break. The psychiatrist conducts an initial 70-minute crisis psychotherapy session to assess the patient's current state, stabilize their symptoms, and initiate a treatment plan within the hospital setting.
Comprehensive documentation should include the patient's presenting problem, detailed history of the crisis event, mental status examination findings, the specific interventions used,resource mobilization efforts, the developed safety plan, and the patient's response to treatment.Time spent in face-to-face psychotherapy should be clearly documented and should justify the duration of the session.
** The total time spent providing psychotherapy for a crisis state must be reported using codes 90839 and 90840. The provider's full attention must be dedicated to the patient during the entire period. This code cannot be used concurrently with other similar codes.
- Revenue Code: M5B (Specialist - Psychiatry)
- RVU: This information is not provided in the source and would require accessing current Medicare Physician Fee Schedule data.
- Global Days: This code does not have a defined global period.Each 30-74 minute session is separately billable.
- Payment Status: Active
- Modifier TC rule: A technical component (TC) modifier is not applicable to this code.
- Fee Schedule: Historical fee schedule data is not available in the provided sources and would need to be obtained from fee schedule databases.Fees vary based on location, payer, and other factors.
- Specialties:Psychiatry, Psychology, Social Work
- Place of Service:Office, Hospital Inpatient, Hospital Outpatient, Emergency Room - Hospital,Telehealth Provided in Patient’s Home, Telehealth Provided Other than in Patient’s Home