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2025 CPT code 90840

Additional 30 minutes of psychotherapy for crisis, following an initial 74-minute session (90839).

Refer to the AMA CPT manual and payer-specific guidelines for detailed coding instructions and limitations.Adherence to guidelines is crucial for accurate reimbursement.

Modifiers may be applicable depending on the circumstances of service delivery (e.g., place of service, type of service, etc.).Consult the CPT manual and payer-specific guidelines for specific modifier use.

Medical necessity is established by the presence of a life-threatening or complex crisis situation requiring immediate psychiatric intervention to stabilize the patient's condition and prevent harm.Documentation must support the severity of the crisis and the need for the extended duration of psychotherapy.

The physician or other qualified healthcare professional provides psychotherapy, assesses the patient's mental status, mobilizes resources to de-escalate the crisis, ensures patient safety, and implements interventions to minimize psychological trauma.

IMPORTANT:Must be used with 90839.Cannot be used with 90791, 90792, 90832-90838, other psychiatric services, or codes 90785-90899.

In simple words: This code is for extra time spent providing mental health crisis therapy.It's used when a therapist has already spent over 74 minutes with a patient in a very serious mental health crisis, and needs an additional 30 minutes to help them.

This CPT code reports each additional 30-minute block of psychotherapy for crisis intervention, provided after the initial 74 minutes documented using code 90839.The crisis must be a life-threatening or complex situation demanding immediate attention to a patient in acute distress.Treatment focuses on resource mobilization to de-escalate the crisis, restore safety, and implement psychotherapeutic interventions to mitigate potential psychological trauma.The service requires the provider's undivided attention to the patient and cannot be rendered concurrently with services for other patients.The patient must be present for at least a portion of the service.

Example 1: A patient presents to the emergency room following a suicide attempt.The psychiatrist spends 74 minutes providing initial crisis intervention (90839), followed by an additional 30 minutes (90840) to address the patient's immediate emotional distress and develop a safety plan., A patient experiencing an acute psychotic episode is admitted to an inpatient psychiatric unit.The psychiatrist utilizes 90839 and 90840 to document the extensive time spent calming the patient, managing the psychosis, and stabilizing the patient's mental state., A patient calls a crisis hotline, and after a 74-minute initial phone session, their therapist continues the crisis intervention using telehealth, needing an additional 30-minute block. This would be billed as 90839 and 90840 using appropriate telehealth modifiers.

Detailed clinical notes documenting the crisis situation, the patient's mental status, the interventions provided, the time spent, and the patient's response to treatment.Progress notes should clearly describe the need for additional time beyond the initial 74 minutes.

** This code is only reported when the total time of psychotherapy for crisis is greater than 74 minutes.The additional time must be contiguous with the initial psychotherapy provided under 90839, although breaks for the provider may be possible within the 30 minute reporting block. Accurate documentation is critical for justifying medical necessity and appropriate code selection.

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