When a patient presents in a state of high distress with life-threatening complexity, standard therapy codes do not adequately reimburse the provider for the intense work required. This is when you use CPT 90839 and 90840.
Defining a "Crisis"
To bill these codes, the patient must be experiencing an urgent assessment and history of a crisis state, requiring immediate attention. Examples include active suicidal ideation, severe panic attacks, or acute psychotic breaks requiring potential hospitalization.
Time Requirements
Crisis therapy is heavily scrutinized for time compliance:
- 90839 (First 60 mins): You must spend at least 30 minutes to bill this base code.
- +90840 (Add-on each 30 mins): You can only add this once you reach 75 total minutes.
NCCI Edits
You cannot bill crisis codes on the same day as standard psychotherapy codes (90832, 90834, 90837) or psychiatric diagnostic evaluations (90791, 90792). They are mutually exclusive.