CPT code 90839: Psychotherapy for crisis, first 60 minutes

What is the 90839 CPT code?

CPT code 90839 or "Psychotherapy for crisis, first 60 minutes", part of the American Medical Association's Procedural Terminology Manual, describes psychotherapy provided during a mental health crisis. It signifies a high-intensity intervention requiring urgent assessment and stabilization and includes assessment, formulation, and intervention to reduce immediate danger and restore functioning.

This code is common for patients experiencing acute suicidal ideation, severe panic, or trauma reactions.

Documentation requirements

For proper documentation, the healthcare provider must note the following in the patient's medical records:

• Description of crisis state (risk, severity, precipitating factors)
• Urgent assessment (history, mental status exam, risk assessment for self-harm, etc.)
• Immediate interventions and goals for de-escalation
• Mobilization of resources
• Duration of the psychotherapy services provided
• Medical necessity of crisis services
• Outcome
• Follow-up plan and coordination with other services
• Level of provider involvement (must be licensed clinician)

Billing guidelines

When billing crisis codes, healthcare providers must consider the following guidelines:

• It is used for the first 60 minutes (though a 30-74 minute range is generally accepted for this code)
• An add-on code is used for each additional 30 minutes.
• The code is billed in unites based on each additional 30 minutes of service
• The code is only billed only once per day for the same patient
• It is not billed wttih other individual psychotherapy codes, psychiatric diagnostic evaluation codes, etc.
• The coverage and requirements of the individual insurance companies have been checked.