What Are 90839 and 90840?
These codes are used for psychotherapy for crisis.
CMS currently describes:
90839: Psychotherapy for crisis; first 60 minutes.
90840: Each additional 30 minutes, used in conjunction with 90839.
How Is Crisis Psychotherapy Different?
Crisis psychotherapy is not simply a longer standard psychotherapy session.
The service must meet the applicable requirements for psychotherapy for crisis.
The clinical circumstances and documentation should support the service.
Time Matters
CMS instructs providers to use the crisis psychotherapy codes to report the time spent furnishing psychotherapy for crisis services, even if the time on the date of service isn't continuous.
The medical record should support the reported service and time.
90839 and 90840
The basic structure is:
90839 → first 60 minutes
90840 → each additional 30 minutes
90840 is an add-on to 90839.
Important Billing Restriction
CMS currently states that psychotherapy-for-crisis codes should not be billed with several other psychiatric services, including 90791, 90792, 90832–90838 and other listed psychiatric codes.
This makes claim review especially important when multiple behavioral-health services are performed on the same date.
Telehealth Crisis Psychotherapy
CMS currently indicates that psychotherapy-for-crisis services can be furnished via telehealth when applicable requirements are met.
Telehealth requirements should be verified for the payer and date of service.
Common 90839/90840 Problems
- Incorrect time
- Insufficient crisis documentation
- Incorrect code combination
- Same-day coding conflicts
- Authorization issues
- Incorrect POS
- Payer-specific requirements