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90840 CPT Code: Essential Billing Guide for Crisis Therapy [2025 Update]

Stanley Efrem

Jul 13, 2025

The CPT code 90840 plays a significant role at the time you provide extended crisis therapy to patients facing urgent mental health situations. You need to understand how this specific add-on code works among other base crisis therapy codes, especially for crisis interventions that last more than 74 minutes.

Patients' emotional states during crisis psychotherapy need more attention and longer sessions to work . The base code 90839 covers the original 60 minutes of crisis therapy . The 90840 code serves as an add-on for each additional 30 minutes you spend with a patient in crisis . On top of that, practitioners billing under Medicare can expect a reimbursement rate of $78.64 , with 2025 rates projected at $72.78 .

This piece shows you how to use the 90840 CPT code, what documentation you need, and the billing practices that help you get proper compensation for extended crisis care. The relationship between CPT codes 90839 and 90840 is a vital part of getting maximum reimbursement while following billing regulations.

Understanding CPT Code 90840 and Its Role in Crisis Therapy

Crisis therapy patients in severe distress often require extended time with their providers. CPT code 90840 helps mental health providers bill accurately for this critical care.

What is CPT code 90840?

The American Medical Association has managed to keep CPT code 90840 as a medical procedural code under the Psychotherapy for Crisis Services and Procedures category [1]. This code works exclusively as an add-on code and providers cannot use it independently [2]. Each additional 30-minute increment of crisis intervention beyond the first 60 minutes covered by code 90839 falls under this billing code [3].

Mental health providers can receive fair compensation for extended time they spend with patients during acute psychiatric emergencies. They can bill this code multiple times for lengthy crisis sessions, with each unit covering 30 minutes of additional care [4].

How it complements CPT code 90839

These two codes work together in a simple yet crucial way. CPT code 90839 are the foundations of crisis intervention billing by covering the first 60 minutes of crisis therapy [5].

Providers must add 90840 to 90839 for proper reimbursement when crisis sessions last longer than 74 minutes [2]. Here's how the billing works for extended crisis management:

75-104 minutes: Bill 90839 + one unit of 90840
105-134 minutes: Bill 90839 + two units of 90840 [2]

In fact, both codes represent crisis therapy but cover different time frames within the same session [2]. This setup recognizes that complex crises usually take more time than a standard session.

90840 CPT code description and purpose

The 90840 CPT code helps providers handle situations where "the crisis state is a life-threatening condition that just needs immediate attention" [1]. Providers use this code to bill for additional crisis intervention time beyond the first hour.

Medicare explains these services as ways to "reduce a patient's mental health crisis through an urgent assessment and history of a crisis state, a mental status exam, and a disposition" [6]. So, providers can only use this code for patients in acute, high-distress situations—like those with suicidal thoughts, severe mental health deterioration, or life-threatening psychiatric emergencies [4].

This is a big deal as it means that both 90839 and 90840 reimbursements are higher than standard therapy rates because crisis intervention requires intensive assessment, quick action, and coordination with emergency services [2][4].

When and How to Use CPT Code 90840

The right way to use the 90840 CPT code needs a clear grasp of time limits, qualifying cases, and who can bill for it. Let's get into the practical side of using this add-on code the right way.

90840 CPT code time requirements

The 90840 CPT code has a simple rule - you can only bill it when a crisis session exceeds 74 minutes [5]. This code works as an add-on to the base code 90839 and covers each extra 30-minute block of crisis therapy [7]. Here's how to bill it:

30-74 minutes: Bill only 90839
75-104 minutes: Bill 90839 + one unit of 90840
105-134 minutes: Bill 90839 + two units of 90840 [8]

Your records need exact timing details—either start/stop times or the total minutes you spent with the patient [7]. The total time can be added up for billing even if you didn't see the patient continuously on the same day.

Scenarios that qualify as crisis therapy

Crisis therapy steps in when patients face "life-threatening or complex problems that need immediate attention while in high distress" [3]. These situations usually include:

Suicidal thoughts or actions
Severe disability needing urgent help
Actions that put the patient or others at risk [7]
Bad dissociation or PTSD flashbacks [5]
Panic attacks that need quick stabilization [5]

Who can bill for 90840?

Medicare lets these mental health experts bill for crisis psychotherapy:

Psychiatrists and physicians (MDs/DOs)
Clinical psychologists
Licensed clinical social workers
Clinical nurse specialists and nurse practitioners
Physician assistants
Certified nurse-midwives
Marriage and family therapists
Mental health counselors [6]

Telehealth and after-hours considerations

The 90840 CPT code works great in emergencies and Medicare and most insurers have approved it for telehealth delivery [7]. Medicare won't change its mind about keeping both 90839 and 90840 on its telehealth list [7]. For virtual crisis sessions, you should:

Use place-of-service code 02 (Telehealth) or
Use normal POS with modifier -95 (real-time audio/visual) [7]

Medicare wants providers to meet all regular rules while using secure video platforms for telehealth billing [7]. This flexibility means crisis care stays available no matter where your patients are.

Documentation and Compliance Essentials

A complete documentation is crucial to get reimbursement for your 90840 CPT code. Your claims might face denial and leave you unpaid for crisis intervention work without proper records.

What to include in your session notes

Your session documentation needs these vital elements:

Start and stop times or total duration (for example: "2:00 PM to 4:10 PM, total 130 minutes = 90839 + two units of 90840") [5]
Detailed crisis description that proves medical necessity
Specific interventions you provided during extended time
Patient response to treatment
Changes in risk level or safety planning
Any coordination with emergency services as needed [2]

Each 30-minute unit of the 90840 CPT code needs full documentation that proves continued crisis intervention was needed [2].

Medical necessity and risk documentation

Medicare requires documentation that shows your patient experienced "high distress with life-threatening, complex problems that need immediate attention" [6]. Your notes should include:

Urgent assessment details and crisis state history
Complete mental status examination findings
Disposition plan outlining next steps for patient safety
Proof that you needed more than 74 minutes [8]

Your documentation should separate crisis sessions from routine therapy. Insurers look specifically for language that suggests emergency intervention instead of standard treatment [4].

Avoiding common billing errors

You can avoid claim denials by watching out for these common mistakes:

Billing 90840 without 90839 - You can't use the add-on code by itself [2]
Overestimating session time - Never round up minutes [2]
Insufficient documentation of why you needed extended crisis work
Using crisis codes for routine follow-ups - These codes work only for real crisis situations [2]
Failing to document coordination with other providers when needed [4]

Document every minute of your crisis intervention precisely to support your billing [10].

Reimbursement and Billing Best Practices for 2025

Success with crisis therapy billing depends on understanding CPT code 90840 reimbursement and becoming skilled at proper billing techniques for 2025.

90840 CPT code reimbursement rates

Medicare plans to reimburse CPT code 90840 at approximately $72.78 per 30-minute unit in 2025 [11]. This shows an uptick from $71.38 in 2024 [12]. Private insurers typically use Medicare rates as their baseline, though actual reimbursement varies.

The 90840 CPT code pays about half the rate of the original crisis code 90839 ($148.47 for 2025) [11]. This reflects its role as an add-on code for additional 30-minute segments.

Billing CPT code 90839 and 90840 together

The time-based relationship between these codes determines proper billing:

30-74 minutes = Bill only 90839
75-104 minutes = Bill 90839 + one unit of 90840
105-134 minutes = Bill 90839 + two units of 90840 [13]

These codes cannot be reported with other psychotherapy codes (90791, 90792, 90832-90838) or psychiatric service codes (90785-90899) on the same day [14].

Payer-specific rules and prior authorization

Medicare covers both codes. However, non-office settings must use HCPCS codes G0017 and G0018 instead [14][6]. These alternative codes reimburse at 150% of the non-facility rate [6].

Commercial insurers often limit how many times providers can bill 90840 per day, month, or year [1]. You should verify coverage policies before providing extended crisis services [5].

Tips for faster claim approval

Your reimbursement success and fewer denials depend on:

Clear notes with precise session times and intervention details [15]
Never mixing 90839/90840 with unrelated E/M codes for same-day visits [15]
Separate documentation of direct patient-provider time from family discussions [5]
Verification of insurance requirements before billing telehealth crisis sessions [5]
Risk levels and clinical reasons that justify extended crisis care [16]

These reimbursement basics help you secure proper payment for the critical extended crisis care you deliver.

Conclusion

Mental health providers must grasp the details of CPT code 90840 to deliver extended crisis therapy services effectively. This piece shows how this add-on code pairs with base code 90839. You'll receive fair compensation for those vital extra minutes spent with patients during crisis situations.

Your success in reimbursement depends on proper documentation. Your session notes should capture exact timing, detailed crisis descriptions, and clear proof of medical necessity. Claims might face rejection without these key elements, even when you provide legitimate extended crisis care.

Time thresholds and billing follow a clear pattern. You'll need 90839 plus one unit of 90840 for 75-104 minutes of care. Sessions between 105-134 minutes require 90839 plus two units. Precise time tracking becomes essential for your reimbursement.

The 2025 updated reimbursement rates are approaching. Knowledge of payer-specific rules will help you get maximum compensation while staying compliant. On top of that, telehealth options for crisis services let you provide this vital care whatever your physical location.

Crisis therapy stands as the most demanding yet significant work in mental health care. Becoming skilled at billing aspects lets you concentrate on what matters most - helping patients through life-threatening situations and directing them toward stability and safety. A solid grasp of CPT code 90840 ensures excellent patient care and fair financial compensation for this vital service.

FAQs

What is CPT code 90840 and when should it be used?

CPT code 90840 is an add-on code for crisis therapy sessions that exceed 74 minutes. It's used in conjunction with the base code 90839 to bill for each additional 30-minute increment of crisis intervention beyond the initial hour.

How do you bill for a 90-minute crisis therapy session?

For a 90-minute crisis therapy session, you would bill CPT code 90839 for the first 60 minutes, plus one unit of CPT code 90840 for the additional 30 minutes. This combination covers sessions lasting between 75-104 minutes.

Who can bill for CPT code 90840?

Various mental health professionals can bill for 90840, including psychiatrists, clinical psychologists, licensed clinical social workers, clinical nurse specialists, nurse practitioners, physician assistants, certified nurse-midwives, marriage and family therapists, and mental health counselors.

Can CPT code 90840 be used for telehealth crisis therapy?

Yes, CPT code 90840 is approved for telehealth delivery by Medicare and most insurers. When billing for virtual crisis sessions, use place-of-service code 02 (Telehealth) or your normal place-of-service code with modifier -95 (real-time audio/visual).

What documentation is required when billing CPT code 90840?

When billing 90840, your documentation should include precise start and stop times or total duration, a detailed crisis description, specific interventions provided, patient response to treatment, changes in risk level, and any coordination with emergency services. It's crucial to demonstrate that extended crisis intervention was medically necessary.