Psychotherapy for Patients in Crisis

CPT code 90839 is used to report the first 60 minutes of psychotherapy provided to a patient experiencing a crisis. If additional time is required, code 90840 should be reported for each extra 30-minute increment. These codes are not limited by place of service and are typically used in outpatient clinics, office settings, or emergency departments.

CPT defines psychotherapy for crisis as involving an urgent clinical evaluation, including a focused history, assessment of the crisis, and a mental status exam. Treatment includes therapeutic intervention, resource mobilization to manage the crisis and ensure safety, and efforts to reduce the risk of psychological trauma. The presenting issues are usually severe, high-risk, or life-threatening, requiring immediate and focused clinical attention.

Time Documentation for Psychotherapy for Patients in Crisis

According to CPT guidance, report only the total time spent face-to-face with the patient and/or family. The time need not be continuous but must reflect periods where the provider is fully engaged with the patient. The patient must be present for all or part of the session.

Key Points for Reporting

• These codes can be billed by psychiatrists, psychologists, social workers, nurse practitioners (NPs), physician assistants (PAs), and other licensed mental health professionals.
• These are time-based services, and the face-to-face time must be clearly documented in the patient’s medical record.
• If a patient requests an urgent session but is not in a true crisis, use standard psychotherapy CPT codes instead.
• These codes should be used only when the clinical situation and treatment meet the described criteria.

New HCPCS Codes for Crisis Psychotherapy Services

As part of the Consolidated Appropriations Act of 2023, CMS introduced new HCPCS codes to support psychotherapy for patients experiencing a crisis outside of traditional office or facility settings.

These services are designed for outreach workers and crisis teams who treat patients in homes, homeless shelters, or on the street, often addressing complex mental health needs in unstable environments.

To reflect the higher intensity and cost of care, these crisis-related codes are reimbursed at 150% of the standard rates for CPT codes 90839 and 90840.

CMS allows these services to be performed by auxiliary personnel under physician or practitioner supervision, including those employed, contracted, or independently engaged. While “peer support” is discussed, CMS does not specifically define the types of auxiliary personnel.

New HCPCS Codes

• G0017 – Psychotherapy for crisis in an applicable site, first 60 minutes
• G0018 – Each additional 30 minutes

BillingFreedom Supports Crisis Psychotherapy Billing with New HCPCS Codes

BillingFreedom is here to help providers navigate Medicare's latest changes with the introduction of new HCPCS codes for crisis psychotherapy services in 2025. These codes, G0017 and G0018, are designed for use in non-traditional settings such as patient homes, shelters, or public locations. Reimbursed at 150% of standard crisis therapy rates, these services acknowledge the increased complexity and cost of serving individuals without stable housing.

Our billing experts at BillingFreedom ensure that your claims for crisis services are accurate, compliant, and submitted correctly in accordance with the new guidelines. We assist providers and crisis teams in understanding how these codes apply, who qualifies as auxiliary personnel under CMS supervision rules, and how to document care appropriately. Whether you're part of a mobile outreach team or delivering community-based mental health care, BillingFreedom makes it easier to get reimbursed for the critical services you provide.

For more details about our exceptional mental health billing services, please don't hesitate to email us at info@billingfreedom.com or call us at +1 (855) 415-3472. 

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