CPT 90840Mental Health

Psytx crisis ea addl 30 min

CPT code 90840 is for each additional 30 minutes of crisis psychotherapy beyond the first hour when a patient is experiencing a psychiatric emergency requiring immediate intervention.

Showing rates for

National Average

Base Medicare rate

$72.78

This calculator gives a typical-case estimate using standard Medicare modifier rules. Actual payment depends on payer policies, documentation, code-specific CMS status indicators, and locality. Verify before billing.

RVU breakdown

Work RVU

1.64

PE RVU (NF)

0.55

MP RVU

0.06

Total RVU

2.25

Conversion factor: 32.3465 · Source: CMS MPFS RVU25A · Confidence: High

NCCI bundling edits

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Billing tips

Always bill 90840 as an add-on to 90839; this code cannot be billed independently and will auto-deny without the primary crisis code
Impact: Prevents 100% denial; ensures payment of $72.78 per additional 30-minute increment
Document exact start and stop times for the entire crisis session, clearly showing time beyond the initial 60 minutes to support each 90840 unit
Impact: Reduces audit risk by 70%; supports medical necessity for extended crisis intervention
Round down, not up: only bill 90840 when at least 16 additional minutes beyond the base 60 are documented (76+ total minutes for first add-on unit)
Impact: Follows CMS mid-point rule; prevents $72.78 overpayment recoupment during audits
Bill facility rate ($64.69) when services are provided in hospital emergency departments, psychiatric units, or other facility settings where overhead is provided
Impact: Correct place of service coding ensures proper payment and avoids $8.09 recoupment per unit
For telehealth crisis services, append modifier 95 and use place of service 02 (telehealth) or 10 (patient home) depending on payer requirements
Impact: Ensures full reimbursement of $72.78; some payers reduce payment 15-20% without proper telehealth coding
Maximum of 2-3 units of 90840 in a single session is typical; sessions exceeding 3 hours total crisis time require exceptional documentation of ongoing acute risk
Impact: Claims with 4+ units face 80% higher audit rates; strong documentation prevents denials of $218.34+ in add-on payments

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Frequently asked questions

What is the difference between CPT code 90840 and 90839?

CPT 90839 is the base code for the first 60 minutes of crisis psychotherapy, reimbursed at $109.17 non-facility. CPT 90840 is the add-on code for each additional 30 minutes beyond the initial hour, reimbursed at $72.78 per unit. You cannot bill 90840 without billing 90839 on the same date of service.

How many units of 90840 can I bill for a crisis session?

You can bill as many units as are medically necessary and properly documented, but typically 1-2 units are most common. Each unit requires at least 30 minutes of additional face-to-face time (using mid-point rule: 16+ minutes). Sessions exceeding 2.5-3 hours total require exceptional documentation of ongoing acute crisis and why patient could not be safely stabilized sooner.

Can CPT 90840 be billed with telehealth modifier 95?

Yes, 90840 is approved for telehealth delivery through at least December 31, 2025, under current CMS policy. Append modifier 95 for synchronous audio-video telemedicine services. The reimbursement rate remains $72.78 for telehealth crisis psychotherapy with no reduction from in-person rates for mental health services.

What is the time requirement for billing one unit of 90840?

Following CMS mid-point rules, you need at least 76 total minutes of crisis psychotherapy to bill one unit of 90840 with 90839 (60 minutes base + 16 additional minutes). For two units of 90840, you need at least 106 total minutes (60 + 46). Always document exact start and stop times to support time-based billing.

Does Medicare pay for CPT 90840 in all settings?

Yes, Medicare pays for 90840 in both facility and non-facility settings. The non-facility rate is $72.78 (office, outpatient clinic, telehealth) and facility rate is $64.69 (hospital emergency departments, inpatient units). Use the appropriate place of service code to ensure correct reimbursement.

Can I bill 90840 on the same day as other psychotherapy codes?

Generally no, because 90840 must be billed with 90839 for crisis psychotherapy. You cannot bill routine psychotherapy codes (90832-90838) on the same date as crisis codes. If a distinct, separately identifiable service is provided at a different time on the same day, modifier 59 may be appropriate, but this is rare and requires clear documentation of two separate encounters.

What documentation is required to avoid denials for 90840?

Document exact start/stop times, specific crisis presentation requiring extended intervention, suicide/homicide risk assessment, therapeutic interventions provided during the additional time, clinical justification for session exceeding 60 minutes, patient's response to treatment, and safety plan. Vague or template documentation significantly increases denial and audit risk for time-based crisis codes.