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Psychotherapy for crisis, as denoted by CPT® Code 90839, is a specialized form of mental health intervention designed to address acute psychological distress that arises from overwhelming situations or events. A mental health crisis can manifest when an individual feels unable to cope with significant emotional, mental, or behavioral challenges. This type of psychotherapy aims to provide immediate and short-term support to patients, helping them navigate through their distressing experiences. The focus of the therapy is on the current crisis, with the goal of alleviating the stress associated with the event, offering emotional support, and equipping the patient with effective coping strategies. In addition to therapeutic conversation, the intervention may also involve the use of reassurance and, when necessary, psychotropic medications to help reduce anxiety and enhance the patient's ability to cope with the crisis. The reporting of Code 90839 is specifically for the initial 60 minutes of this crisis psychotherapy, while Code 90840 is utilized for each subsequent 30 minutes of therapy provided during the crisis intervention.
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The indications for psychotherapy for crisis, as represented by CPT® Code 90839, include situations where patients are experiencing significant emotional, mental, or behavioral distress due to overwhelming circumstances. This may encompass a variety of scenarios, such as:
The procedure for psychotherapy for crisis, as outlined by CPT® Code 90839, involves several key steps that are critical to effectively addressing the patient's immediate needs. These steps include:
After the initial 60 minutes of psychotherapy for crisis, the patient may require follow-up sessions to continue addressing their emotional and psychological needs. Post-procedure care may include ongoing therapy to further develop coping strategies, regular check-ins to monitor the patient's mental health status, and adjustments to any prescribed medications. It is also important for the therapist to provide the patient with resources and support systems that can assist them in managing their crisis beyond the immediate intervention. The expected recovery process may vary based on the individual circumstances of the patient, and continued support is essential for long-term stability and well-being.
| Short Descr | PSYTX CRISIS INITIAL 60 MIN | Medium Descr | PSYCHOTHERAPY FOR CRISIS INITIAL 60 MINUTES | Long Descr | Psychotherapy for crisis; first 60 minutes | Status Code | Active Code | Global Days | XXX - Global Concept Does Not Apply | PC/TC Indicator (26, TC) | 0 - Physician Service Code | Multiple Procedures (51) | 0 - No payment adjustment rules for multiple procedures apply. | Bilateral Surgery (50) | 0 - 150% payment adjustment for bilateral procedures does NOT apply. | Physician Supervisions | 09 - Concept does not apply. | Assistant Surgeon (80, 82) | 0 - Payment restriction for assistants at surgery applies to this procedure... | Co-Surgeons (62) | 0 - Co-surgeons not permitted for this procedure. | Team Surgery (66) | 0 - Team surgeons not permitted for this procedure. | Diagnostic Imaging Family | 99 - Concept Does Not Apply | APC Status Indicator | Codes That May Be Paid Through a Composite APC | Type of Service (TOS) | 1 - Medical Care | Berenson-Eggers TOS (BETOS) | M5B - Specialist - psychiatry | MUE | 1 | CCS Clinical Classification | 218 - Psychological and psychiatric evaluation and therapy |
This is a primary code that can be used with these additional add-on codes.
| 90840 | Telehealth Service (Medicare) Addon Code Telemedicine Service (AMA) Audio-Only Telemedicine (AMA) MPFS Status: Active Code APC N Psychotherapy for crisis; each additional 30 minutes (List separately in addition to code for primary service) |
| 95 | Synchronous telemedicine service rendered via a real-time interactive audio and video telecommunications system: synchronous telemedicine service is defined as a real-time interaction between a physician or other qualified health care professional and a patient who is located at a distant site from the physician or other qualified health care professional. the totality of the communication of information exchanged between the physician or other qualified health care professional and the patient during the course of the synchronous telemedicine service must be of an amount and nature that would be sufficient to meet the key components and/or requirements of the same service when rendered via a face-to-face interaction. modifier 95 may only be appended to the services listed in appendix p. appendix p is the list of cpt codes for services that are typically performed face-to-face, but may be rendered via a real-time (synchronous) interactive audio and video telecommunications system. | AH | Clinical psychologist | GT | Via interactive audio and video telecommunication systems | AJ | Clinical social worker | GW | Service not related to the hospice patient's terminal condition | GY | Item or service statutorily excluded, does not meet the definition of any medicare benefit or, for non-medicare insurers, is not a contract benefit | GC | This service has been performed in part by a resident under the direction of a teaching physician | X4 | Episodic/focused services: for reporting services by clinicians who provide focused care on particular types of treatment limited to a defined period and circumstance; the patient has a problem, acute or chronic, that will be treated with surgery, radiation, or some other type of generally time-limited intervention; reporting clinician service examples include but are not limited to, the orthopedic surgeon performing a knee replacement and seeing the patient through the postoperative period | 93 | Synchronous telemedicine service rendered via telephone or other real-time interactive audio-only telecommunications system : synchronous telemedicine service is defined as a real-time interaction between a physician or other qualified health care professional and a patient who is located away at a distant site from the physician or other qualified health care professional. the totality of the communication of information exchanged between the physician or other qualified health care professional and the patient during the course of the synchronous telemedicine service must be of an amount and nature that is sufficient to meet the key components and/or requirements of the same service when rendered via a face-to-face interaction. | U4 | Medicaid level of care 4, as defined by each state | HB | Adult program, non geriatric | 59 | Distinct procedural service: under certain circumstances, it may be necessary to indicate that a procedure or service was distinct or independent from other non-e/m services performed on the same day. modifier 59 is used to identify procedures/services, other than e/m services, that are not normally reported together, but are appropriate under the circumstances. documentation must support a different session, different procedure or surgery, different site or organ system, separate incision/excision, separate lesion, or separate injury (or area of injury in extensive injuries) not ordinarily encountered or performed on the same day by the same individual. however, when another already established modifier is appropriate it should be used rather than modifier 59. only if no more descriptive modifier is available, and the use of modifier 59 best explains the circumstances, should modifier 59 be used. note: modifier 59 should not be appended to an e/m service. to report a separate and distinct e/m service with a non-e/m service performed on the same date, see modifier 25. | FQ | The service was furnished using audio-only communication technology | HO | Masters degree level | GQ | Via asynchronous telecommunications system | HT | Multi-disciplinary team | U9 | Medicaid level of care 9, as defined by each state | 25 | Significant, separately identifiable evaluation and management service by the same physician or other qualified health care professional on the same day of the procedure or other service: it may be necessary to indicate that on the day a procedure or service identified by a cpt code was performed, the patient's condition required a significant, separately identifiable e/m service above and beyond the other service provided or beyond the usual preoperative and postoperative care associated with the procedure that was performed. a significant, separately identifiable e/m service is defined or substantiated by documentation that satisfies the relevant criteria for the respective e/m service to be reported (see evaluation and management services guidelines for instructions on determining level of e/m service). the e/m service may be prompted by the symptom or condition for which the procedure and/or service was provided. as such, different diagnoses are not required for reporting of the e/m services on the same date. this circumstance may be reported by adding modifier 25 to the appropriate level of e/m service. note: this modifier is not used to report an e/m service that resulted in a decision to perform surgery. see modifier 57 for significant, separately identifiable non-e/m services, see modifier 59. | 32 | Mandated services: services related to mandated consultation and/or related services (eg, third party payer, governmental, legislative or regulatory requirement) may be identified by adding modifier 32 to the basic procedure. | 58 | Staged or related procedure or service by the same physician or other qualified health care professional during the postoperative period: it may be necessary to indicate that the performance of a procedure or service during the postoperative period was: (a) planned or anticipated (staged); (b) more extensive than the original procedure; or (c) for therapy following a surgical procedure. this circumstance may be reported by adding modifier 58 to the staged or related procedure. note: for treatment of a problem that requires a return to the operating/procedure room (eg, unanticipated clinical condition), see modifier 78. | 76 | Repeat procedure or service by same physician or other qualified health care professional: it may be necessary to indicate that a procedure or service was repeated by the same physician or other qualified health care professional subsequent to the original procedure or service. this circumstance may be reported by adding modifier 76 to the repeated procedure or service. note: this modifier should not be appended to an e/m service. | 77 | Repeat procedure by another physician or other qualified health care professional: it may be necessary to indicate that a basic procedure or service was repeated by another physician or other qualified health care professional subsequent to the original procedure or service. this circumstance may be reported by adding modifier 77 to the repeated procedure or service. note: this modifier should not be appended to an e/m service. | AM | Physician, team member service | AQ | Physician providing a service in an unlisted health professional shortage area (hpsa) | CC | Procedure code change (use 'cc' when the procedure code submitted was changed either for administrative reasons or because an incorrect code was filed) | CG | Policy criteria applied | CR | Catastrophe/disaster related | FR | The supervising practitioner was present through two-way, audio/video communication technology | GV | Attending physician not employed or paid under arrangement by the patient's hospice provider | GZ | Item or service expected to be denied as not reasonable and necessary | HE | Mental health program | HK | Specialized mental health programs for high-risk populations | HM | Less than bachelor degree level | HN | Bachelors degree level | HP | Doctoral level | HW | Funded by state mental health agency | KX | Requirements specified in the medical policy have been met | Q2 | Demonstration procedure/service | QJ | Services/items provided to a prisoner or patient in state or local custody, however the state or local government, as applicable, meets the requirements in 42 cfr 411.4 (b) | SA | Nurse practitioner rendering service in collaboration with a physician | TD | Rn | U2 | Medicaid level of care 2, as defined by each state | U6 | Medicaid level of care 6, as defined by each state | U7 | Medicaid level of care 7, as defined by each state | U8 | Medicaid level of care 8, as defined by each state | UA | Medicaid level of care 10, as defined by each state | UB | Medicaid level of care 11, as defined by each state | UD | Medicaid level of care 13, as defined by each state | UH | Services provided in the evening | X2 | Continuous/focused services: for reporting services by clinicians whose expertise is needed for the ongoing management of a chronic disease or a condition that needs to be managed and followed with no planned endpoint to the relationship; reporting clinician service examples include but are not limited to: a rheumatologist taking care of the patient's rheumatoid arthritis longitudinally but not providing general primary care services | XE | Separate encounter, a service that is distinct because it occurred during a separate encounter | XP | Separate practitioner, a service that is distinct because it was performed by a different practitioner |
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