The 90840 CPT code, specifically, pertains to psychotherapy for crisis services and is often accompanied by questions about when and how to use it correctly.
Used alongside CPT 90839, 90840 is also in the family of CPT codes for mental health and makes sure that practitioners can accurately bill for time-intensive crisis care.
What is the 90840 CPT Code?
The 90840 CPT code is designated by the American Medical Association (AMA) for psychotherapy for crisis for each additional 30 minutes beyond the first 60 minutes.
Typically, this code is paired with CPT 90839, which covers the initial 60 minutes of crisis intervention. Together, they capture the extended duration of crisis care that some patients may require.
When to Use CPT Code 90840?
90840 CPT code is used in crisis situations that necessitate immediate and intensive intervention to alleviate acute symptoms. These might include instances of severe emotional distress, suicidal ideation, or other conditions where the patient’s well-being is at significant risk.
Practitioners should use this code when the session extends beyond the initial hour covered by 90839. For instance, if a session lasts 90 minutes, practitioners would bill for CPT 90839 (for the first 60 minutes) and 90840 CPT code (for the additional 30 minutes).
Documentation Requirements for 90840 CPT code
Accurate documentation is key to billing CPT code 90840. Practitioners must include details such as:
- The patient’s presenting symptoms and reason for crisis intervention.
- The specific interventions provided and the rationale for the extended session.
- Time spent with the patient, ensuring a clear distinction between the initial 60 minutes and additional increments.
These details are essential for guaranteeing reimbursement and for meeting medical necessity criteria during audits or claims reviews.
Procedure Crosswalks for 90840 CPT code
Procedure crosswalks help practitioners navigate between different coding systems, which is especially useful when handling cases involving multiple services or insurance providers.
90840 CPT code is often cross-referenced with crisis services within the Healthcare Common Procedure Coding System (HCPCS), making it easier to align treatment documentation with specific payer requirements.
Additionally, some insurers may have unique interpretations of what constitutes a crisis, so understanding how 90840 aligns with other codes—both within CPT and across other billing systems—is valuable for avoiding denials and ensuring compliance.
Best Practices for Using 90840 CPT Code
When billing for the 90840 CPT code make sure to apply these best practices:
- Verify Coverage: Not all insurers reimburse for the 90840 CPT code, so it’s wise to check with the payer before filing claims.
- Document the Crisis: Include specific symptoms, risks, and interventions to establish the medical necessity for crisis intervention.
- Time Management: Record the time accurately, specifying when the initial 60 minutes ends and the additional increments begin.
- Review Crosswalks Regularly: Coding guidelines can evolve. Staying informed about crosswalks and billing updates helps practitioners remain compliant and avoid claim issues.
Medicare Reimbursement for 90840 CPT Code
For practitioners billing under Medicare, CPT code 90840 has a reimbursement rate of $78.64. This is a standardized rate; however, other insurers may have varying rates, so it’s important to verify with each payer.
If you’re looking for assistance with coding, Medical Claims Billing can manage the billing process for the 90840 CPT code and make sure that all requirements are met to optimize claims and minimize denials.
