Psychotherapy for Crisis

Psychotherapy for Crisis

Physician Fee Schedule Final Rule: Learn What’s New for CY 2024

CMS issued the CY 2024 Physician Fee Schedule (PFS) final rule that announces policy changes for Medicare payments under the PFS and other Medicare Part B payment policy issues, including implementing sections of the Consolidated Appropriations Act (CAA), 2023, effective January 1, 2024:

  • Recognizes Marriage and Family Therapists (MFTs) and Mental Health Counselors (MHCs) as practitioners who may enroll with Medicare and bill independently for services furnished for the diagnosis and treatment of mental illnesses.
  • Establishes new HCPCS codes for psychotherapy for crisis services (HCPCS codes G0017 and G0018) that are furnished in an applicable site of service (any place of service at which the non-facility rate for psychotherapy for crisis services applies, other than the office setting). Payment for these psychotherapy for crisis services is equal to 150% of the fee schedule amount for services furnished in non-facility sites of service.

Psychotherapy for Crisis

Medicare pays for psychotherapy for crisis (currently billed using CPT codes 90839 and 90840). These services help reduce a patient’s mental health crisis through an urgent assessment and history of a crisis state, a mental status exam, and a disposition (or what happens next for the patient). Psychotherapy for crisis services are appropriate for patients in high distress with life-threatening, complex problems that require immediate attention.

What’s Covered?

Medicare pays for psychotherapy for crisis under the Physician Fee Schedule. The services include:

  • Providing an urgent assessment and history of a crisis state
  • Performing a mental status exam and psychotherapy
  • Mobilizing resources to defuse the crisis and restore safety
  • Using interventions to minimize the potential for psychological trauma
Who Can Furnish Psychotherapy for Crisis Services?

Physicians and non-physician practitioners who furnish services for the diagnosis and treatment of mental illnesses can offer these services, including: 

  • Physicians (MDs and DOs)
  • Clinical psychologists (CPs)
  • Clinical social workers (CSWs)
  • Clinical nurse specialists (CNSs)
  • Nurse practitioners (NPs)
  • Physician assistants (PAs)
  • Certified nurse-midwives (CNMs)

These types of practitioners may furnish and bill for outpatient psychiatric services and supplies as professional services they furnish directly. They can also bill for services performed by auxiliary personnel (like a peer support specialist) under their supervision incident to their professional services.  Services furnished incident to the services of a physician, CP, CSW, CNS, NP, PA, or CNM must comply with state law and meet all applicable requirements.

Where Can I Currently Furnish Psychotherapy for Crisis Services?

You can furnish the services described by CPT codes 90839 and 90840 in facility or non-facility locations, including, but not limited to:

  • Hospitals
  • Skilled nursing facilities
  • Physician’s offices
  • Patient’s homes 

You can also furnish these services via telehealth (PDF) if you meet all requirements.

How Do I Bill for Psychotherapy for Crisis?

Use these CPT codes to report the time you spend with the patient furnishing psychotherapy for crisis services, even if the time spent on the date of service isn’t continuous. 

CPT CodeDescription
90839Psychotherapy for crisis; first 60 minutes
90840

Each additional 30 minutes

Use in conjunction with 90839

Don’t bill psychotherapy for crisis codes with these codes:

  • 90791 (Psychiatric diagnostic evaluation)
  • 90792 (Psychiatric diagnostic evaluation with medical services)
  • 90785-90899 (Psychiatric services and procedures)
  • 90832-90838 (Psychotherapy services and procedures)
Get More Information


 

Page Last Modified:
09/10/2024 06:21 PM
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