CPT code 90839: Crisis psychotherapy, initial 60 minutes2026 Medicare rate & RVUs in Maryland
Report this service for intensive psychotherapy addressing an acute mental health crisis that requires immediate assessment, intervention, and disposition planning.
Medicare pays $161.91–$173.97 for 90839 in the office in Maryland, from Rest of Maryland to Washington, DC area. Which amount applies depends on the service address.
Medicare allowed amount for participating (non-QP) physicians, before deductible, coinsurance and claim adjustments. Not a patient’s bill or a hospital charge.
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On this page 9 sections
What 90839 covers
90839 covers an intensive psychotherapy encounter for a patient in an acute mental health crisis, such as severe emotional distress with urgent safety concerns. The clinician assesses the immediate situation, provides crisis-focused therapeutic intervention, and determines an appropriate disposition. Psychiatrists, psychologists, and other Medicare-recognized mental health practitioners may provide the service in settings such as an outpatient behavioral health clinic, office, or emergency department. This is crisis care, not simply a longer routine therapy session.
Select 90839 for the initial 60 minutes of crisis psychotherapy. Document the crisis presentation, assessment, interventions, the patient's response, time, and disposition. For additional crisis service, 90840 is the related add-on code, reported in 30-minute increments. CMS physician fee schedule values include work, practice expense, and malpractice components; the practice-expense values differ between office and facility settings.
This summary was written with AI assistance from CMS physician fee schedule data and checked against the CMS billing rules shown here. Rates on this page come directly from CMS files.
Billing guides for 90839: Psychotherapy CPT codes · Mental health billing
Where 90839 pays more and less in Maryland
The same RVUs, adjusted for each area’s costs. Open a locality for its calculation, history and nearby areas.
3 payment localities
$161.91 to $173.97
| Payment locality | Office | Facility |
|---|---|---|
| Baltimore area, MD | $165.38 | $132.40 |
| Rest of Maryland | $161.91 | $130.82 |
| Washington, DC area | $173.97 | $137.77 |
How the 90839 rate is calculated
Each of 90839’s three RVUs is multiplied by a geographic index (GPCI) for the payment locality, added up, and multiplied by the conversion factor. Drag the indexes or enter a ZIP to see what moves the rate.
How the rate is built · 90839
RVUs × geographic indexes × conversion factor
Work3.58
3.58 RVUs× 1.000 GPCI
Practice expense1.19
1.19 RVUs× 1.000 GPCI
Malpractice0.03
0.03 RVUs× 1.000 GPCI
Adjusted RVUs
4.8000
Conversion factor
$33.4009
Medicare rate
$160.32
Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.
Payment rules and modifiers for 90839
90839 has no global surgery period, no multiple-procedure, bilateral or assistant-at-surgery adjustment, and no professional/technical split. What changes the payment is where the service happens: the place of service on the claim decides whether Medicare pays the office or the facility rate.
Place of service · 90839
Which rate does Medicare pay?
The POS code on the claim line (CMS-1500 box 24B).
POS 11 · non-facility rate · national
$160.32
- Non-facility (office)
- $160.32
- Facility
- $129.60
Higher because the practice carries its own overhead.
90839 compared with similar codes
Compare codes · National
4 codes, side by side
How to choose
- 90837Psychotherapy60 minutes, no E/M
- Choose 90839 for acute crisis intervention requiring immediate assessment and disposition planning. Choose 90837 for a routine 60-minute individual psychotherapy session.
- 90840Crisis psychotherapyEach additional 30 minutes
- 90839 reports the initial 60 minutes of crisis psychotherapy. 90840 reports each additional 30-minute increment and is used with 90839.
- 90838PsychotherapyWith E/M, 60 minutes
- 90838 is psychotherapy reported with a separately furnished E/M service. 90839 represents psychotherapy focused on an acute crisis.
90839 billing questions
How is 90839 different from 90837?
90839 is for psychotherapy addressing an acute crisis that needs immediate assessment and intervention. Use 90837 for a routine individual psychotherapy session, even when it lasts 60 minutes.
Can 90840 be reported with 90839?
Yes. 90840 is the add-on for each additional 30 minutes of crisis psychotherapy beyond the initial service reported with 90839.
What should the note support?
Document the acute crisis, the assessment and crisis-focused interventions, the patient's response, the time spent, and the disposition or plan for immediate follow-up.
Can 90839 be used for an extended therapy appointment?
No. The encounter must involve an acute crisis requiring immediate clinical attention; duration alone does not make a routine therapy session a crisis service.
Which time belongs to 90839 versus 90840?
90839 represents the initial 60 minutes of crisis psychotherapy. Report 90840 for additional 30-minute increments when the documented crisis service continues beyond that initial period.
Where these rates come from
FeeBase calculates base physician payments from CMS work, practice-expense and malpractice RVUs, adjusted by each locality’s geographic indexes and the conversion factor. Services without a published rate are labeled, never given a made-up amount. Amounts are Medicare allowed amounts before claim adjustments: not a patient’s bill or a commercial rate.
CMS RVU26D · effective Oct 1, 2026 through the day before Jan 1, 2027
Show the CMS file lines behind this rate
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