CPT code 90839: Crisis psychotherapy, initial 60 minutes2026 Medicare rate & RVUs in North Dakota

Report this service for intensive psychotherapy addressing an acute mental health crisis that requires immediate assessment, intervention, and disposition planning.

CMS RVU26DEffective Oct 1, 2026One payment locality21.6K Medicare services in 2024

In North Dakota, Medicare pays $159.73 for 90839 in the office and $129.00 when it’s performed in a hospital or facility.

$159.73Office (non-facility)
$129.00Hospital or facility
−0.4%vs the national office rate ($160.32)

Check a contract rate as a % of Medicare · 90839 nationwide

Medicare allowed amount for participating (non-QP) physicians, before deductible, coinsurance and claim adjustments. Not a patient’s bill or a hospital charge.

We’ll open 90839 for the payment locality that covers the ZIP.

On this page 11 sections
  1. Rate in North Dakota
  2. What 90839 covers
  3. Compared with other areas
  4. Rate map
  5. How it’s calculated
  6. Payment rules
  7. Related codes
  8. Rate history
  9. Where it applies
  10. Billing questions
  11. Sources

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

How North Dakota compares for 90839

Across 109 of 109 payment localities, the office rate for 90839 runs from $154.23 in Arkansas to $222.25 in Alaska. North Dakota pays $159.73. The RVUs are the same everywhere; the geographic indexes change the dollars.

90839 in North Dakota vs other payment areas
  1. North Dakota · this page$159.73
  2. Los Angeles, CA · California$172.16+$12.43
  3. Washington, DC area · District of Columbia$173.97+$14.24
  4. Miami, FL · Florida$163.49+$3.76
  5. Chicago, IL · Illinois$162.66+$2.93
  6. Manhattan, NY · New York$175.00+$15.27
  7. Alaska · Alaska$222.25+$62.52

Other areas in North Dakota first, then benchmark localities. Bars start at $0.

Every other payment area

90839 in every other Medicare payment locality
Payment localityOfficeFacility
AlabamaAlabama$154.92$128.03
ArkansasArkansas$154.23$127.84
ArizonaArizona$158.95$129.17
Bakersfield, CACalifornia$166.02$132.34
Chico, CACalifornia$165.71$132.03
El Centro, CACalifornia$165.71$132.03
Fresno, CACalifornia$165.71$132.03
Hanford, CACalifornia$165.71$132.03

90839 rates by state

Office rate range in each state. Select a state to see its payment localities.

Explore a state

Local rates. Clear comparisons.

Hover or focus a tile to see its rate range. Select it to open the state’s fee schedule.

$154.23

$222.25

Color shows the midpoint of each state’s locality range.

View every state and territory as a table
90839 office rate range by state
State / territoryOffice rate rangeLocalities
AK$222.251
AL$154.921
AR$154.231
AZ$158.951
CA$165.71–$190.5829
CO$164.081
CT$165.991
DC$173.971
DE$160.341
FL$159.08–$163.493
GA$156.22–$161.522
GU$165.351
HI$165.351
IA$156.341
ID$156.621
IL$157.43–$163.014
IN$156.911
KS$156.011
KY$155.831
LA$155.71–$158.122
MA$164.14–$172.832
MD$161.91–$173.973
ME$156.77–$159.602
MI$157.00–$159.622
MN$160.771
MO$154.81–$158.423
MS$154.541
MT$160.321
NC$157.301
ND$159.731
NE$156.641
NH$161.831
NJ$168.86–$174.292
NM$157.231
NV$160.201
NY$158.04–$176.355
OH$156.871
OK$155.851
OR$159.87–$166.392
PA$157.01–$164.302
PR$160.751
RI$163.801
SC$157.151
SD$159.661
TN$156.241
TX$156.68–$162.758
UT$157.841
VA$159.35–$173.972
VI$160.751
VT$159.431
WA$163.75–$175.142
WI$157.961
WV$155.551
WY$160.061

See 90839 in every payment locality

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

Office or facility?

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.

The exact North Dakota inputs and CMS source lines

PPRRVU2026_Oct_nonQPP.csv

11,535

Code
90839
Physician work
3.58
Practice expense
1.19
Malpractice
0.03

GPCI2026.csv

84

Locality
North Dakota
Physician work
1.000
Practice expense
1.000
Malpractice
0.406
Office calculation for 90839 in North Dakota
ComponentRVULocality factorAdjusted
Physician work3.58× 1.0003.5800
Practice expense1.19× 1.0001.1900
Malpractice0.03× 0.4060.0122
Total RVUs4.7822
Conversion factor× 33.4009

Office rate, North Dakota$159.73

Office: (3.58 × 1 + 1.19 × 1 + 0.03 × 0.406) × $33.4009 = $159.73

Facility: (3.58 × 1 + 0.27 × 1 + 0.03 × 0.406) × $33.4009 = $129.00

Open 90839 in the RVU calculator

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.

How 90839 has changed in North Dakota

90839 · Office / nonfacility

$159.73

Effective 2026-10-01

The base rate is $12.82 higher than on 2025-10-01, moving from $146.91 to $159.73 (8.7%).

It is unchanged from the immediately preceding available release, effective 2026-07-01.

Base rate by release · bars start at $0 · select a bar to compare

One bar per available release, ordered by effective date. Missing rates remain gaps. These comparisons hold the code, setting and locality identifiers constant; they do not isolate which policy or input caused a change.

What changed, release by release
  1. January 1, 2026

    RVU26A

    $146.91changed to$159.73

    • Conversion factor 32.3465 changed to 33.4009
    • Work RVU 3.43 changed to 3.58
    • Practice expense RVU 1.06 changed to 1.19
    • Malpractice RVU 0.10 changed to 0.03
    • Malpractice GPCI 0.517 changed to 0.406

    Held through RVU26B, RVU26C, RVU26D.

  2. January 1, 2025

    RVU25A

    $144.86changed to$146.91

    • Conversion factor 33.2875 changed to 32.3465
    • Work RVU 3.28 changed to 3.43
    • Practice expense RVU 1.02 changed to 1.06

    Held through RVU25B, RVU25C, RVU25D.

  3. March 9, 2024

    RVU24AR

    $142.49changed to$144.86

    • Conversion factor 32.7442 changed to 33.2875

    Held through RVU24B, RVU24C, RVU24D.

  4. January 1, 2024

    RVU24A

    $139.53changed to$142.49

    • Conversion factor 33.8872 changed to 32.7442
    • Work RVU 3.13 changed to 3.28
    • Practice expense RVU 0.94 changed to 1.02
    • Malpractice GPCI 0.474 changed to 0.517
  5. January 1, 2023

    RVU23A

    $141.94changed to$139.53

    • Conversion factor 34.6062 changed to 33.8872
    • Practice expense RVU 0.92 changed to 0.94
    • Malpractice RVU 0.12 changed to 0.10
    • Malpractice GPCI 0.431 changed to 0.474

    Held through RVU23B, RVU23C, RVU23D.

  6. January 1, 2022

    RVU22A

    $142.57changed to$141.94

    • Conversion factor 34.8931 changed to 34.6062
    • Practice expense RVU 0.90 changed to 0.92
    • Malpractice RVU 0.13 changed to 0.12

    Held through RVU22B, RVU22C, RVU22D.

  7. January 1, 2021

    RVU21A

    $145.56changed to$142.57

    • Conversion factor 36.0896 changed to 34.8931
    • Practice expense RVU 0.85 changed to 0.90
    • Malpractice RVU 0.11 changed to 0.13
    • Malpractice GPCI 0.485 changed to 0.431

    Held through RVU21B, RVU21C, RVU21D.

  8. January 1, 2020

    RVU20A

    $140.89changed to$145.56

    • Conversion factor 36.0391 changed to 36.0896
    • Practice expense RVU 0.72 changed to 0.85
    • Malpractice GPCI 0.540 changed to 0.485

    Held through RVU20B, RVU20C, RVU20D.

  9. January 1, 2019

    RVU19A

    $136.78changed to$140.89

    • Conversion factor 35.9996 changed to 36.0391
    • Practice expense RVU 0.61 changed to 0.72

    Held through RVU19B, RVU19C, RVU19D.

  10. January 1, 2018

    RVU18AR1

    $132.08changed to$136.78

    • Conversion factor 35.8887 changed to 35.9996
    • Practice expense RVU 0.49 changed to 0.61
    • Malpractice GPCI 0.547 changed to 0.540

    Held through RVU18B, RVU18C, RVU18D.

  11. January 1, 2017

    RVU17A

    $131.79changed to$132.08

    • Conversion factor 35.8043 changed to 35.8887
    • Malpractice GPCI 0.554 changed to 0.547

    Held through RVU17B, RVU17C, RVU17D.

  12. January 1, 2016

    RVU16A

    $132.07changed to$131.79

    • Conversion factor 35.9335 changed to 35.8043
    • Malpractice RVU 0.10 changed to 0.11

    Held through RVU16B, RVU16C, RVU16D.

  13. July 1, 2015

    RVU15C

    $131.41changed to$132.07

    • Conversion factor 35.7547 changed to 35.9335

    Held through RVU15D.

  14. January 1, 2015

    RVU15A

    $132.51changed to$131.41

    • Conversion factor 35.8228 changed to 35.7547
    • Practice expense RVU 0.51 changed to 0.49
    • Malpractice RVU 0.11 changed to 0.10
    • Malpractice GPCI 0.536 changed to 0.554

    Held through RVU15B.

  15. January 1, 2014

    RVU14A

    No ratechanged to$132.51

    Held through RVU14B, RVU14C, RVU14D.

  16. January 1, 2013

    RVU13AR

    Earliest loaded release: No rate

    Held through RVU13B, RVU13C, RVU13D.

Rates in every CMS release
Effective fromOfficeFacilityCMS release
2026-10-01$159.73$129.00RVU26D
2026-07-01$159.73$129.00RVU26C
2026-04-01$159.73$129.00RVU26B
2026-01-01$159.73$129.00RVU26A
2025-10-01$146.91$128.79RVU25D
2025-07-01$146.91$128.79RVU25C
2025-04-01$146.91$128.79RVU25B
2025-01-01$146.91$128.79RVU25A
2024-10-01$144.86$127.21RVU24D
2024-07-01$144.86$127.21RVU24C
2024-04-01$144.86$127.21RVU24B
2024-03-09$144.86$127.21RVU24AR
2024-01-01$142.49$125.14RVU24A
2023-10-01$139.53$123.26RVU23D
2023-07-01$139.53$123.26RVU23C
2023-04-01$139.53$123.26RVU23B
2023-01-01$139.53$123.26RVU23A
2022-10-01$141.94$125.33RVU22D
2022-07-01$141.94$125.33RVU22C
2022-04-01$141.94$125.33RVU22B
2022-01-01$141.94$125.33RVU22A
2021-10-01$142.57$125.48RVU21D
2021-07-01$142.57$125.48RVU21C
2021-04-01$142.57$125.48RVU21B
2021-01-01$142.57$125.48RVU21A
2020-10-01$145.56$131.13RVU20D
2020-07-01$145.56$131.13RVU20C
2020-04-01$145.56$131.13RVU20B
2020-01-01$145.56$131.13RVU20A
2019-10-01$140.89$131.16RVU19D
2019-07-01$140.89$131.16RVU19C
2019-04-01$140.89$131.16RVU19B
2019-01-01$140.89$131.16RVU19A
2018-10-01$136.78$131.38RVU18D
2018-07-01$136.78$131.38RVU18C
2018-04-01$136.78$131.38RVU18B
2018-01-01$136.78$131.38RVU18AR1
2017-10-01$132.08$131.00RVU17D
2017-07-01$132.08$131.00RVU17C
2017-04-01$132.08$131.00RVU17B
2017-01-01$132.08$131.00RVU17A
2016-10-01$131.79$131.08RVU16D
2016-07-01$131.79$131.08RVU16C
2016-04-01$131.79$131.08RVU16B
2016-01-01$131.79$131.08RVU16A
2015-10-01$132.07$130.99RVU15D
2015-07-01$132.07$130.99RVU15C
2015-04-01$131.41$130.34RVU15B
2015-01-01$131.41$130.34RVU15A
2014-10-01$132.51$131.43RVU14D
2014-07-01$132.51$131.43RVU14C
2014-04-01$132.51$131.43RVU14B
2014-01-01$132.51$131.43RVU14A
2013-10-01Contractor-pricedContractor-pricedRVU13D
2013-07-01Contractor-pricedContractor-pricedRVU13C
2013-04-01Contractor-pricedContractor-pricedRVU13B
2013-01-01Contractor-pricedContractor-pricedRVU13AR

Price 90839 for an earlier date of service

Where the North Dakota rate applies

North Dakota is a Medicare payment area, not a city. Our Census mapping connects it to 406 cities and communities in North Dakota. Some span more than one payment area; confirm with the service ZIP.

  • Abercrombie
  • Adams
  • Alamo
  • Alexander
  • Alice
  • Almont
  • Alsen
  • Ambrose

Browse all communities in North Dakota

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
RVUs for 90839PPRRVU2026_Oct_nonQPP.csv, line 11,535 (RVU26D)
Geographic factors for North DakotaGPCI2026.csv, line 84 (RVU26D)

Open CMS sourceHow we calculate rates

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