CPT code 90840: Crisis psychotherapy, each additional 30 minutes2026 Medicare rate & RVUs in Washington, DC area
Report 90840 for each additional 30 minutes of crisis psychotherapy beyond the initial crisis service, when a patient needs urgent psychiatric intervention.
In Washington, DC area, Medicare pays $83.76 for 90840 in the office and $66.45 when it’s performed in a hospital or facility.
Check a contract rate as a % of Medicare · 90840 nationwide
Medicare allowed amount for participating (non-QP) physicians, before deductible, coinsurance and claim adjustments. Not a patient’s bill or a hospital charge.
On this page 11 sections
What 90840 covers
90840 represents additional time spent providing psychotherapy during an acute psychiatric crisis, such as severe emotional distress or an urgent safety concern. A physician or other qualified health care professional may provide the service in an office, emergency department, or another setting where crisis care is delivered. The intervention addresses the immediate crisis through assessment, therapeutic support, and planning for stabilization or disposition; it is not a routine scheduled psychotherapy session.
Report 90840 only with 90839, which covers the initial crisis service. Use 90840 for each additional 30 minutes after that initial service, following applicable CPT time thresholds. Documentation should identify the crisis, describe the interventions and the patient’s response, and support the total time spent in crisis psychotherapy. CMS treats 90840 as an add-on code billed with its primary procedure and paid within that procedure’s global period.
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 90840: Psychotherapy CPT codes · Mental health billing
How Washington, DC area compares for 90840
Across 109 of 109 payment localities, the office rate for 90840 runs from $74.10 in Arkansas to $106.67 in Alaska. Washington, DC area pays $83.76. The RVUs are the same everywhere; the geographic indexes change the dollars.
- Washington, DC area · this page$83.76
- Los Angeles, CA · California$82.82−$0.94
- Miami, FL · Florida$78.97−$4.79
- Chicago, IL · Illinois$78.52−$5.24
- Manhattan, NY · New York$84.34+$0.58
- Alaska · Alaska$106.67+$22.91
- Alabama · Alabama$74.44−$9.32
Other areas in District of Columbia first, then benchmark localities. Bars start at $0.
Every other payment area
| Payment locality | Office | Facility |
|---|---|---|
| ArkansasArkansas | $74.10 | $61.48 |
| ArizonaArizona | $76.46 | $62.22 |
| Bakersfield, CACalifornia | $79.84 | $63.73 |
| Chico, CACalifornia | $79.68 | $63.57 |
| El Centro, CACalifornia | $79.68 | $63.57 |
| Fresno, CACalifornia | $79.68 | $63.57 |
| Hanford, CACalifornia | $79.68 | $63.57 |
| Madera, CACalifornia | $79.68 | $63.57 |
| Merced, CACalifornia | $79.68 | $63.57 |
| Modesto, CACalifornia | $79.68 | $63.57 |
| Napa, CACalifornia | $86.59 | $67.22 |
| Oxnard, CACalifornia | $82.03 | $64.66 |
| Redding, CACalifornia | $79.68 | $63.57 |
| Rest of CaliforniaCalifornia | $79.68 | $63.57 |
| Riverside, CACalifornia | $79.95 | $63.84 |
| Sacramento, CACalifornia | $82.06 | $64.97 |
| Salinas, CACalifornia | $81.70 | $64.66 |
| San Diego, CACalifornia | $82.36 | $64.78 |
| Marin County, CACalifornia | $90.16 | $69.44 |
| San Francisco, CACalifornia | $90.14 | $69.42 |
| San Benito County, CACalifornia | $91.69 | $70.50 |
| Santa Clara County, CACalifornia | $91.60 | $70.41 |
| San Luis Obispo, CACalifornia | $80.51 | $63.77 |
| Santa Cruz, CACalifornia | $82.21 | $64.35 |
| Santa Maria, CACalifornia | $81.66 | $64.53 |
| Santa Rosa, CACalifornia | $82.98 | $64.93 |
| Stockton, CACalifornia | $79.68 | $63.57 |
| Vallejo, CACalifornia | $86.55 | $67.18 |
| Visalia, CACalifornia | $79.68 | $63.57 |
| Yuba City, CACalifornia | $79.68 | $63.57 |
| ColoradoColorado | $78.94 | $63.30 |
| ConnecticutConnecticut | $79.93 | $64.10 |
| DelawareDelaware | $77.14 | $62.62 |
| Fort Lauderdale, FLFlorida | $77.95 | $63.06 |
| Rest of FloridaFlorida | $76.64 | $62.59 |
| Atlanta, GAGeorgia | $77.77 | $62.84 |
| Rest of GeorgiaGeorgia | $75.19 | $62.08 |
| Hawaii, Guam, HIHawaii | $79.53 | $62.82 |
| IowaIowa | $75.11 | $61.66 |
| IdahoIdaho | $75.25 | $61.73 |
| East St. Louis, ILIllinois | $76.28 | $62.76 |
| Rest of IllinoisIllinois | $75.85 | $62.43 |
| Suburban Chicago, ILIllinois | $78.59 | $63.50 |
| IndianaIndiana | $75.40 | $61.77 |
| KansasKansas | $74.96 | $61.68 |
| KentuckyKentucky | $74.95 | $61.88 |
| New Orleans, LALouisiana | $76.10 | $62.27 |
| Rest of LouisianaLouisiana | $74.90 | $61.89 |
| Metropolitan Boston, MAMassachusetts | $83.18 | $65.64 |
| Rest of MassachusettsMassachusetts | $78.96 | $63.49 |
| Baltimore area, MDMaryland | $79.64 | $63.87 |
| Rest of MarylandMaryland | $77.90 | $63.03 |
| Rest of MaineMaine | $75.35 | $61.83 |
| Southern Maine, MEMaine | $76.74 | $62.17 |
| Detroit, MIMichigan | $76.94 | $62.75 |
| Rest of MichiganMichigan | $75.56 | $62.14 |
| MinnesotaMinnesota | $77.25 | $62.13 |
| Metropolitan Kansas City, MOMissouri | $75.96 | $62.16 |
| Metropolitan St. Louis, MOMissouri | $76.23 | $62.24 |
| Rest of MissouriMissouri | $74.47 | $61.80 |
| MississippiMississippi | $74.29 | $61.64 |
| MontanaMontana | $77.15 | $62.46 |
| North CarolinaNorth Carolina | $75.62 | $61.91 |
| North DakotaNorth Dakota | $76.76 | $62.06 |
| NebraskaNebraska | $75.25 | $61.68 |
| New HampshireNew Hampshire | $77.87 | $62.57 |
| Northern New JerseyNew Jersey | $83.90 | $66.85 |
| Rest of New JerseyNew Jersey | $81.29 | $65.24 |
| New MexicoNew Mexico | $75.68 | $62.21 |
| NevadaNevada | $77.06 | $62.35 |
| NYC suburbs and Long Island, NYNew York | $85.05 | $67.57 |
| Poughkeepsie and northern NYC suburbs, NYNew York | $81.71 | $65.61 |
| Queens, NYNew York | $84.63 | $67.26 |
| Rest of New YorkNew York | $75.99 | $62.03 |
| OhioOhio | $75.48 | $62.06 |
| OklahomaOklahoma | $74.93 | $61.81 |
| Portland, OROregon | $80.05 | $63.72 |
| Rest of OregonOregon | $76.88 | $62.24 |
| Metropolitan Philadelphia, PAPennsylvania | $79.11 | $63.81 |
| Rest of PennsylvaniaPennsylvania | $75.53 | $62.04 |
| Puerto RicoPuerto Rico | $77.36 | $62.50 |
| Rhode IslandRhode Island | $78.81 | $63.63 |
| South CarolinaSouth Carolina | $75.58 | $62.00 |
| South DakotaSouth Dakota | $76.71 | $62.02 |
| TennesseeTennessee | $75.08 | $61.72 |
| Austin, TXTexas | $78.32 | $62.77 |
| Beaumont, TXTexas | $75.37 | $61.99 |
| Brazoria, TXTexas | $77.29 | $62.73 |
| Dallas, TXTexas | $77.50 | $62.86 |
| Fort Worth, TXTexas | $77.31 | $62.82 |
| Galveston, TXTexas | $77.36 | $62.77 |
| Houston, TXTexas | $77.73 | $63.14 |
| Rest of TexasTexas | $76.10 | $62.16 |
| UtahUtah | $75.93 | $62.11 |
| VirginiaVirginia | $76.63 | $62.18 |
| Virgin Islands, VIUnited States Virgin Islands | $77.36 | $62.50 |
| VermontVermont | $76.63 | $62.08 |
| Rest of WashingtonWashington | $78.77 | $63.29 |
| King County, WAWashington | $84.29 | $66.25 |
| WisconsinWisconsin | $75.88 | $61.80 |
| West VirginiaWest Virginia | $74.91 | $62.14 |
| WyomingWyoming | $76.98 | $62.29 |
90840 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.
$74.10
$106.67
Color shows the midpoint of each state’s locality range.
View every state and territory as a table
| State / territory | Office rate range | Localities |
|---|---|---|
| AK | $106.67 | 1 |
| AL | $74.44 | 1 |
| AR | $74.10 | 1 |
| AZ | $76.46 | 1 |
| CA | $79.68–$91.69 | 29 |
| CO | $78.94 | 1 |
| CT | $79.93 | 1 |
| DC | $83.76 | 1 |
| DE | $77.14 | 1 |
| FL | $76.64–$78.97 | 3 |
| GA | $75.19–$77.77 | 2 |
| GU | $79.53 | 1 |
| HI | $79.53 | 1 |
| IA | $75.11 | 1 |
| ID | $75.25 | 1 |
| IL | $75.85–$78.59 | 4 |
| IN | $75.40 | 1 |
| KS | $74.96 | 1 |
| KY | $74.95 | 1 |
| LA | $74.90–$76.10 | 2 |
| MA | $78.96–$83.18 | 2 |
| MD | $77.90–$83.76 | 3 |
| ME | $75.35–$76.74 | 2 |
| MI | $75.56–$76.94 | 2 |
| MN | $77.25 | 1 |
| MO | $74.47–$76.23 | 3 |
| MS | $74.29 | 1 |
| MT | $77.15 | 1 |
| NC | $75.62 | 1 |
| ND | $76.76 | 1 |
| NE | $75.25 | 1 |
| NH | $77.87 | 1 |
| NJ | $81.29–$83.90 | 2 |
| NM | $75.68 | 1 |
| NV | $77.06 | 1 |
| NY | $75.99–$85.05 | 5 |
| OH | $75.48 | 1 |
| OK | $74.93 | 1 |
| OR | $76.88–$80.05 | 2 |
| PA | $75.53–$79.11 | 2 |
| PR | $77.36 | 1 |
| RI | $78.81 | 1 |
| SC | $75.58 | 1 |
| SD | $76.71 | 1 |
| TN | $75.08 | 1 |
| TX | $75.37–$78.32 | 8 |
| UT | $75.93 | 1 |
| VA | $76.63–$83.76 | 2 |
| VI | $77.36 | 1 |
| VT | $76.63 | 1 |
| WA | $78.77–$84.29 | 2 |
| WI | $75.88 | 1 |
| WV | $74.91 | 1 |
| WY | $76.98 | 1 |
How the 90840 rate is calculated
Each of 90840’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 · 90840
RVUs × geographic indexes × conversion factor
Work1.71
1.71 RVUs× 1.000 GPCI
Practice expense0.58
0.58 RVUs× 1.000 GPCI
Malpractice0.02
0.02 RVUs× 1.000 GPCI
Adjusted RVUs
2.3100
Conversion factor
$33.4009
Medicare rate
$77.16
Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.
The exact Washington, DC area inputs and CMS source lines
PPRRVU2026_Oct_nonQPP.csv
11,536
- Code
- 90840
- Physician work
- 1.71
- Practice expense
- 0.58
- Malpractice
- 0.02
GPCI2026.csv
39
- Locality
- Washington, DC area
- Physician work
- 1.054
- Practice expense
- 1.178
- Malpractice
- 1.113
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 1.71 | × 1.054 | 1.8023 |
| Practice expense | 0.58 | × 1.178 | 0.6832 |
| Malpractice | 0.02 | × 1.113 | 0.0223 |
| Total RVUs | 2.5078 | ||
| Conversion factor | × 33.4009 | ||
Office rate, Washington, DC area$83.76
Office: (1.71 × 1.054 + 0.58 × 1.178 + 0.02 × 1.113) × $33.4009 = $83.76
Facility: (1.71 × 1.054 + 0.14 × 1.178 + 0.02 × 1.113) × $33.4009 = $66.45
Payment rules and modifiers for 90840
The CMS indicators that decide how 90840 is paid alongside other services.
CMS payment indicators · 90840
Crisis psychotherapy, each additional 30 minutes
| Rule | CMS value | What it means |
|---|---|---|
| Global period | ZZZ | Add-on code: falls within the primary procedure’s global period. |
| Multiple procedures | 0 | No multiple-procedure reduction. |
| Bilateral (modifier 50) | 0 | The 150% bilateral adjustment doesn’t apply. |
| Assistant at surgery (80/81/82/AS) | 0 | Not paid without supporting documentation. |
| Co-surgeons (62) | 0 | Not permitted. |
| Team surgery (66) | 0 | Not permitted. |
| Professional/technical | 0 | Physician service: no professional/technical split. |
How 90840 has changed in Washington, DC area
90840 · Office / nonfacility
$83.76
Effective 2026-10-01
The base rate is $4.21 higher than on 2025-10-01, moving from $79.55 to $83.76 (5.3%).
It is unchanged from the immediately preceding available release, effective 2026-07-01.
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
January 1, 2026
RVU26A
$79.55changed to$83.76
- Conversion factor 32.3465 changed to 33.4009
- Work RVU 1.64 changed to 1.71
- Practice expense RVU 0.55 changed to 0.58
- Malpractice RVU 0.06 changed to 0.02
- Work GPCI 1.057 changed to 1.054
- Practice expense GPCI 1.192 changed to 1.178
- Malpractice GPCI 1.168 changed to 1.113
Held through RVU26B, RVU26C, RVU26D.
January 1, 2025
RVU25A
$79.38changed to$79.55
- Conversion factor 33.2875 changed to 32.3465
- Work RVU 1.57 changed to 1.64
- Practice expense RVU 0.53 changed to 0.55
- Malpractice RVU 0.08 changed to 0.06
Held through RVU25B, RVU25C, RVU25D.
March 9, 2024
RVU24AR
$78.08changed to$79.38
- Conversion factor 32.7442 changed to 33.2875
Held through RVU24B, RVU24C, RVU24D.
January 1, 2024
RVU24A
$77.17changed to$78.08
- Conversion factor 33.8872 changed to 32.7442
- Work RVU 1.50 changed to 1.57
- Practice expense RVU 0.49 changed to 0.53
- Work GPCI 1.056 changed to 1.057
- Practice expense GPCI 1.214 changed to 1.192
- Malpractice GPCI 1.231 changed to 1.168
January 1, 2023
RVU23A
$79.74changed to$77.17
- Conversion factor 34.6062 changed to 33.8872
- Practice expense RVU 0.47 changed to 0.49
- Malpractice RVU 0.11 changed to 0.08
- Work GPCI 1.054 changed to 1.056
- Practice expense GPCI 1.236 changed to 1.214
- Malpractice GPCI 1.294 changed to 1.231
Held through RVU23B, RVU23C, RVU23D.
January 1, 2022
RVU22A
$75.54changed to$79.74
- Conversion factor 34.8931 changed to 34.6062
- Practice expense RVU 0.42 changed to 0.47
- Malpractice RVU 0.05 changed to 0.11
Held through RVU22B, RVU22C, RVU22D.
January 1, 2021
RVU21A
$77.18changed to$75.54
- Conversion factor 36.0896 changed to 34.8931
- Practice expense RVU 0.40 changed to 0.42
- Malpractice RVU 0.06 changed to 0.05
- Work GPCI 1.049 changed to 1.054
- Practice expense GPCI 1.221 changed to 1.236
- Malpractice GPCI 1.277 changed to 1.294
Held through RVU21B, RVU21C, RVU21D.
January 1, 2020
RVU20A
$73.96changed to$77.18
- Conversion factor 36.0391 changed to 36.0896
- Practice expense RVU 0.35 changed to 0.40
- Malpractice RVU 0.05 changed to 0.06
- Work GPCI 1.045 changed to 1.049
- Practice expense GPCI 1.205 changed to 1.221
- Malpractice GPCI 1.261 changed to 1.277
Held through RVU20B, RVU20C, RVU20D.
January 1, 2019
RVU19A
$71.28changed to$73.96
- Conversion factor 35.9996 changed to 36.0391
- Practice expense RVU 0.29 changed to 0.35
Held through RVU19B, RVU19C, RVU19D.
January 1, 2018
RVU18AR1
$68.64changed to$71.28
- Conversion factor 35.8887 changed to 35.9996
- Practice expense RVU 0.23 changed to 0.29
- Work GPCI 1.048 changed to 1.045
- Malpractice GPCI 1.271 changed to 1.261
Held through RVU18B, RVU18C, RVU18D.
January 1, 2017
RVU17A
$68.66changed to$68.64
- Conversion factor 35.8043 changed to 35.8887
- Work GPCI 1.051 changed to 1.048
- Malpractice GPCI 1.280 changed to 1.271
Held through RVU17B, RVU17C, RVU17D.
January 1, 2016
RVU16A
$68.91changed to$68.66
- Conversion factor 35.9335 changed to 35.8043
Held through RVU16B, RVU16C, RVU16D.
July 1, 2015
RVU15C
$68.57changed to$68.91
- Conversion factor 35.7547 changed to 35.9335
Held through RVU15D.
January 1, 2015
RVU15A
$69.35changed to$68.57
- Conversion factor 35.8228 changed to 35.7547
- Practice expense RVU 0.24 changed to 0.23
- Malpractice RVU 0.06 changed to 0.05
- Work GPCI 1.050 changed to 1.051
- Practice expense GPCI 1.202 changed to 1.205
- Malpractice GPCI 1.205 changed to 1.280
Held through RVU15B.
January 1, 2014
RVU14A
No ratechanged to$69.35
Held through RVU14B, RVU14C, RVU14D.
January 1, 2013
RVU13AR
Earliest loaded release: No rate
Held through RVU13B, RVU13C, RVU13D.
| Effective from | Office | Facility | CMS release |
|---|---|---|---|
| 2026-10-01 | $83.76 | $66.45 | RVU26D |
| 2026-07-01 | $83.76 | $66.45 | RVU26C |
| 2026-04-01 | $83.76 | $66.45 | RVU26B |
| 2026-01-01 | $83.76 | $66.45 | RVU26A |
| 2025-10-01 | $79.55 | $69.91 | RVU25D |
| 2025-07-01 | $79.55 | $69.91 | RVU25C |
| 2025-04-01 | $79.55 | $69.91 | RVU25B |
| 2025-01-01 | $79.55 | $69.91 | RVU25A |
| 2024-10-01 | $79.38 | $69.86 | RVU24D |
| 2024-07-01 | $79.38 | $69.86 | RVU24C |
| 2024-04-01 | $79.38 | $69.86 | RVU24B |
| 2024-03-09 | $79.38 | $69.86 | RVU24AR |
| 2024-01-01 | $78.08 | $68.72 | RVU24A |
| 2023-10-01 | $77.17 | $68.12 | RVU23D |
| 2023-07-01 | $77.17 | $68.12 | RVU23C |
| 2023-04-01 | $77.17 | $68.12 | RVU23B |
| 2023-01-01 | $77.17 | $68.12 | RVU23A |
| 2022-10-01 | $79.74 | $70.33 | RVU22D |
| 2022-07-01 | $79.74 | $70.33 | RVU22C |
| 2022-04-01 | $79.74 | $70.33 | RVU22B |
| 2022-01-01 | $79.74 | $70.33 | RVU22A |
| 2021-10-01 | $75.54 | $65.62 | RVU21D |
| 2021-07-01 | $75.54 | $65.62 | RVU21C |
| 2021-04-01 | $75.54 | $65.62 | RVU21B |
| 2021-01-01 | $75.54 | $65.62 | RVU21A |
| 2020-10-01 | $77.18 | $68.81 | RVU20D |
| 2020-07-01 | $77.18 | $68.81 | RVU20C |
| 2020-04-01 | $77.18 | $68.81 | RVU20B |
| 2020-01-01 | $77.18 | $68.81 | RVU20A |
| 2019-10-01 | $73.96 | $67.88 | RVU19D |
| 2019-07-01 | $73.96 | $67.88 | RVU19C |
| 2019-04-01 | $73.96 | $67.88 | RVU19B |
| 2019-01-01 | $73.96 | $67.88 | RVU19A |
| 2018-10-01 | $71.28 | $68.24 | RVU18D |
| 2018-07-01 | $71.28 | $68.24 | RVU18C |
| 2018-04-01 | $71.28 | $68.24 | RVU18B |
| 2018-01-01 | $71.28 | $68.24 | RVU18AR1 |
| 2017-10-01 | $68.64 | $68.21 | RVU17D |
| 2017-07-01 | $68.64 | $68.21 | RVU17C |
| 2017-04-01 | $68.64 | $68.21 | RVU17B |
| 2017-01-01 | $68.64 | $68.21 | RVU17A |
| 2016-10-01 | $68.66 | $68.23 | RVU16D |
| 2016-07-01 | $68.66 | $68.23 | RVU16C |
| 2016-04-01 | $68.66 | $68.23 | RVU16B |
| 2016-01-01 | $68.66 | $68.23 | RVU16A |
| 2015-10-01 | $68.91 | $68.47 | RVU15D |
| 2015-07-01 | $68.91 | $68.47 | RVU15C |
| 2015-04-01 | $68.57 | $68.13 | RVU15B |
| 2015-01-01 | $68.57 | $68.13 | RVU15A |
| 2014-10-01 | $69.35 | $68.91 | RVU14D |
| 2014-07-01 | $69.35 | $68.91 | RVU14C |
| 2014-04-01 | $69.35 | $68.91 | RVU14B |
| 2014-01-01 | $69.35 | $68.91 | RVU14A |
| 2013-10-01 | Contractor-priced | Contractor-priced | RVU13D |
| 2013-07-01 | Contractor-priced | Contractor-priced | RVU13C |
| 2013-04-01 | Contractor-priced | Contractor-priced | RVU13B |
| 2013-01-01 | Contractor-priced | Contractor-priced | RVU13AR |
Where the Washington, DC area rate applies
Washington, DC area is a Medicare payment area, not a city. Our Census mapping connects it to 1 cities and communities in District of Columbia. Some span more than one payment area; confirm with the service ZIP.
- Washington
90840 billing questions
Can 90840 be billed by itself?
No. Report it only with 90839, the primary code for the initial crisis psychotherapy service.
When should 90840 be added to 90839?
Use 90840 when crisis psychotherapy continues beyond the initial service represented by 90839. Each 90840 unit represents an additional 30 minutes, subject to applicable CPT time thresholds.
What documentation supports an additional unit?
Record the nature of the crisis, the therapeutic interventions, the patient’s response, and the total time spent. The record should support the additional time beyond the 90839 service.
Is 90840 appropriate for a long routine therapy session?
No. It is for additional time in crisis psychotherapy reported with 90839, not simply for extending a scheduled psychotherapy visit.
Can a modifier replace the required 90839 pairing?
No. 90840 must be reported with 90839; a modifier does not make it a stand-alone service.
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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