The Question · Mental health · Crisis services
Crisis care outside the office pays 150% in Medicare. Most teams still bill it like an office visit.
988 routed about 19.1 million contacts in its first three years. The calls end in a mobile team, a home visit or a crisis session. Medicare and Medicaid both pay more for that work, but only on the right code and only for a limited time.
By ASP-RCM Editorial, Healthcare RCM Practice · Updated
The question we asked on LinkedIn
Medicare pays 150% for crisis psychotherapy delivered outside the office. Is your crisis team billing the higher code, or leaving it on the table?
988 contacts routed
Calls, texts and chats, July 2022 to September 2025, per GAO-26-108114
Medicare crisis rate outside the office
G0017 and G0018, paid at 150% of the non-facility amount since January 1, 2024
Medicaid match on mobile crisis
For 12 fiscal quarters per state, under section 1947 of the Social Security Act
Enhanced match window closes
The five-year window that opened April 1, 2022 ends
From a 988 call to a paid claim
Each step has its own payer rule. Revenue leaks where the team changes hands.
988 contact
A crisis center answers by call, text or chat. Center funding is grants and state money, not a claim.
Mobile team goes out
A multidisciplinary team meets the person outside a hospital. Medicaid pays this as a mobile crisis service where the state covers it.
Crisis session
A licensed clinician delivers crisis psychotherapy at the home or another non-office site. In Medicare that is G0017 and G0018.
Follow-up
The person moves to outpatient care. Ongoing visits go back to routine psychotherapy and E/M codes.
Which code fits where
Medicare crisis psychotherapy codes, per the CMS psychotherapy for crisis page.
| Setting | Medicare codes | Payment |
|---|---|---|
| Office | 90839, first 60 minutes; 90840, each added 30 minutes | Standard fee schedule amount |
| Home, mobile unit or other non-facility site that is not the office | G0017, first 60 minutes; G0018, each added 30 minutes | 150% of the non-facility fee schedule amount |
| Hospital or other facility setting | 90839 and 90840 | Facility rate |
| Same session | Do not add 90791, 90792 or 90832 to 90838 | Crisis codes stand alone |
Source: CMS, Psychotherapy for Crisis, and CY 2024 PFS final rule fact sheet (CAA, 2023 section 4123).
Same hour of crisis care, two different payments
Medicare pays the out-of-office crisis code at one and a half times the fee schedule amount.
Relative to the non-facility fee schedule amount. Local rates vary by locality.
Who can bill Medicare crisis psychotherapy
CMS lists these practitioners as able to furnish the service personally.
Physicians and psychologists
MDs, DOs and clinical psychologists bill 90839, 90840 or the G-codes directly.
Social workers, MFTs and counselors
Clinical social workers, marriage and family therapists and mental health counselors can bill. MFTs and MHCs only since 2024. See MFT and MHC billing.
NPs, PAs, CNSs and CNMs
These practitioners can bill too. Auxiliary staff may work incident to under general supervision if state law allows.
The crisis billing clock
- Mar 11, 2021
ARPA adds section 1947: 85% match for qualifying mobile crisis services.
- Apr 1, 2022
The five-year section 1947 window opens.
- Jul 2022
988 goes live as the national crisis number.
- Jan 1, 2024
G0017 and G0018 pay 150% outside the office. MFTs and MHCs can enroll in Medicare.
- Jul 1, 2026
GAO reports 19.1 million contacts routed through September 2025.
- Mar 31, 2027
Section 1947 window closes. No enhanced quarters after this date.
Mobile crisis under section 1947
The enhanced match only applies to services that meet the statute's definition.
Does not qualify
- A single clinician with no team
- Services delivered inside a hospital or facility
- A service only available business hours
- Staff without de-escalation or trauma-informed training
Qualifies
- A multidisciplinary mobile team
- At least one behavioral health professional who can assess
- Care delivered where the person is, outside a facility
- Available 24 hours a day, every day of the year
Check your crisis billing
Tick what is true for your program today.
Crisis care has its own codes and its own money. Bill out-of-office Medicare sessions on G0017 and G0018, document minutes, and plan now for the end of the 85% Medicaid match.
Questions operators ask next
What are HCPCS codes G0017 and G0018?
They are Medicare codes for psychotherapy for crisis furnished at an applicable site: any place where the non-facility rate applies, other than the office, such as the home or a mobile unit. G0017 covers the first 60 minutes and G0018 each added 30 minutes. Medicare pays them at 150% of the non-facility fee schedule amount.
When does the 85% Medicaid match for mobile crisis end?
Section 1947 of the Social Security Act gives an 85% federal match for the first 12 fiscal quarters a state provides qualifying mobile crisis services, within a five-year window from April 1, 2022. That window closes March 31, 2027. Each state's 12 quarters depend on when its program started.
Can therapists bill Medicare for crisis psychotherapy?
Yes. CMS lists clinical social workers, marriage and family therapists and mental health counselors among the practitioners who can personally furnish psychotherapy for crisis, alongside physicians, psychologists, nurse practitioners, physician assistants, clinical nurse specialists and certified nurse midwives. MFTs and MHCs have been able to enroll since January 1, 2024.
Does a 988 call create a billable claim?
Not on its own. GAO reports that 988 crisis centers are funded by SAMHSA, state appropriations, state 988 telecom fees and other sources. Billing starts when a covered service follows, such as a Medicaid mobile crisis visit or a crisis psychotherapy session.
Is your crisis work paid at the crisis rate?
Send us 90 days of crisis and psychotherapy claims. A senior behavioral health billing partner shows you where codes, place of service and payer rules are costing you, in a free 30-minute call with a written gap report after.
Keep reading
Sources
- CMS, Psychotherapy for Crisis (Physician Fee Schedule)
- CMS, CY 2024 Physician Fee Schedule final rule fact sheet
- 42 U.S.C. 1396w-6, qualifying community-based mobile crisis intervention services
- GAO-26-108114, 988 Suicide and Crisis Lifeline, July 2026
Checked November 4, 2026. Medicaid crisis codes, rates and enhanced-match quarters vary by state; confirm with your state plan and MCO contracts. General information, not legal advice.