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Billing and coding

How to use CPT code 90846

Text on a background: Billing CPT code 90846

Family therapy can be a covered benefit for many care-seeking couples and households, but you should understand how to leverage code 90846 effectively for clinically-focused sessions.

CPT code 90846 description

Code 90846 represents a 50-minute session of psychotherapy where the focus of the intervention is on a family or partnership dynamic, and the identified patient is not present for the majority of the session. 

In order to be reimbursed by most payers for a 90846 session, the identified patient should have a legitimate clinical diagnosis that the session is helping to treat. 

For example, this code might be used when a provider is meeting with the parents of a teenage patient diagnosed with ADHD. The provider can conduct a family psychotherapy session coded with 90846, focusing on the parents' understanding of ADHD, implementing effective parenting strategies, and creating an environment conducive to the teenager's well-being. 

This is is how the American Medical Association defines 90846 in the official CPT codebook:

Family psychotherapy (without the patient present), 50 minutes

Psychotherapy is the treatment of mental illness and behavioral disturbances in which the physician or other qualified health care professional, through definitive therapeutic communication, attempts to alleviate the emotional disturbances, reverse or change maladaptive patterns of behavior, and encourage personality growth and development.

See codes 90846, 90847 when utilizing family psychotherapy techniques, such as focusing on family dynamics.

Your documentation for this code should include all the standard elements of a progress note, including:

  • Session details: Including start and stop times, and the date and place of service
  • Person-centered details
  • Patient-centered observations
  • Progress towards clearly-defined goals and/or objectives
  • Risk assessment
  • Clinical path forward

It’s important to use the code that most accurately reflects the time you spent with the patient to treat their condition, and ensure that documentation for the session supports the chosen code. 

CPT code 90846 time frame

The 90846 code is associated with a 50-minute session of psychotherapy, which is the clinical standard length for a family therapy session. At a minimum, coding guidelines state the session must include at least 26 minutes of documented face-to-face time.

CPT code 90846 reimbursement rates

Reimbursement rates for sessions billed with 90846 will vary depending on the plan, your contract, your location, and your license type.

What’s the difference between 90846 and 90847?

The only difference between 90846 and 90847 is whether or not the identified patient is present for the majority of the session. 

If you need to see a family member or partner of your identified patient without the patient present, you would use the 90846 CPT code. If the identified patient is present for most of the session, you’d use 90847

If you’re seeing the identified patient for a session apart from their partner or other family members, use an individual psychotherapy code, such as 90834 (for a 45-minute session)

It’s important to establish the identified patient at the start of treatment, and ensure your documentation is consistent.

This document is intended for educational purposes only. It is designed to facilitate compliance with payer requirements and applicable law, but please note that the applicable laws and requirements vary from payer to payer and state to state. Please check with your legal counsel or state licensing board for specific requirements.

Headway is a free service that makes it easier and more profitable for therapists and psychiatrists to accept insurance.

Billing and coding

How to use CPT code 90847

Code 90847 represents a session where the identified patient actively participates, giving the provider important visibility into the ways family interactions can contribute to or alleviate a patient’s condition.

How to use CPT code 90847

How to use CPT code 90837

The 90837 CPT code is often understood to be the standard of a therapy session among providers. However, insurers have a tendency to flag 90837 more frequently than other codes.

How to use CPT code 90837

How to use CPT code 90834

The “45 minute” session is a core element of mental health care, so it’s vital that every provider knows how to apply the 90834 code to their work.

How to use CPT code 90834