Writing effective progress notes for family and group therapy sessions
When it comes to family therapy and group therapy, progress notes can become more complex due to the multiple parties involved.
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.
CPT code 90847 description
Code 90847 represents a 50-minute session of psychotherapy where the identified patient is present along with one or more members of their family (including a spouse or partner).
This code reflects a more integrated and comprehensive approach to family therapy that goes beyond addressing family dynamics in the absence of the identified patient (as in the case of a 90846 session).
In order to be reimbursed by most payers for a 90847 session, the identified patient should have a confirmed clinical diagnosis that the session is helping to treat.
For example, in a family therapy session for a teenager recently diagnosed with major depressive disorder, a provider can help aid the teenager’s recovery by educating the family on ways to provide support, and facilitating open communication about the emotional challenges they are facing. The patient’s presence in the session can help the provider gain a deeper understanding of the family dynamics at hand in order to provide the most appropriate course of treatment.
This is is how the American Medical Association defines 90847 in the official CPT codebook:
Family psychotherapy (conjoint psychotherapy) (with 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.
Your documentation for family therapy should include all the standard elements of a progress note, including:
- Session details: Including patient name and date of birth on every page, start and stop times, date, and place of service
- Person-centered details
- Patient-centered observations
- Clinical interventions and evidence-based practices used during the session
- Progress towards goals
- 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.
Writing effective progress notes for family and group therapy sessions
CPT code 90847 time frame
The 90847 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 90847 reimbursement rates
Reimbursement rates for sessions billed with 90847 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 a majority of the session.
If the identified patient is present for 16 minutes or more of the session, you would use the 90847 CPT code. If you’d like to see only the family member(s) or partner of your identified patient without the patient present, you’d use 90846.
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.
What’s the difference between 90847 and 90837?
CPT code 90837 refers to an individual 60-minute session of psychotherapy, where only the patient is present. While 90847 is a 50-minute family therapy session, where the patient is present along with their spouse, partner, or one or more members of their family
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.
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Billing and coding
View all resources
How to use 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.
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 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.
