CPT code 90846: Family psychotherapy (without the patient present), 50 minutes

Better understand how to use CPT code 90846, its requirements, and guidelines, to ensure proper reimbursement.

What is CPT code 90846?

CPT code 90846, one of the family therapy codes, pertains to family psychotherapy services or family therapy services, specifically a family therapy session conducted without the patient present, offered by licensed behavioral health providers or licensed mental health professionals.

The family psychotherapy session under this code lasts from 26 minutes minimum to 50 minutes. It involves addressing issues related to the patient's mental health and how the family members can support it through addressing family dynamics and the stressors impacting them, promoting supportive behavior, coming up with communication strategies, etc.

This code is commonly used in mental health family therapy treatment plans for minors or patients with serious psychiatric conditions, emotional or behavioral disturbances, etc., who rely on multiple family members or family-based care.

CPT code 90846 documentation requirements

Comprehensive documentation is needed for accurate billing and demonstration of the medical necessity of the service. To ensure this, the following key elements must be included in the patient's medical records:

Name and diagnosis of the identified patient
Name, relationship, and roles of the individuals to the patient
Family history, issues addressed, therapeutic methods used, and family response
Indication for family therapy and relation to patient’s care plan
Duration of session (typically 50 minutes)

CPT code 90846 billing guidelines

Here's a quick overview of the billing guidelines for CPT code 90846:

The time spent is around 50 minutes or less
Document family involvement in the treatment plan and medical necessity.
CPT 90846 is billed per session, without the patient present.
Differentiate from CPT 90847 (family therapy with patient present).
Confirm insurance company guidelines and payer-specific policies on coverage and session frequency, since reimbursement rates and specific billing rules can vary among insurance companies or insurance providers.

Frequently asked questions

90846 is used for family psychotherapy sessions where the identified patient is not present for the majority of the session. Meanwhile, 90847 is used for family (conjoint) psychotherapy sessions where the same patient is present with one or more family members.

While the code descriptor specifies 50 minutes, you can bill under 90846 for sessions lasting at least 26 minutes. Accurate documentation of the session start and end times is crucial.

There isn't typically a strict limit, but payers will expect the frequency and duration of sessions to be medically necessary and align with the identified patient's treatment plan and progress. Some payers may have specific limitations on the number of family therapy sessions they cover per year or per episode of care. It's always best to verify with the individual insurance provider.

‍