CPT Code 90846: Family Psychotherapy without Patient Present
Reviewed against AMA CPT and CMS guidance. See sources.
What is CPT 90846?
CPT 90846 is family psychotherapy without the patient present: a session with family members, such as the parents of a child client, focused on the identified client's treatment. CPT lists it as 50 minutes, and it is not reported for sessions under 26 minutes. When the client attends, use 90847 instead.
Family or couples psychotherapy conducted without the identified client present. Used when a clinician meets with family members to address family dynamics, psychoeducation, or treatment strategies related to the identified client's condition.
Time Requirements
CPT lists 50 minutes. It is not reported for family psychotherapy under 26 minutes. Some payers set their own time expectations.
Modifiers
| Code | Description |
|---|---|
| 95 | Synchronous audio-video telehealth. Many payers also require a telehealth place of service code (02 or 10). |
| 93 | Synchronous audio-only service, where the payer allows audio-only care. |
Billing a session by video or phone? See telehealth modifiers 95, 93, GT and POS 02 vs 10.
When to Use
- Meeting with parents or guardians about a minor client's treatment
- Family psychoeducation sessions, for example explaining a diagnosis and how to respond to symptoms
- Sessions with a spouse or partner, without the client, focused on the client's treatment
When Not to Use
- When the identified client is present: use 90847
- When treating the family member's own condition (they would need their own case)
- Brief updates, phone calls, or sessions under 26 minutes
- Case management or care coordination without a psychotherapy component
What to Document for CPT 90846
- Who attended and their relationship to the client
- That the client was not present
- How the session addressed the client's diagnosis and treatment goals
- Family interventions used and the family's response
- Start and stop times
Common Denial Reasons
- Identified client was present during the session (should be 90847)
- Session under 26 minutes
- Documentation does not connect the session to the client's treatment plan
- Session did not include psychotherapeutic work
Payer Notes
Coverage varies by payer. Medicare and many other payers expect the session to focus on the patient's condition and treatment rather than the family members' own concerns. Medicaid coverage varies by state.
ICD-10 diagnosis codes
Every claim pairs the CPT code with the diagnosis the clinician documented. See the mental health ICD-10 code reference or a condition guide:
Related Codes
Frequently Asked Questions
Can I bill the family member's insurance instead?
No. Family psychotherapy codes are billed under the identified client's case and insurance. The diagnosis and treatment plan must relate to the identified client's condition.
What is the minimum time for 90846?
26 minutes. CPT lists 90846 as 50 minutes and says it is not reported for family psychotherapy under 26 minutes. Document start and stop times so the time is clear.
What is the difference between 90846 and 90847?
Whether the client attends. 90846 is used when only family members are present; 90847 is used when the identified client takes part in the family session.
Can I bill 90785 with 90846?
Generally no. CPT lists interactive complexity (90785) for use with diagnostic evaluations, individual psychotherapy, and group psychotherapy, not with the family psychotherapy codes.
Is a parent meeting about a child client billable as 90846?
It can be when it is psychotherapy aimed at the child's treatment goals, lasts at least 26 minutes, and the child is not present. Brief updates, scheduling, or coordination calls are not 90846.
Sources: American Medical Association (AMA), CPT Professional codebook: code descriptors, psychotherapy time rules, and add-on code guidance. Centers for Medicare & Medicaid Services (CMS): Medicare Physician Fee Schedule and National Correct Coding Initiative (NCCI) policy.
- AMA: CPT overview
- CMS: National Correct Coding Initiative (NCCI) edits
- CMS Medicare Coverage Database: Billing and Coding, Psychiatry and Psychology Services (A57480)
- CMS: Physician Fee Schedule relative value files
- CMS MLN901705: Telehealth and Remote Monitoring (PDF)
Payer rules vary. Confirm coverage, time, modifier, and documentation rules with each payer before billing. This page is general education, not billing or legal advice.
Write documentation for CPT 90846 sessions faster
Spend less time on documentation and more time with clients. You review every note before it is used for billing.
Stop spending evenings on documentation
WellNotes generates complete clinical notes in 2 minutes. Starting at $27/month.
Cancel anytime · Secure & private