90847 — Family Psychotherapy with Patient Present
Family or couples therapy session with the identified patient present along with one or more family members. This is the standard code for conjoint therapy sessions, couples counseling, and family systems work where the identified client participates.
Time Requirements
50 minutes face-to-face. Similar time expectations as 90846.
Modifiers
| Code | Description |
|---|---|
| 95 | Synchronous telemedicine service. |
When to Use
- Couples therapy or marriage counseling with both partners present
- Family therapy sessions with the identified client and family members
- Conjoint sessions addressing relational dynamics
- Family systems interventions with the patient participating
When Not to Use
- When the identified patient is not present — use 90846
- Individual therapy with one person — use 90832/90834/90837
- Group therapy with unrelated individuals — use 90853
Common Denial Reasons
- Documentation does not reflect family/couples therapy (reads as individual session)
- Identified patient not documented as present
- Medical necessity not established through the identified patient's treatment plan
- Billed simultaneously with individual therapy code for the same client on the same day
Payer Notes
Most commercial payers cover 90847. For couples therapy specifically, coverage may depend on whether the identified patient has a qualifying mental health diagnosis. "Relationship problems" (Z codes) alone may not be covered.
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