CPT Code 90847: Family Psychotherapy with Patient Present
Reviewed against AMA CPT and CMS guidance. See sources.
What is CPT 90847?
CPT 90847 is family psychotherapy (conjoint psychotherapy) with the patient present, used for family and couples sessions where the identified client attends with family members or a partner. CPT lists it as 50 minutes, and it is not reported for sessions under 26 minutes. When family members meet without the client, use 90846 instead.
Family or couples psychotherapy with the identified client present along with one or more family members. This is the code for conjoint sessions, couples counseling, and family systems work where the identified client participates.
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
- Couples therapy with both partners present, when one partner is the identified client
- Family therapy sessions with the identified client and family members
- Conjoint sessions addressing relational patterns that affect the client's condition
When Not to Use
- When the identified client is not present: use 90846
- Individual therapy with one person: use 90832, 90834, or 90837
- Group therapy with unrelated clients: use 90853
- Sessions under 26 minutes
What to Document for CPT 90847
- Who attended, their relationship to the client, and that the client was present
- How the session addressed the client's diagnosis and treatment goals
- Interventions used with the family or couple and their response
- Start and stop times
Common Denial Reasons
- Documentation reads as an individual session rather than family or couples therapy
- Identified client not documented as present
- Medical necessity not tied to the identified client's diagnosis
- Billed with an individual psychotherapy code for the same client on the same day without clear separate sessions
Payer Notes
Most commercial payers cover 90847 when it treats the identified client's diagnosed condition. For couples therapy, a relational Z code alone (such as relationship distress) is often not covered. Payer rules vary.
Couples therapy and CPT 90847
Couples therapy is billed with 90847 when one partner is the identified client, that client is present, and the session treats the client's diagnosed condition. The note should name the identified client, show how the relational work addresses that client's diagnosis and goals, and record the time. When only the partner attends, 90846 is the family psychotherapy code without the client present.
Relationship distress on its own is usually captured with Z63.0, Problems in relationship with spouse or partner. Under the FY2027 ICD-10-CM Official Guidelines, social determinant codes in categories Z55 to Z65, including Z63.0, are reported as secondary diagnoses only, so the identified client's mental health diagnosis is listed first. Coverage for couples work varies by plan, so verify benefits before starting.
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
Do both partners need a diagnosis for couples therapy?
No. Only the identified client needs a qualifying diagnosis, and the treatment must address that client's condition. Some payers do not cover couples therapy when the only diagnosis is a relational Z code.
Is couples therapy billed as 90847?
Couples sessions with the identified client present are billed as 90847 when they treat the client's diagnosed mental health condition. Coverage for couples work varies, so verify benefits before starting.
What is the minimum time for 90847?
26 minutes. CPT lists 90847 as 50 minutes and says it is not reported for family psychotherapy under 26 minutes.
Can I bill 90847 and individual therapy on the same day?
Many payers deny a second psychotherapy code for the same client and date unless the note shows two clearly separate sessions. Check the payer policy before scheduling both.
Can 90847 be provided by telehealth?
Many payers cover it by audio-video telehealth with modifier 95 and a telehealth place of service code. Confirm each payer's rules.
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.
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