CPT Code for Couples Therapy: How to Bill 90847
CPT code 90847 is the code for couples therapy. It describes family psychotherapy, also called conjoint therapy, with the patient present. When the patient is not in the room, the code is 90846. This guide covers how to choose between them, what Medicare says, what to document, and what you cannot bill on the same day. It is written for psychotherapists and psychiatrists.
For the full code reference, see our family psychotherapy guide.
Which couples therapy CPT code fits this session?
Operational guidance for psychotherapists and psychiatrists. Verify against the current AMA CPT manual and each payer’s policy.
What is CPT 90847?
CPT 90847 is family psychotherapy with the patient present, the code for couples therapy. When the patient is not in the room, use 90846. Choose the code by who attended, then document who was there, why family involvement was necessary and the times. Each payer sets its own same-day rule, so check before you bill it with another psychotherapy code. See the 90847 vs 90846 comparison.
90847 CPT code description: what 90847 and 90846 mean
CPT descriptors (AMA): 90846 is family psychotherapy without the patient present. 90847 is family psychotherapy (conjoint) with the patient present. Medicare contractor Article A57480 (CMS Coverage Database, WPS, rev. 1/1/2026) says “CPT Codes 90846 and 90847 represent family psychotherapy services for the treatment of mental disorders.”
How to choose between them
| Question | 90846 | 90847 |
|---|---|---|
| Is the identified patient in the session? | No | Yes |
| Who attends? | Family members | Patient plus partner or family |
| Typical use | Work with family about the patient’s treatment | Conjoint couples or family session |
For a couple, the claim goes under the partner being treated. Ask each payer how it wants couples billed.
What Medicare says
CMS lists “family psychotherapy with or without the patient present, as medically reasonable and necessary, with patient treatment as the primary purpose” as a covered service (CMS, Medicare & Mental Health Coverage, MLN1986542, March 2026). It also covers family counseling “whose primary purpose is treating a patient’s condition,” including counseling for caregivers. A CMS billing guideline adds that the codes “should not be used when the service performed is taking a family history or E/M counseling services” (L34616 attachment PSYCH014). The primary purpose has to be treating the patient.
Time and same-day billing
No time range is defined for 90846 or 90847. Ask each payer for its minimum, and record the date of service plus start and end time for every session.
CMS’s NCCI manual allows CPT code 90847 with 90832, 90833, 90834, 90836, 90837 or 90838 on the same date only as a separate, distinct service in a separate time interval, focused on the patient’s interactions with family. It is not reported with 90791 or 90792 on the same date (NCCI Medicare Policy Manual, Ch. XI, 1/1/2026). Individual and conjoint time must not overlap. See our individual psychotherapy guide for 90832, 90834 and 90837.
Same-day billing checker for CPT 90847
Source: NCCI Medicare Policy Manual, Chapter XI, effective 1/1/2026. Private payers set their own same-day rules.
CPT code for marriage counseling and couples therapy
Insurance claims for couples sessions use the family psychotherapy codes on this page. Payers pay for treatment of a patient’s condition, so write the diagnosis and the treatment purpose into every note. See documentation requirements for the full note standard.
Who bills it
Psychotherapists: use CPT code 90847 when the patient joins the session, 90846 when not. State the treatment purpose in the note.
Psychiatrists: same codes. If you also bill an E/M code the same day, keep the time and content of each service separate. See the E/M and home-visit guide.
What to document
- Date of service, start and end time
- Who attended and each person’s relationship to the patient
- The treatment purpose tied to the patient’s diagnosis
- What you worked on and the plan
See documentation requirements.
Documentation checklist for a 90847 session
Tick each item before you close the note. Copy the list into your own records.
Telehealth
Telehealth billing for CPT code 90847 depends on the payer and the modifier it requires. Our modifiers 93 and 95 guide explains the options. Confirm the payer’s current rule before billing.
Medicare vs private payers vs state rules
The rules above are Medicare. Private payers and state Medicaid programs set their own coverage, limits and authorization rules, and these vary by state. Check each payer.
FAQ
What is the CPT code for couples therapy?
90847 when the patient is present with the partner or family. Use 90846 if the patient is not present.
Is there a time range for CPT code 90847?
No time range is defined for 90846 or 90847. Ask the payer for its minimum and record start and end times.
Can I bill CPT code 90847 and 90837 on the same day?
Per NCCI, only as a separate, distinct service in a separate time interval, focused on the patient’s interactions with family.
Can I bill 90847 for taking a family history?
CMS says not to: the codes are not for taking a family history or E/M counseling.
The short version: CPT code 90847
Use CPT code 90847 when the patient attends with a partner or family member, and 90846 when the patient is not in the room. The couples therapy CPT code must treat the patient’s condition, carry a clear time record, and sit in its own time interval if you bill another psychotherapy code that day. Check each payer for its own rules before you bill.
Keep going
Related reading
Where this applies
MCM South supports psychotherapists and psychiatrists in Georgia, Massachusetts, Connecticut, Texas, Florida, New York, Colorado, Tennessee, North Carolina and Illinois. Payer rules differ by state. Get a free quote or schedule a consultation.
For quick reference only: verify against the current AMA CPT manual and each payer’s policy before billing. Operational billing guidance, not legal advice.
