Family Psychotherapy: CPT 90846 and 90847
What CMS.gov says these codes are, when Medicare covers family psychotherapy, and what the note has to show. Checked against CMS.gov on 9/29/26.
Get My Free Consultation
Family Psychotherapy at a glance
This page covers family psychotherapy for mental health billing: what the codes cover, how payers apply them, and what to document. Psychotherapists and psychiatrists both use these codes, so the sections below call out differences where they matter. Payer rules vary, so confirm current requirements with the payer before you bill.
What CMS.gov says these codes are
Quotes are copied from CMS.gov pages. Each quote names its source. Contractor articles are written by Medicare Administrative Contractors (MACs), the companies that process Medicare claims for a region, and apply to their own region.
Code list entry
“Family psychotherapy”
What the service is
“CPT Codes 90846 and 90847 represent family psychotherapy services for the treatment of mental disorders.”
“Family psychotherapy with or without the patient present, as medically reasonable and necessary, with patient treatment as the primary purpose”
“Family counseling services whose primary purpose is treating a patient's condition. These services include counseling services for caregivers.”
“They should not be used when the service performed is taking a family history or E/M counseling services.”
Time range and documentation
Every timed code needs the date of service and the start and end time of the service.
| Code | Service | Time range | Document |
|---|---|---|---|
| 90846 | Family psychotherapy, without the patient presentAsk the payer for its minimum. Record who attended. | No time range defined | Date of service + start and end time Documentation rules |
| 90847 | Family psychotherapy (conjoint), with the patient presentCan be billed with 90832–90838 on the same date only as a separate, distinct time interval (NCCI). | No time range defined | Date of service + start and end time Documentation rules |
How often and with what?
- May be reported with 90832, 90833, 90834, 90836, 90837, 90838 on the same date only as a separate, distinct service in a separate time interval, focused on the patient's interactions with family.
Source: CMS, NCCI Medicare Policy Manual, Ch. XI (1/1/2026) - Not reported with 90791 or 90792 on the same date.
Source: CMS, NCCI Medicare Policy Manual, Ch. XI (1/1/2026) - No annual cap appears in the CMS sources reviewed.
Source: CMS Coverage Database, Article A57480 (WPS, rev. 1/1/2026)
These are Medicare rules. Private payers and state Medicaid programs set their own; ask each payer. Full list: frequency and documentation rules.
Psychotherapists and psychiatrists
Psychotherapists
Use 90847 when the patient joins the session and 90846 when the patient is not there. State the treatment purpose in the note.
Psychiatrists
Same codes. If you also bill an E/M the same day, keep the time and content of each service separate.
Frequently asked questions
What is the difference between 90846 and 90847?
90846 is family psychotherapy without the patient present. 90847 is family psychotherapy with the patient present. CMS says Medicare covers family psychotherapy with or without the patient present when it is medically reasonable and necessary and patient treatment is the primary purpose.
Is there a time range for 90846 and 90847?
Neither CPT nor the CMS sources reviewed set a minute range. Some payers apply their own minimum, so ask the payer. Record the date of service and the start and end time every time.
Can I bill family therapy and individual therapy on the same day?
Yes, but only when the family psychotherapy is a separate, distinct service in a separate time interval. That is the rule in the Medicare NCCI policy manual, Chapter XI. Document each interval's start and end time.
What can't be billed as family psychotherapy?
A CMS billing guideline says these codes should not be used when the service performed is taking a family history or E/M counseling services.
More CPT code guides
CMS.gov sources
- CMS Coverage Database billing guideline, L34616 attachment PSYCH014
- CMS Coverage Database, Article A57480 (WPS, rev. 1/1/2026)
- CMS, Medicare & Mental Health Coverage (MLN1986542, March 2026)
- CMS, NCCI Medicare Policy Manual, Ch. XI (1/1/2026)
Current as of last search (9/29/26). Reconfirm before publishing. For quick reference only: verify against the current AMA CPT manual and each payer's policy before billing. Operational billing guidance, not legal advice.
Want these codes billed right, every time?
Get a free, no-pressure consultation with a specialist who only works mental and behavioral health billing.
Get My Free Consultation