In this article, we explore how CPT code 90846 makes family therapy more accessible and affordable. Learn how to enhance family dynamics and resolve conflicts easily.

Understanding CPT Code 90846

CPT codes are essential in medical billing and coding. They help in identifying specific services and procedures provided by healthcare professionals. CPT code 90846 is one of the most commonly used codes in psychotherapy services. This code is used to describe a family psychotherapy session without the presence of the patient.

CPT 90846 Definition and Document Requirements

CPT code 90846 refers to a family psychotherapy session with the patient, not present. The therapy is conducted by a licensed healthcare professional, usually a psychiatrist, psychologist, or licensed clinical social worker. The therapist can only bill for this code if the session lasts 60 minutes or longer. Moreover, documentation requirements for this code include the reason for the therapy, treatment goals, progress made, and plans for further treatment.

CPT 90846 Fee Schedule and Place of Service

The allowed rate for CPT code 90846 varies depending on the healthcare provider’s location and payer. The code is reimbursable by most insurance providers, including Medicare and Medicaid. The fee schedule also depends on the place of service where the therapy session is conducted. The most common places of service for this code include a therapist’s office, clinic, or hospital.

Differences between CPT 90846 and 90834

CPT codes 90846 and 90834 are both commonly used codes in psychotherapy services, but they refer to different types of therapy sessions.

CPT code 90846 refers to a family psychotherapy session without the presence of the patient. This therapy is conducted by a licensed healthcare professional and lasts for 60 minutes or longer.

On the other hand, CPT code 90834 refers to an individual psychotherapy session that lasts for 45 to 50 minutes. This therapy session can be conducted with the patient or with the patient and their family present.

In summary, the main difference between CPT codes 90846 and 90834 is that 90846 is used for family psychotherapy sessions without the patient present, while 90834 is used for individual psychotherapy sessions with the patient present.

Differences between CPT 90846 and 90837

CPT code 90846 is used for family psychotherapy sessions that do not include the patient. The therapy session is conducted by a licensed healthcare professional and lasts for 60 minutes or longer.

On the other hand, CPT code 90837 is used for individual psychotherapy sessions that last for 60 minutes or longer. The therapy session can be conducted with the patient present, and it is often used for more intensive therapy.

Differences between CPT 90846 and 90847

The main difference between CPT codes 90846 and 90847 is that 90846 is used for family psychotherapy sessions without the patient present, while 90847 is used for family psychotherapy sessions that include the patient. Both codes involve the same amount of therapy time, but the presence of the patient is the distinguishing factor between the two codes.

CPT 90846 Modifier and Age Limit

It is also important to note that there is no age limit for CPT code 90846. It can be used for families with children of any age, as long as the therapy session lasts for 60 minutes or more.

CPT 90846 Covered by Insurance Providers

CPT code 90846 is covered by most insurance providers, including Medicare and Medicaid. However, checking with the specific payer to verify coverage and payment rates is essential. Some insurance providers may have additional requirements or limitations for reimbursement.

Conclusion

CPT code 90846 is a vital code in medical billing and coding for family psychotherapy sessions. Understanding the code’s definition, documentation requirements, fee schedule, and differences with other CPT codes are essential to ensure proper reimbursement and avoid confusion. With this knowledge, healthcare professionals can provide efficient and effective family therapy services while ensuring accurate billing and coding practices.