CPT Code 90846: How to Bill Family Therapy Without the Patient Present
CPT code 90846 is family psychotherapy without the patient present. When the patient joins the session, the code is 90847. This guide shows how to choose between them, how CPT code 90846 differs from 90834 and 90837, what Medicare says, and what the note has to show. It is written for psychotherapists and for psychiatrists.
For the full code reference, see our family psychotherapy guide.
What CPT code 90846 means
CPT descriptors (AMA): 90846 is family psychotherapy without the patient present, and 90847 is family psychotherapy (conjoint) with the patient present. Medicare contractor article A57480 says “CPT Codes 90846 and 90847 represent family psychotherapy services for the treatment of mental disorders” (CMS Coverage Database, Article A57480, WPS, rev. 1/1/2026).
CPT code 90846 vs 90847
| 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 couples with the patient present, see our CPT code 90847 guide.
CPT code 90846 vs 90834 and 90837
Individual psychotherapy codes bill the patient, or the patient with a family member, by documented face-to-face minutes. CPT code 90846 bills a family session when the patient is not in the room. The time ranges for the individual codes come from our individual psychotherapy guide.
| Code | Service | Time range |
|---|---|---|
| 90834 | Psychotherapy, patient and/or family member | 38–52 minutes |
| 90837 | Psychotherapy, patient and/or family member | 53 minutes or more |
| 90846 | Family psychotherapy, patient not present | No range defined; record start and end time |
Choose the code by who was in the session first, then by time. A family meeting that the patient does not attend is not a 90834 or 90837.
What Medicare says about family psychotherapy
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). 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.
Same-day billing with CPT code 90846
Per the NCCI Medicare Policy Manual, Chapter XI (1/1/2026), family psychotherapy (90846 or 90847) can be reported on the same date as individual psychotherapy only as a separate, distinct service in a separate time interval. Individual and family time must not overlap. No time range is defined for 90846, so ask each payer for its minimum.
Who bills CPT code 90846
Psychotherapists: use 90846 when family members meet with you about the patient’s treatment and the patient is not present. State the treatment purpose in the note.
Psychiatrists: same code. 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 time and end time
- Who attended and each person’s relationship to the patient
- Why the patient was not present
- The treatment purpose tied to the patient’s diagnosis
- What you worked on and the plan
See documentation requirements for the full list, and the CPT & E/M code guide for other code families.
Telehealth, private payers and state rules
Telehealth billing for 90846 depends on the payer and the modifier it requires. Our modifiers 93 and 95 guide explains the options. 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 before you bill.
Frequently asked questions about CPT code 90846
What is CPT code 90846?
Family psychotherapy without the patient present. Use 90847 when the patient is in the session.
Is there a time range for CPT code 90846?
No time range is defined for 90846 or 90847. Ask the payer for its minimum and record start and end times.
Can I bill 90846 and 90837 on the same day?
Per NCCI, only as a separate, distinct service in a separate time interval.
Can I bill 90846 for taking a family history?
CMS says not to: the codes are not for taking a family history or E/M counseling.
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. Current as of last search (sources checked 9/29/26).
