Billing and coding
How to use CPT code 90846
Family therapy can be a covered benefit for many care-seeking couples and households, but you should understand how to leverage code 90846 effectively for clinically-focused sessions.
December 21, 2023 • Updated on July 27, 2026
10 min read
Key insights
1
Code 90846 represents a 50-minute session of psychotherapy where the focus of the intervention is on a family or partnership dynamic, and the identified patient is not present for the majority of the session.
2
If you met with a client’s family or partner without them present — perhaps to better understand dynamics, provide psychoeducation, or collaborate on treatment planning — you’ll likely use code 90846.
3
Make sure the session lasted at least 26 minutes and did not include the identified client before using code 90846.
CPT code 90846 description
Code 90846 represents a 50-minute session of psychotherapy where the focus of the intervention is on a family or partnership dynamic, and the identified patient is not present for the majority of the session.
In order to be reimbursed by most payers for a 90846 session, the identified patient should have a confirmed clinical diagnosis that the session is helping to treat.
For example, this code might be used when a provider is meeting with the parents of a teenage patient diagnosed with ADHD. The provider can conduct a family psychotherapy session coded with 90846, focusing on the parents' understanding of ADHD, implementing effective parenting strategies, and creating an environment conducive to the teenager's well-being.
This is is how the American Medical Association defines 90846 in the official CPT codebook:
Family psychotherapy (without the patient present), 50 minutes
Psychotherapy is the treatment of mental illness and behavioral disturbances in which the physician or other qualified health care professional, through definitive therapeutic communication, attempts to alleviate the emotional disturbances, reverse or change maladaptive patterns of behavior, and encourage personality growth and development.
See codes 90846, 90847 when utilizing family psychotherapy techniques, such as focusing on family dynamics.
Your documentation for this code should include all the standard elements of a progress note, including:
- Session details: Including patient name and date of birth on every page, start and stop times, date, and place of service
- Person-centered details
- Patient-centered observations
- Clinical interventions and evidence-based practices used during the session
- Progress towards goals
- Risk assessment
- Clinical path forward
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It’s important to use the code that most accurately reflects the time you spent with the patient to treat their condition, and ensure that documentation for the session supports the chosen code.
When to use CPT code 90846
The 90846 code is associated with a 50-minute session of psychotherapy, which is the clinical standard length for a family therapy session. At a minimum, coding guidelines state the session must include at least 26 minutes of documented face-to-face time.
Crucially, code 90846 is used when the identified patient is not present for the session. Examples of this scenario include:
- You provided psychoeducation to a client’s parents
- You met with your client’s loved one(s) to better understand family dynamics
- You and your client’s loved one(s) met to discuss treatment planning
- You completed a session with only one half of a couple
CPT code 90846 reimbursement rates
Reimbursement rates for sessions billed with 90846 will vary depending on the plan, your contract, your location, and your license type, but are generally around $100. Want to earn higher reimbursement rates? Join the Headway network, where we leverage our nation-leading cohort of in-network providers to negotiate enhanced reimbursement rates.
What’s the difference between 90846 and 90847?
The only difference between 90846 and 90847 is whether or not the identified patient is present for the majority of the session.
If you need to see a family member or partner of your identified patient without the patient present, you would use the 90846 CPT code. If the identified patient is present for most of the session, you’d use 90847.
If you’re seeing the identified patient for a session apart from their partner or other family members, use an individual psychotherapy code, such as 90834 (for a 45-minute session).
It’s important to establish the identified patient at the start of treatment, and ensure your documentation is consistent.
Common billing issues with CPT code 90846
Using the wrong CPT code can lead to billing headaches down the line. At Headway, our goal is to prevent those issues through dedicated billing and claims support for our providers. Whether you’re part of the Headway network or not, avoid these common mistakes:
- Mixing up codes 90847 (for a family session in which the identified patient is present) and 90846 (for a family session in which they’re not)
- Using code 90846 for a session that included fewer than 26 minutes of face-to-face therapeutic time
- Using code 90846 for an individual therapy session with the identified client
CPT code 90846 FAQs
When is it appropriate to bill 90846 instead of 90847?
Use code 90846 if you met with an identified client’s loved one(s), but they were not present for the session. If you met with your client and their family together, use code 90847.
Does the identified patient need a formal diagnosis for 90846 to be covered?
Generally, yes. Otherwise, insurers may not deem the session medically necessary.
Whose information goes on the claim when billing 90846?
Even though the identified patient is not present for the session when using code 90846, you must include their key details — name, date of birth, diagnosis, and so on — on the claim.
Can 90846 and 90847 be billed on the same day?
Usually not. Typically, however, you can bill both 90846 and an individual therapy session with the identified client on the same day, as long as they are totally distinct appointments.
Can 90846 be used for couples therapy?
In many cases, yes, as long as the identified client is not present.
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If billing codes are starting to look like alphabet soup, it’s time to join Headway. Our mission is to support in-network therapists however possible, including providing dedicated billing support. Features like automatic insurance verification, payment protection, and claim management take tasks off your plate, so you can focus on client care.
Disclaimer: This document is intended for educational purposes only. It is designed to facilitate compliance with payer requirements and applicable law, but please note that the applicable laws and requirements vary from payer to payer and state to state. Please check with your legal counsel or state licensing board for specific requirements.
This content is for general informational and educational purposes only and does not constitute clinical, legal, financial, or professional advice. All decisions should be made at the discretion of the individual or organization, in consultation with qualified clinical, legal, or other appropriate professionals.
© 2026 Therapymatch, Inc. dba Headway. All rights reserved. No part of this publication may be reproduced without permission.
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