CPT Code 90846 Guide to Family Therapy without the Patient Present

CPT code 90846 is a Current Procedural Terminology (CPT) code used for family psychotherapy sessions without the patient present. Licensed behavioral health providers use it.

CPT Code 90846 documents 50-minute family psychotherapy sessions where the patient is absent. This code applies to in-person and telehealth sessions and is vital for categorizing services and ensuring accurate mental and behavioral health care billing.

Key Details about CPT 90846

• Purpose: Designed for sessions where family members collaborate with the therapist to improve the patient’s mental health without the patient being in attendance.
• Duration: 50 minutes.
• Applicability: Includes therapy for couples (when identified as a family) and sessions addressing family dynamics to support a patient’s treatment plan.

Billing Guidelines

• Session Focus: Document the purpose of the session, such as improving family interactions or addressing issues impacting the patient’s well-being.
• Exclusions: This code cannot be used for Gathering family history, brief updates about the patient’s condition, or counseling for caregivers or staff members.
• Same-Day Billing: Therapists can bill for family therapy (90846) and individual psychotherapy for the same patient if they are distinct services. However, codes 90846 and 90847 (family therapy with the patient present) typically cannot be billed on the same day.

Services Included in CPT Code 90846

Service Type Description

Family Counseling Conducting therapeutic sessions with family members without the patient present.

Family Dynamics Assessment Analyzing how family history and relationships influence the patient’s care.

Treatment Planning Creating a tailored treatment plan involving family participation.

Related CPT codes

• 90847:?Family psychotherapy with the patient present, also known as conjoint psychotherapy
• 90849:?Multiple-family group psychotherapy

Benefits and Limitations of CPT Code 90846

Benefit Description

Family Insight Provides families with a better understanding of their role in the patient’s treatment.

Treatment Optimization Improves treatment plans through a detailed evaluation of family dynamics.

Enhanced Communication Promotes healthier communication between family members.

Documentation Requirements

• Session Details: Include the date, start time, end time, and a description of the activities.
• Clinical Notes: Provide details on the therapeutic goals, progress made, challenges encountered, and plans.
• Compliance: Ensure records justify the session’s necessity for treatment and align with insurance requirements.

Common Modifiers

• Modifiers may be necessary depending on specific circumstances or payer policies:

Reimbursement Insights

• Reimbursement rates for 90846 vary based on:

Tips for Effective Billing

• Verify Insurance Coverage: Confirm details with the payer before sessions to avoid surprises.
• Document Thoroughly: Ensure notes meet both clinical and medical billing standards.
• Stay Updated: Keep abreast of changes in CPT coding and payer guidelines.

CPT Code 90846 underscores the importance of family dynamics in mental health treatment. Proper usage ensures that therapists are compensated fairly while facilitating holistic care for patients and their families.