CPT 90847: Family Psychotherapy With Patient Present
What Is CPT 90847?
CPT 90847 is the billing code for family psychotherapy conducted with the patient present. The session includes the patient and one or more family members, lasting 50 minutes. Payers reimburse 90847 at rates between $100 and $160 depending on the plan and region. This code is distinct from 90846, which covers family therapy without the patient.
When to Bill 90847
- Family therapy session with the identified patient present and participating in the session, lasting at least 26 minutes.
- Couples therapy billed under a patient's insurance when the patient is the identified member. Use the patient's diagnosis code (e.g., F33.1 for major depressive disorder).
- Parent-child sessions where the child is the patient and the parent participates in treatment planning and skill-building.
Documentation Requirements
Chart notes must include: session start and end time (minimum 26 minutes), names of all participants, the patient's diagnosis code, treatment modality used, therapeutic goals addressed, and the patient's response. If the session runs under 26 minutes, bill the appropriate add-on or time-based code instead. Payers audit session length and participant documentation.
Common Denials and Fixes
| CARC Code | Reason | Fix |
|---|---|---|
| CO-50 | No prior auth | Request auth before first family session |
| CO-16 | Code mismatch | Verify 90847 vs 90846 (patient present vs absent) |
| CO-97 | Bundling | Do not bill 90847 with individual therapy on the same day without modifier 25 |
Payer Notes
UnitedHealthcare covers 90847 with prior auth after the initial evaluation. Anthem requires a treatment plan on file before the third family session. Aetna reimburses 90847 at the same rate as individual therapy (90837) in most plans. Medicare covers family therapy under Part B when medically necessary and documented. Behavioral health denial appeals follow payer-specific timelines.
Common Questions About CPT 90847
Can I bill 90847 and 90837 on the same day?
Only if the sessions are separate encounters with distinct documentation. Use modifier 25 on the individual therapy code. The family session and individual session must address different treatment goals.
What if the patient leaves partway through the family session?
If the patient was present for at least 26 minutes, bill 90847. If the patient left before 26 minutes and you continued with the family, bill 90846 (without patient) instead.
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This reference is for informational purposes. Always verify against current payer policies, CPT guidelines, and CMS documentation. Last updated: 2026-04-06.