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BehavioralBase2026 Compliant

CPT 90846

2026 Billing Guide

Family Psychotherapy w/o Patient

Reimbursement

$95.19

Threshold

50m

2026 Status

Active

What is CPT Code 90846?

CPT 90846 is defined as: Family psychotherapy (without the patient present), 50 minutes. This code is used when the therapist meets with family members of the patient to discuss the patient's treatment and progress, and to provide guidance and support to the family, without the patient being physically present in the session.

This code is primarily used for Behavioral services. It falls under the category of Behavioral Health and is valid for the 2026 calendar year according to the CMS Physician Fee Schedule.

2026 RVU Components

Relative Value Units (Non-Facility)

Standard Formula Applied

Work RVU

2.4

Physician Effort

PE (Non-Fac)

0.35

Practice Expense

Malpractice

0.1

Risk Factor

Total RVU

2.85

Note: [(Work RVU * Work GPCI) + (PE RVU * PE GPCI) + (MP RVU * MP GPCI)] * Conversion Factor

2026 CMS Policy Intelligence

efficiency shield

Classified as a time-based code, granting exemption from the statutory -2.5% efficiency reduction.

telehealth permanence

Permanently added to the Medicare Telehealth Services List for 2026.

audio only flexibility

Retains flexibility for audio-only delivery if the beneficiary lacks video technology access, requiring specific documentation.

pos differential

POS 10 (Home) typically pays at the higher non-facility rate.

Administrative Framework

Place of Service

11 (Office)02 (Telehealth Other)10 (Telehealth Home)

NCCI Exclusions

Do not bill with:90847

Key Modifiers

59Distinct procedural service. Used if billed with 90847 on the same day for separate sessions.
95Synchronous Telemedicine Service Rendered via Real-Time Interactive Audio and Video Telecommunications System.

Operational Requirements

minimum time

26 minutes (CPT Mid-point Rule)

staff type

Physician or QHP (Psychologist, LCSW, etc.)

frequency

As medically necessary; commercial plans may have volume limits.

add on codes

nexus requirement

The service must be for the benefit of the patient, and the documentation must clearly state how the session impacts the patient's treatment goals.

Compliance Checklist

Clinical note must clearly articulate the 'Nexus of Care' (how it benefits the patient).
Documentation of session duration (minimum 26 minutes).
If telehealth, statement of patient consent for video or reason for audio-only.

Audit Defense

No specific audit defense elements defined.

2026 Update

Telehealth rules for 90846 are now permanent, reducing previous regulatory uncertainty.

Common Clinical Scenarios

Counseling parents of a pediatric patient with behavioral disorders.
Counseling caregivers of a geriatric patient with dementia.

CMS Eligibility: 1+ psychiatric diagnosis for the identified patient.. Duration of therapy depends on the treatment plan.

Target Specialties & Utilization

PsychiatryClinical PsychologyClinical Social Work

Typical Clinical Indications (ICD-10)

F32.9 (Major depressive disorder, single episode, unspecified)F41.1 (Generalized anxiety disorder)F90.9 (ADHD, unspecified type)F03.90 (Dementia, unspecified, without behavioral disturbance)

Billing Differentiation

VS 90847

90846 is for therapy WITHOUT the patient present; 90847 is WITH the patient present.

VS 90833_90838

These are add-on codes for individual psychotherapy billed with E/M; 90846 is a standalone family therapy code.

Frequently Asked Questions

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