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)
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
NCCI Exclusions
Key Modifiers
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
Audit Defense
No specific audit defense elements defined.
2026 Update
Telehealth rules for 90846 are now permanent, reducing previous regulatory uncertainty.
Common Clinical Scenarios
CMS Eligibility: 1+ psychiatric diagnosis for the identified patient.. Duration of therapy depends on the treatment plan.
Target Specialties & Utilization
Typical Clinical Indications (ICD-10)
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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