Here's a quick guide on how and when to bill mental health family therapy CPT codes 90847 and 90846.
Unlike individual therapy sessions, using the correct code to bill mental health family therapy depends on the members of the family in session instead of the time allotted.
We are going to explain each mental health family therapy CPT code, walk through four examples, and explain how to bill each example. By the end of this article you’ll know what codes to use, when, to bill family therapy for mental health CPT codes 90847 and 90846.
Official CPT Code Definitions
90846 – Family or couples therapy, without patient present.
90847 – Family or couples therapy, with patient present.
90837 – Individual therapy for 60 minutes.
Let’s say three people all attend therapy, Client A (mom), Client B (child), and Client C (child).
Let’s say that Client B is the person who is specifically needing treatment. Client A and Client C are part of the reason that treatment is needed, as it’s a family matter.
Then Client A, the mother, due to her own distress, decides to enter treatment.
Let’s say these folks have 4 total sessions. Here’s what they look like:
Session 1) They all attend therapy together.
Session 2) Then the following week, the mother, Client A is seen about the child in treatment, Client B.
Session 3) Then the next day, Client B is seen individually.
Session 4) And a final week later, the mother, Client A, decides that she needs to seek out therapy as well and sees the therapist about her own treatment needs.
How do we bill all of this?
Session 1: We use CPT code 90847 for family therapy with the patient (Client B) present. We then use Client B’s information when filing the claim, including their diagnosis code.
Session 2: We use CPT code 90846 for family therapy with the patient (Client B) not present. We use Client B’s information and diagnosis code when filing out the claim form. We may want to add additional diagnoses here as we learn more about the treatment situation.
Session 3: We use CPT code 90837 here for treatment with the client, Client B. Even if this client is seeking therapy about their family issues, they are seeking individual therapy. Use Client B’s information on the claim forms too.
Session 4: We are also using CPT code 90837 for the new client, Client A, as Client A is now requesting their own treatment (about their family issue). We would use Client A’s information and diagnosis when filing this form.
Always use the person who is the primary treatment seeker on your claims forms. They are the person who is seeking treatment, even if a family member is attending therapy to their benefit (90847). So even if they are not in session, like with 90846, their information is to be used.
If all of this is too much, feel free to drop us a line about our mental health billing service for therapists. We handle these sorts of questions daily.