Here's a quick guide on how and when to bill mental health family therapy CPT codes 90847 and 90846. We will teach you the differences between family and couples or marriage counseling.
Unlike individual therapy sessions, using the correct code to bill mental health family therapy depends on the members of the family in session.
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.
If you’d prefer to just have us help you do this, we provide an insurance billing service exclusively for mental health providers and we’re happy to help.
90846 and 90847 CPT Code Definitions
- 90847 – Family or couples therapy, with patient present.
These sessions need to be at least 26 minutes in length. This is the cpt code for ongoing couples therapy or marriage and family therapy for two clients. You cannot bill both clients, this is considered one “service code” and will most often reimburse at a higher rate.
- 90846 – Family or couples therapy, without patient present.
These sessions need to be at least 26 minutes in length.
- 90837 – Individual therapy for 60 minutes.
These sessions need to be at least 53 minutes in length.
If medical management services are performed, use the 25 modifier. Interactive complexity services CPT code 90785 are not allowed with this service.
If you’d rather not worry about remembering any of this, we can help you decipher these situations into maximally paid claims on your behalf with our mental health billing service.
Family Therapy Insurance Billing Scenario
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 to Bill These Family Therapy Sessions
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.