The Definitive Guide to CPT Code 90847

CPT Code 90847 is a procedure code for behavioral health claims. 90847 is defined as Family psychotherapy (conjoint therapy) (with the patient present), 50 minutes.. Along with 90846 it falls into a subgroup of family psychotherapy procedure codes. It’s billed by Licensed Clinical Social Workers (LCSW), Licensed Professional Counselors (LPC), Licensed Marriage Family Therapist (LMFT), clinical psychologists and psychiatrists.

90847 Time Frame

90847 has identical time requirements as 90846. 50 minutes is specifically mentioned in the official description, but sessions do not need to be that long.

Like other time-based CPT codes, 90846 uses a range that is more flexible than the official description would indicate. Appointments need to last for a minimum of 26 minutes for you to bill 90847. As with other time-specific procedure codes, ensure you are documenting the time spent.

90847 vs. 90846

These are very similar CPT codes and both squarely land into the family psychotherapy CPT codes. The difference is 90847 involves the patient being present, whereas 90846 the patient is not in session.

90847 vs. 90837

While these codes may seem similar, they cover different types of sessions. 90847 involves family group therapy whereas 90837 is an individual session. The time frame is also different. 90837 sessions must be at least 53 minutes, and 90847 must be at least 26 minutes.

Extended, 80+ Minute Family Psychotherapy Sessions.

If your session is longer than 50 minutes, there may be a way to get reimbursed for the extra time. 99354 is an add-on code that can be billed in addition to 90847 for prolonged services of 30-74 minutes. This means you can bill 90847 and 99354 for 80 minute sessions or longer.

We recommend calling if you know you will have an extended session as insurance companies have only recently started to allow 99354/99355 in this context. If you bill with us, we can call on your behalf to find out.

For sessions over 125 minutes, there is another add-on code, 99355 that is billed in addition to 99354. See our quick cheat sheet below to figure out how to bill for your extended family psychotherapy session.

  • 90847 + 99354 should be billed for 80-124 minute sessions.
  • 90847 + 99354 + 99355 should be billed for 125-154 minute sessions.
  • 90847 + 99354 + 99355 + 99355 should be billed for 155-184 minute sessions.

Medicare & 90847

90847 is not considered to be a routine service by all insurers. Medicare only will allow for it under two situations.

When there is a need to observe and correct, through psychotherapeutic techniques, the

  1. A need to observe and correct a patient’s interaction with family members.
  2. Where there is a need to assess the conflicts or impediments within the family, and assist, through psychotherapy, the family members in the management of the patient. Billing CPT Code 90847

Not sure if this includes your specific situation?  This is an area where a professional billing service, such as TheraThink can help.

 

Billing Restrictions

There are a couple notable restrictions to 90846.

  • 90847 cannot be billed the same day as 90846. In these situations be sure to bill 90847. It is the correct code to use if the patient is present at all.
  • 90847 isn’t always considered routine. Different insurance companies process 90846 differently and it isn’t as universally accepted as other psychotherapy procedure codes. There are often age requirements of 18 or 21. Authorization is sometimes required. It is always best to call the insurance ahead of time to make sure. Our billing service can do this for you.

Billing CPT Code 90847

Just like other CPT codes, the procedure code 90847 should go in the 24(c) location of a CMS 1500.CMS 1500 90847 Claim

 

90847 Reimbursement

90847 reimbursement can vary significantly depending on the provider’s credentials and the insurer. On average we find that insurer fee schedules allow for payment amounts between 90834 and 90837, and slightly higher than 90846. In general it reimburses between a wide range of $65-$115.