(469) 421-8216CPT Code 90847
A Complete Guide to Billing Family Psychotherapy with the Patient Present
In mental health treatment, family involvement often plays a critical role in supporting recovery. CPT code 90847 is used when a licensed mental health provider conducts a family therapy session with the patient present. This guide outlines its correct use, documentation requirements, billing tips, and payer guidelines for 2025 to help avoid denials and ensure accurate reimbursement.
CPT Code 90847 – Description
CPT 90847 represents a 50-minute family psychotherapy session that includes both the identified patient and at least one family member or caregiver. The focus is on addressing interpersonal dynamics, emotional distress, or behavioral patterns that contribute to the patient's mental health condition.
This service goes beyond educational support. It involves active therapeutic engagement aimed at improving communication, reducing conflict, strengthening support systems, and contributing directly to the patient's treatment plan.
When to Use CPT Code 90847 – Scenarios
The following are clinically appropriate and commonly accepted uses for CPT 90847:
1. Joint therapy for parent-child relational conflict
When relational issues between a parent and child exacerbate the child's mental health symptoms (e.g., anxiety, oppositional behavior), joint family therapy can reduce conflict and foster emotional regulation.
2. Couples therapy as part of an individual's treatment
Suppose a patient's relationship distress with their spouse contributes to their depression or trauma. In such cases, a licensed provider may conduct sessions involving both parties to help them process emotions and rebuild trust within the therapeutic framework.
3. Family support during addiction recovery
Substance use disorders often affect the whole family. This code is applicable when involving family members in a patient's recovery process, which helps reinforce relapse prevention and emotional healing.
4. Psychoeducation and emotional processing for severe mental illness
For patients with disorders like schizophrenia or bipolar disorder, family sessions that include the patient are clinically justified when used to enhance understanding of the diagnosis, medication adherence, or safety planning.
5. Rebuilding relationships after hospitalization or crisis
In cases of recent psychiatric hospitalization or a mental health crisis, this code may be used to assist with reintegration into the family structure, clarify roles, and develop safety and communication strategies.
These scenarios must reflect therapeutic intent and clinical benefit for the patient, not just caregiver education.
Modifiers Commonly Used with CPT 90847
Proper modifier use is essential for ensuring reimbursement and claim clarity:
- Modifier 95: For telehealth sessions
- Modifier GT: Telehealth alternative accepted by some payers
- Modifier 59: When billed with another distinct service on the same day
- Modifier HD: For services delivered as part of a coordinated treatment plan
- Modifier HO: If payer requires clinician level (e.g., master's level provider)
Always verify with the specific payer which modifiers are accepted.
Documentation Requirements for CPT 90847
Your clinical documentation must support medical necessity and therapeutic value. Below are the essential elements:
Presenting Problem & Treatment Need
Document the mental health condition or relational issue being addressed. Clarify why family involvement is necessary as part of the patient's treatment.
Session Goals & Therapeutic Objectives
Identify clear objectives such as improving trust, addressing parenting strategies, building emotional support, or resolving communication breakdowns.
Interventions Used During Session
Include specific therapeutic techniques used (e.g., family systems therapy, cognitive-behavioral interventions, trauma-focused methods) to validate the service as active psychotherapy.
Progress Notes Linked to Treatment Plan
Ensure session notes align with the overall plan of care. Reflect on whether the session achieved intended outcomes or requires further follow-up.
Participant Information & Duration
List those present in the session (e.g., mother, spouse, child) and confirm that the patient was actively involved. Note the session length to validate time-based coding.
Reimbursement Tips for CPT Code 90847
To help ensure accurate payment and reduce the chance of claim rejection, consider these billing insights:
- Avoid same-day billing conflicts.
- Do not bill CPT 90847 and 90846 on the same day unless sessions are entirely separate and documented with distinct goals.
- Telehealth compliance
- Use the correct place of service codes (POS 02 or POS 10) and modifiers (95 or GT). Ensure real-time interaction occurred with both the patient and family members.
- Follow frequency limits
- Most payers will limit the number of reimbursable family therapy sessions included in a treatment plan. Be prepared to justify the clinical need if you exceed standard limits.
- Ensure provider qualifications
- Bill CPT 90847 only if the provider meets the licensing requirements under payer rules (e.g., psychologist, LCSW, psychiatrist).
Estimated Reimbursement Range
- Private insurers typically reimburse between $130 and $180 per session
- Medicare may reimburse $110 to $160, depending on geography and provider type
- Telehealth sessions are often reimbursed at the same rate if correctly documented and coded
Why Choose MindCare for Psychotherapy Billing
At MindCare, we understand the intricacies of behavioral health billing better than anyone. Family therapy billing, especially when the patient is present, requires precision, payer-specific knowledge, and complete documentation to avoid denials.
Our expert team ensures each session is coded accurately, modifiers are applied correctly, and payer rules are followed to the letter. This approach helps providers maintain compliance while maximizing their revenue.
Here's what you gain by partnering with MindCare:
- A 40% faster reimbursement cycle
- Over 85% fewer claim denials
- Up to 70% increase in monthly revenue
- Expert handling of all Mental Health Billing Services
We proactively review clinical documentation, align coding with treatment goals, and stay ahead of payer policy changes so you don't have to.
Let Mind Care Billing Help
We help mental health providers use the correct CPT codes, avoid denials, and get paid faster. If you're unsure which code to use, or tired of dealing with rejections, our team can take billing off your plate entirely.
Schedule a Free Consultation with Mind Care Billing today — and leave the coding confusion behind.
