CPT 90846 is the AMA code for 'Family psychotherapy (without the patient present), 50 minutes.' It bills a psychotherapy session with family members about the identified client's treatment when the client is not in the session.

When the work of the session is the client's treatment but the client is not there. Typical examples are parent sessions in a child's anxiety, ADHD, or behaviour treatment, coaching a family to support an adolescent's safety plan, and sessions with a partner or adult child about the client's care.

How long does a 90846 session need to be?

The descriptor says 50 minutes, but under the CPT time rule 90846 can be reported once the session reaches 26 minutes or more. One unit covers the session; there is no add-on for longer family sessions.

What is the difference between 90846 and 90847?

90847 is family (conjoint) psychotherapy with the identified client present. 90846 is the same service without the client. If the client joins for part of the session, document who was present and when, and follow the payer's rule on which code applies.

Does Medicare cover 90846?

90846 is listed in Medicare contractor billing articles for psychiatric services, but coverage policies for sessions without the beneficiary present vary by contractor and by plan. Check the local contractor policy or the plan's benefits before billing.

How many units of 90846 can be billed per day?

Medicare's Medically Unlikely Edit (MUE) for 90846 is 1 unit per date of service, with adjudication indicator 3 (a clinical benchmark that can be exceeded only with documentation). MUE values are revised quarterly.

Who is the claim billed under?

The identified client, with the client's diagnosis. The family members in the session are not billed as separate clients for 90846.

90846·CPT (AMA)

Family Psychotherapy Without Patient

CPT 90846 bills family psychotherapy without the identified client present, such as parent sessions in a child's treatment. Time rule, MUE, and documentation.

CPT 90846 at a glance

CPT 90846
Family · therapeutic service
Family Psychotherapy Without Patient
Typical reimbursement
$110–$150
US national commercial medians; varies by payer, plan and contract.
Billed with
An ICD-10-CM diagnosis code that establishes medical necessity.
A claim needs both a CPT and an ICD-10 code. ICD-10 reference

Code descriptor (verbatim AMA)

Family psychotherapy (without the patient present), 50 minutes.”
Source: AMA Current Procedural Terminology, code 90846.

Time requirements

Code	Who is present	Reportable from
90846	Family, without the client	26 minutes
90847	Family, with the client	26 minutes

The descriptor names 50 minutes; the CPT time rule allows reporting from 26 minutes. Document start and stop times, or total time.

For conjoint sessions with the client in the room, see CPT 90847.

What 90846 covers

90846 is psychotherapy, not a meeting. The session has to serve the identified client's treatment plan:

Parent work in child and adolescent care. Behaviour plans, accommodation reduction for anxiety, and parent skills in ADHD treatment.
Family support for a safety plan. Helping family members understand warning signs and their role.
Carer sessions for an adult client whose condition affects the household.

Medicare contractor guidance excludes three things from the family codes: taking a family history, E/M counselling (billed with the E/M code for the time involved), and therapy with or supervision of professional caretakers or staff.

Billing rules

Client absent. The client is not present for the session. If they join, use 90847.
Bill on the client's claim with the client's diagnosis. Family members are not separately billed under 90846.
One unit per date of service (MUE 1, adjudication indicator 3).
Coverage varies. Plan and contractor policies for 90846 differ. Verify benefits before the first session.
Interactive complexity. The 90785 primary-code lists in APA and Medicare contractor guidance do not include 90846. See CPT 90785.
Not with crisis codes. Psychotherapy for crisis (90839) may not be reported with codes 90785 to 90899.

Common ICD-10 pairings

F90.0 and F90.2 ADHD, with parent behaviour-plan sessions
F41.1 Generalized anxiety disorder, with parent sessions on accommodation
F84.0 Autism spectrum disorder
F50.0 Anorexia nervosa, in family-based treatment
F33.1 Major depressive disorder, recurrent, moderate

See the full ICD-10 reference for diagnosis-specific scale recommendations.

Documentation requirements

Each 90846 note should include:

Date of service and start and stop times, or total time.
Who attended, by relationship to the client, and a statement that the client was not present.
The client's diagnosis and the treatment goal the session addressed.
The therapeutic interventions used with the family and their response.
How the session changes the client's treatment and the plan for follow-up.

The note should make the link to the client explicit. A session that reads as support for the parent's own difficulties belongs in the parent's own record, not under the child's 90846.

Parent-report scales such as the Vanderbilt, SCARED parent form, or PSC-17 are a practical way to bring the absent client's progress into the room.

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Frequently asked questions

What is CPT 90846?
CPT 90846 is the AMA code for 'Family psychotherapy (without the patient present), 50 minutes.' It bills a psychotherapy session with family members about the identified client's treatment when the client is not in the session.
When is 90846 used?
When the work of the session is the client's treatment but the client is not there. Typical examples are parent sessions in a child's anxiety, ADHD, or behaviour treatment, coaching a family to support an adolescent's safety plan, and sessions with a partner or adult child about the client's care.
How long does a 90846 session need to be?
The descriptor says 50 minutes, but under the CPT time rule 90846 can be reported once the session reaches 26 minutes or more. One unit covers the session; there is no add-on for longer family sessions.
What is the difference between 90846 and 90847?
90847 is family (conjoint) psychotherapy with the identified client present. 90846 is the same service without the client. If the client joins for part of the session, document who was present and when, and follow the payer's rule on which code applies.
Does Medicare cover 90846?
90846 is listed in Medicare contractor billing articles for psychiatric services, but coverage policies for sessions without the beneficiary present vary by contractor and by plan. Check the local contractor policy or the plan's benefits before billing.
How many units of 90846 can be billed per day?
Medicare's Medically Unlikely Edit (MUE) for 90846 is 1 unit per date of service, with adjudication indicator 3 (a clinical benchmark that can be exceeded only with documentation). MUE values are revised quarterly.
Who is the claim billed under?
The identified client, with the client's diagnosis. The family members in the session are not billed as separate clients for 90846.

Sources

1. 1.American Medical Association. Current Procedural Terminology (CPT) 2026, code 90846.
2. 2.American Psychological Association Services. Psychotherapy Codes for Psychologists (descriptors for 90846/90847; time rule: 26 or more minutes; 90785 primary codes).
1. 3.Wisconsin Physicians Service (Medicare contractor). Billing and Coding: Psychiatry and Psychology Services (A57480), revision effective 2026-01-01.
2. 4.Centers for Medicare & Medicaid Services. Medicare NCCI Practitioner Services Medically Unlikely Edits, table effective 2026-10-01 (90846 = 1 unit, adjudication indicator 3). MUE values are revised quarterly; confirm the current table before relying on this figure.