Family psytx w/pt 50 min
CPT code 90847 covers family or couples therapy sessions that include the patient, lasting approximately 50 minutes. The therapist works with the patient and their family members or partner together to address mental health concerns.
This calculator gives a typical-case estimate using standard Medicare modifier rules. Actual payment depends on payer policies, documentation, code-specific CMS status indicators, and locality. Verify before billing.
RVU breakdown
Conversion factor: 32.3465 · Source: CMS MPFS RVU25A · Confidence: High
NCCI bundling edits
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Billing tips
Ensure patient is present and actively participating throughout the session; if patient is not present for entire session, use 90846 instead
Impact: Prevents 100% denials; 90847 vs 90846 coding errors are among top audit findings for family therapy
Document exact session time (start/stop) and all participants present by name and relationship to patient
Impact: Reduces denial risk by 40-60%; time documentation supports the approximate 50-minute descriptor and medical necessity
Bill based on place of service: use non-facility rate ($102.86) for office settings (POS 11) and facility rate ($102.54) for hospital outpatient (POS 22)
Impact: $0.32 difference per session; incorrect POS coding triggers recoupment requests
Do not bill 90847 on same day as E/M services unless distinct and separately identifiable with modifier 25 and extensive documentation
Impact: Prevents bundling denials; most payers consider psychotherapy inclusive of minimal assessment
For sessions under 26 minutes or over 75 minutes, consider alternative codes (90832/90834/90837 with appropriate add-on codes if applicable)
Impact: Accurate time-based coding prevents downcoding; 90847 is for 38-52 minute range per CPT guidelines
Verify state licensure and payer credentialing for non-physician providers; some Medicare MACs require incident-to billing for LCSWs and MFTs
Impact: Prevents 100% denials; incident-to billing at 85% of physician fee schedule vs direct billing rejections
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