CPT 90846
CPT Code 90846: Family psychotherapy without the client present
- Service
- Family psychotherapy without the client present
- Category
- Family / couples
- Time range
- 26 minutes or longer (typically about 50 minutes)
- 2026 Medicare (non-QP)
- $105.88 · contractor-priced
90846 is family or couples therapy without the client in the room - think meeting with a parent or partner to support the client's treatment. The work still has to tie back to the client's diagnosis and plan. When the client is present, you bill 90847 instead.
When to use 90846
- Family/collateral sessions held without the identified client present
- Sessions that still serve the client's treatment plan and diagnosis
What to document
- Who attended and why the client was not present
- How the session relates to the client's diagnosis and treatment goals
- Interventions used and outcomes
- Time spent (generally 26 minutes or more)
Common reasons 90846 gets denied
- The identified client has no covered, billable diagnosis
- Session is relationship counseling only (for example coded Z63) with no billable diagnosis - often not covered
- Plan does not cover family psychotherapy
How much does 90846 pay in 2026?
Heads up: 90846 has restricted Medicare coverage (status indicator R). When it's covered, it's contractor-priced - your Medicare Administrative Contractor sets the amount - so the figure below is an estimate from the code's RVUs, not a published national rate.
The 2026 non-QP Medicare national non-facility amount implied by the RVUs for 90846 is about $105.88. Commercial payers usually land somewhere around $116 - $159 (roughly 110-150% of Medicare), though contracts run from below 80% to above 200%. A few things worth remembering: these figures use the non-QP conversion factor ($33.4009) - clinicians who are Qualifying APM Participants (QPs) are paid under a slightly higher factor - Medicare pays master's-level clinicians (LCSW, LMFT, LPC) about 75% of the listed amount, and your locality's geographic adjustment (GPCI) shifts the number a little.
Want the math for your own week of sessions and payer mix? Try the CPT reimbursement calculator - stack your codes, set your rates, and see weekly, monthly, and annual revenue.
Related codes
Frequently asked questions
What is the difference between 90846 and 90847?
90846 is family psychotherapy without the client present; 90847 is family or couples psychotherapy with the client present. Both are tied to the identified client's diagnosis and treatment plan.
This page is general reference for 2026 and is not billing, legal, or coding advice. Code rules, time ranges, and reimbursement depend on the current CPT and CMS guidelines, your payer contracts, state, locality, and credentials - always confirm against your payer's policy. See the full mental health CPT code list.