CPT code 90847: Family or couples psychotherapy with the client present

90847 is family or couples therapy with the client present. It's the usual couples-therapy code when one partner is the identified client with a covered diagnosis. When the client isn't in the room, use 90846.

Time range
26 minutes or longer (typically about 50 minutes)
2026 Medicare rate
$109.55
Category
Family / couples

When to use 90847

  • Family or couples sessions with the identified client present
  • Couples therapy where one partner is the identified client with a billable diagnosis

What to document

  • Who attended the session
  • How the work relates to the client's diagnosis and treatment goals
  • Interventions used and the family/couple's response
  • Time spent (generally 26 minutes or more)

Common reasons 90847 gets denied

  • No covered, billable diagnosis for the identified client
  • Relationship counseling only, with no billable diagnosis. Plans often don't cover it
  • Plan does not cover family or couples psychotherapy

Billing 90847 by telehealth

The CPT code stays the same when you see a client by video or phone. For Medicare, the place of service changes. Use 10 when the client is at home and 02 when they are somewhere else, such as a clinic. Add modifier 93 when the session was audio-only. Commercial plans and Medicaid set their own rules, and many of them also want modifier 95 on video sessions, so check each payer's telehealth policy.

Medicare covers mental health telehealth in the client's home permanently, wherever the client lives. Through 2027 it pays for audio-only sessions with no extra conditions. From January 1, 2028, audio-only needs a client who can't use video or doesn't agree to it. In 2028 Medicare also starts requiring an in-person visit within 6 months before a client's first mental health telehealth session, then one every 12 months. Clients who start telehealth before 2028 only need the yearly visit. The CMS telehealth page has the current Medicare rules.

How much does 90847 pay in 2026?

Medicare, national non-QP
$109.55
Typical commercial range
$121 to $164
  • The commercial range is 110 to 150% of Medicare. Real contracts run from below 80% to above 200%.
  • Medicare pays master's-level clinicians (LCSW, LMFT, LPC) about 75% of the listed amount.
  • Your locality's geographic adjustment (GPCI) moves the rate a little.
  • Qualifying APM Participants are paid under a slightly higher conversion factor than the non-QP $33.4009 used here.

Medicare figures checked against the official CMS 2026 Physician Fee Schedule Relative Value Files (RVU26D) on .

Want the numbers for your own caseload?

Add your sessions to the CPT reimbursement calculator, set your rates, and see weekly, monthly and annual revenue.

Related codes

Frequently asked questions

What CPT code is used for couples therapy?

Couples therapy is usually billed as 90847 (family psychotherapy with the client present) when one partner is the identified client with a covered diagnosis. Coverage varies, and many plans don't pay for relationship counseling without a billable diagnosis.

How long does a 90847 session need to be?

At least 26 minutes. 90847 describes a 50-minute session, and CPT counts a timed service once you pass the halfway point. A session shorter than 26 minutes doesn't support the code.

General reference for 2026, not billing, legal or coding advice. Code rules, time ranges and payment depend on current CPT and CMS guidelines, your payer contracts, state, locality and credentials, so confirm against your payer's policy. See the full mental health CPT code list.