CPT code 90849: Multiple-family group psychotherapy

When to use 90849

• A therapy group made up of several families, or family members of different clients
• Sessions focused on issues the families share, tied back to each client's treatment plan
• Not for a single family, which is 90846 or 90847, or a group of individual clients, which is 90853

What to document

• Who attended from each family
• The group's focus and the interventions used
• How the session relates to each identified client's diagnosis and goals
• Session length

Common reasons 90849 gets denied

• The plan does not cover multiple-family group psychotherapy
• No covered, billable diagnosis for the identified client
• The group type does not match the code (a single family or a group of individual clients)

Billing 90849 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 90849 pay in 2026?

Check Medicare coverage. Medicare often won't pay for 90849. Wellpoint Federal, the Medicare contractor for jurisdictions J6 and JK, says multiple-family group psychotherapy doesn't meet Medicare's standard of therapy directed at the beneficiary's own condition, and approves claims only on individual consideration. Check your own contractor's billing article before counting on the rate below. Read the CMS article .

Medicare, national non-QP

$40.42

Typical commercial range

$44 to $61

• 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 Oct 17, 2026.

Related codes

Frequently asked questions