CPT Code 90847: Family Therapy With the Patient Present

CPT code 90847 is used to bill for family therapy sessions when the patient is actively participating. It’s commonly used in behavioral health, pediatrics, and substance use treatment to involve family members in the therapeutic process.

In this guide, we’ll break down:

• What CPT 90847 includes
• When to use it
• Documentation requirements
• Reimbursement rates
• Common billing mistakes

What is CPT Code 90847?

CPT 90847 refers to family psychotherapy with the patient present, typically lasting 45–60 minutes. These sessions focus on improving family relationships, communication, and behavior patterns to support the patient’s treatment plan.

Common clinical use cases include:

• Family therapy for adolescents with depression or anxiety
• Couples therapy when addressing relationship dynamics and mental health
• Parent training in autism or ADHD treatment plans

Tip: If the patient is not present, use CPT 90846 instead.

When to Use CPT Code 90847

Use 90847 when:

• The patient is present and actively participating
• The session includes at least one family member or caregiver
• The goal is to address issues within the family that impact the patient’s mental health

Do not use 90847 for:

• Group therapy with multiple unrelated families (use group psychotherapy codes)
• Sessions without the patient (use 90846 instead)
• Medication management (use E/M codes with add-on psychotherapy)

Documentation Requirements

For CPT 90847, documentation should include:

• Time spent in the session
• Family members present and their relationship to the patient
• Therapeutic goals addressed and relevance to the patient’s diagnosis
• Interventions used (e.g., systemic therapy, communication training)
• Patient’s participation and response

Link all session content back to the patient’s mental health treatment plan.

Average Reimbursement for 90847

Medicare typically reimburses $100–$135 for CPT 90847, depending on provider type and region. Commercial insurers may reimburse at higher rates, particularly in high-need populations (e.g., children, autism care).

Pro tip: Include detailed documentation to avoid reimbursement delays or downcoding.

Common Billing Errors to Avoid

• Patient not present (use 90846 instead)
• Missing clinical rationale for family involvement
• Incorrect session duration—sessions under 26 minutes may not be billable
• Failure to tie session to the patient’s mental health condition

Final Thoughts

CPT 90847 plays a vital role in collaborative, family-centered care. When billed and documented correctly, it allows providers to engage families in the therapeutic process—leading to stronger clinical outcomes and better continuity of care.