The 90847 CPT code is the one family therapy code that pays for the session the patient sits in. It looks simple on the fee schedule and then generates a denial queue, because three separate rules govern it at once: who was in the room, how long the session ran, and whether the note proves both.
This page answers the 90847 questions clinics actually ask, in the order they ask them. Every coding rule below is taken from the psychotherapy code guidance published by APA Services or from the CMS telehealth list, and each is attributed where it appears. Where a rule is set by the individual payer rather than by CPT, this page says so instead of guessing.
What is CPT code 90847?
CPT code 90847 is family psychotherapy, also described as conjoint psychotherapy, delivered with the patient present, at a stated duration of 50 minutes. That is the full descriptor. Two things inside it carry the billing weight: the service is family psychotherapy rather than individual psychotherapy, and the identified patient is in the session.
| Element of the code | What it means for the claim |
|---|---|
| Service type | Family psychotherapy, also called conjoint psychotherapy |
| Patient present | The identified patient attends the session |
| Stated duration | 50 minutes |
| Code family | Psychotherapy codes, not diagnostic evaluation and not group therapy |
| Who is treated | The identified patient, with family members participating in that treatment |
| Claim carries | One unit per session, under the identified patient's record |
The distinction that decides most 90847 questions is that the family is present in service of the identified patient's treatment. The claim goes out under that patient. Family members in the room are participants in the patient's care, not additional patients with their own claims.
- 90847 is billed once for the session, not once per person in the room.
- The identified patient must be present for 90847 rather than 90846.
- The session is part of the identified patient's treatment plan.
- The diagnosis on the claim is the identified patient's diagnosis.
- The note lives in the identified patient's chart.
How many minutes is a 90847 session?
The descriptor says 50 minutes, but the billing threshold is not 50 minutes. Under the CPT time rule published by APA Services, 90846 and 90847 are reportable at 26 or more minutes. This is the single most useful number on this page, and the one the tiered structure of the individual codes trains people to get wrong: the family codes do not work that way.
| CPT code | Total duration of the session |
|---|---|
| 90832 | 16 to 37 minutes |
| 90834 | 38 to 52 minutes |
| 90837 | 53 or more minutes |
| 90846 and 90847 | 26 or more minutes |
Source: the CPT time rule table published by APA Services. Note the shape of the family row. The individual codes sit in bands, so a 40 minute individual session maps to one code and a 55 minute session maps to another. The family codes have a floor and no ceiling. A 30 minute family session and a 75 minute family session are both reported as one unit of 90847.
- Under 26 minutes, 90847 is not reportable for that session.
- At 26 minutes or more, 90847 is reportable as a single unit.
- There is no second tier of family psychotherapy code for a longer session.
- Time is counted as time spent with the patient and family, per the APA Services guidance.
- The start time, end time and total minutes belong in the note, because the floor is a time floor.
Notes that carry the elements your payer asks for
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BOOK A FREE DEMO →What is the difference between 90846 and 90847?
One variable separates them: whether the identified patient is in the room. Both are family psychotherapy, both are stated at 50 minutes, and both share the same 26 minute reporting floor.
| 90846 | 90847 | |
|---|---|---|
| Descriptor | Family psychotherapy without the patient present | Family psychotherapy, conjoint, with the patient present |
| Stated duration | 50 minutes | 50 minutes |
| Reporting floor | 26 or more minutes | 26 or more minutes |
| Identified patient in the room | No | Yes |
| Typical use | A session with parents or caregivers about the patient's treatment | A session where the patient and family are treated together |
| Claim filed under | The identified patient | The identified patient |
| What the note must establish | Who attended, and that the work served the patient's treatment | Who attended, including the patient, and that the work served the patient's treatment |
Because the only difference is attendance, attendance is what an auditor checks. A note that says family session without naming who was in the room cannot distinguish 90846 from 90847, and a claim that cannot be distinguished is a claim that can be recouped.
What is the difference between 90847 and 90837?
90837 is individual psychotherapy at 60 minutes. 90847 is family psychotherapy with the patient present at 50 minutes. They are not interchangeable and they are not a choice between a longer and a shorter session. They describe different services.
| 90837 | 90847 | |
|---|---|---|
| Service | Individual psychotherapy | Family psychotherapy, conjoint |
| Stated duration | 60 minutes | 50 minutes |
| Reporting floor | 53 or more minutes | 26 or more minutes |
| Who is in the room | The patient | The patient and one or more family members |
| What drives code choice | Session length | Who attended, then the 26 minute floor |
| Interactive complexity add on | May be reported with 90785 | Not on the APA Services list of primary codes for 90785 |
If a session begins with the patient alone and family members join partway through, the code follows the service actually delivered, and the note has to make that sequence legible. Read the companion pages for 90837, 90834 and 90832 for the individual side of that decision.
Can you bill 90847 and 90837 on the same day?
CPT does not answer this one. Same day pairing of two psychotherapy services for the same patient is governed by payer policy and by claim edits, and the answer differs between a commercial plan, a Medicaid program and Medicare. Anyone who tells you there is a single national rule here is describing their own payer mix.
What you can do is make the question answerable before the claim goes out:
- Check the specific payer's psychotherapy policy for same day services.
- Confirm whether the payer requires a modifier to identify distinct services.
- Record the two sessions as separate encounters with separate start and end times.
- Document a distinct clinical rationale for each service.
- Keep both notes in the identified patient's chart, each standing on its own.
Denials in this category tend to be recoverable on appeal when the documentation separates the services cleanly, and unrecoverable when the two notes read as one session split in half. Our guide to denial management covers the appeal path in more detail.
Can 90847 be billed alone?
Yes. 90847 is a standalone psychotherapy code, not an add on code. It does not require a primary service to be reported alongside it. Add on codes such as 90785 for interactive complexity and 90840 for additional crisis time are the ones that cannot stand alone, and both the principal service code and the add on code have to appear on the billing form when an add on is used.
| Code | Can it be billed alone? |
|---|---|
| 90847 | Yes, it is a principal psychotherapy service |
| 90846 | Yes, it is a principal psychotherapy service |
| 90785 interactive complexity | No, it is an add on to a listed primary procedure |
| 90840 crisis, each additional 30 minutes | No, it is an add on to 90839 |
Can you bill couples therapy under 90847?
This is where clinics lose the most money, and the answer is conditional. 90847 describes family psychotherapy with the patient present. A couples session can meet that description when one member of the couple is the identified patient, the session treats that patient's diagnosed condition, and the partner participates in that treatment. It does not meet the description when the presenting problem is the relationship itself and no identified patient is being treated for a covered condition.
| Scenario | Does the 90847 framing hold? |
|---|---|
| Patient with a diagnosed condition, partner joins to support that treatment | The service matches the descriptor, subject to the payer's benefit terms |
| Relationship counselling with no identified patient and no covered diagnosis | Outside the descriptor, and generally outside the behavioral health benefit |
| Partner attends but the session treats only the partner | The claim is under the wrong patient |
| Both members carry separate diagnoses and separate treatment plans | A payer specific question, confirm before billing rather than after |
The practical guard is the benefit check, not the code. Verify coverage for family psychotherapy under the identified patient's plan before the first session, and record what you were told. Read our page on insurance eligibility verification for the checks worth running up front.
Can 90785 interactive complexity be added to 90847?
Not according to the primary code list published by APA Services. The interactive complexity add on code 90785 is listed as reportable with diagnostic evaluation (90791), psychotherapy (90832, 90834, 90837) and group psychotherapy (90853). The family psychotherapy codes 90846 and 90847 are not on that list.
This matters because the complicating factors that 90785 exists to capture, such as difficult communication with family members and the involvement of third parties, are exactly the factors present in family work. The instinct to attach 90785 to a hard family session is understandable and the code list does not support it.
| Primary code | 90785 reportable with it, per APA Services |
|---|---|
| 90791 diagnostic evaluation | Yes |
| 90832 psychotherapy 30 minutes | Yes |
| 90834 psychotherapy 45 minutes | Yes |
| 90837 psychotherapy 60 minutes | Yes |
| 90853 group psychotherapy | Yes |
| 90846 family psychotherapy without patient | Not listed |
| 90847 family psychotherapy with patient | Not listed |
APA Services also states that interactive complexity cannot be reported solely for translation or interpretation services, which is a separate trap on the same code.
Can 90847 be billed for telehealth?
For Medicare, yes. 90847 appears on the CY 2026 Final List of Medicare Telehealth Services published by CMS, listed under its short descriptor as family psychotherapy with patient at 50 minutes, with a status of Maintain. 90846 and 90853 appear on the same list with the same status.
| HCPCS | Short descriptor on the CMS list | Status on the CY 2026 list |
|---|---|---|
| 90846 | Family psytx w/o pt 50 min | Maintain |
| 90847 | Family psytx w/pt 50 min | Maintain |
| 90853 | Group psychotherapy | Maintain |
Source: CMS, List of Telehealth Services, CY 2026 final list, checked 22 September 2026. Two cautions apply. Commercial and Medicaid telehealth coverage is set separately by each payer and does not follow the Medicare list. And the modifier and place of service expected on a telehealth claim vary by payer, so confirm the pairing with the plan rather than carrying one convention across your whole payer mix.
What must a 90847 progress note document?
The code is decided by two facts, attendance and duration, so those two facts are what the note has to prove. Everything else in the note supports medical necessity.
| Note element | Why the claim depends on it |
|---|---|
| Names and roles of everyone present | Separates 90847 from 90846 and shows the patient attended |
| Explicit statement that the identified patient was present | The single fact that makes the code 90847 |
| Start time, end time and total minutes | Establishes the 26 minute reporting floor was met |
| The identified patient's diagnosis | Ties the family session to a treated condition |
| Treatment plan goal addressed in the session | Carries medical necessity |
| Interventions delivered to the family unit | Shows family psychotherapy rather than a family meeting |
| Patient response and clinical progress | Supports continued authorisation |
| Plan for the next session | Shows the session sits inside a course of treatment |
| Clinician signature, credential and date | Standard attestation requirement |
A note that records family session, 50 minutes, good participation fails all three of the tests that matter. It does not name who attended, it does not evidence the minutes, and it does not connect the work to the treatment plan.
- Name each attendee and their relationship to the identified patient.
- State in one sentence that the identified patient attended.
- Record clock times, not a rounded session length.
- Reference the treatment plan goal by name.
- Describe the intervention, not the conversation.
- Close with the clinical rationale for the next session.
Why do 90847 claims get denied?
90847 denials cluster into a small number of repeatable causes, and each has a documentation fix that sits upstream of the claim.
| Denial pattern | Underlying cause | Fix at the note level |
|---|---|---|
| Service not covered under the benefit | Relationship counselling billed with no identified patient | Verify the family psychotherapy benefit before the first session |
| Wrong code for the service | 90846 billed when the patient attended, or the reverse | State attendance explicitly in every family note |
| Time not supported | No clock times, so the 26 minute floor cannot be evidenced | Record start and end times as structured fields |
| Medical necessity not established | No link between the family session and the treatment plan | Name the treatment plan goal in the note |
| Duplicate or conflicting claim | Two psychotherapy services on one day without distinct documentation | Document each encounter separately with its own rationale |
| Authorisation missing or exhausted | Family sessions counted against a limited visit allowance | Track authorised units against the identified patient |
| Add on code rejected | 90785 attached to 90847 | Reserve 90785 for the primary codes APA Services lists |
| Claim filed under the wrong member | Family member treated as the patient | File under the identified patient every time |
The pattern across all eight is that the claim fails on something the note could have settled. Our wider guide to behavioral health billing covers the workflow around these, and mental health billing software covers the systems side.
How is 90847 reimbursed?
There is no single national rate for 90847, and any page that publishes one figure as the rate is describing one payer in one place. Reimbursement is set by the mechanism below, and the number your clinic sees is the output of that mechanism, not a property of the code.
| Input | What sets it |
|---|---|
| Medicare physician fee schedule | The relative value units assigned to the code and the annual conversion factor |
| Geographic adjustment | The locality applied to your practice address |
| Commercial contract | The percentage of the fee schedule negotiated in your contract |
| Medicaid program | The state's own fee schedule, which does not track Medicare |
| Provider credential | Payer rules on reimbursement by licence type |
| Place of service and modifier | Payer specific telehealth and site rules |
The practical consequence is that improving 90847 revenue is rarely a coding exercise. It is a matter of the claim surviving the edits, which returns to attendance and time in the note, and of catching the denial fast when it does not.
How does 90847 compare to the other family and group codes?
| CPT code | Descriptor | Patient present |
|---|---|---|
| 90846 | Family psychotherapy without the patient present, 50 minutes | No |
| 90847 | Family psychotherapy, conjoint, with the patient present, 50 minutes | Yes |
| 90849 | Multiple family group psychotherapy | Group setting across families |
| 90853 | Group psychotherapy other than of a multiple family group | Group setting |
Descriptors as published by APA Services. 90849 and 90853 are group services and are not substitutes for a family session with one identified patient. A family session does not become a group service because several people attended.
It is as useful to be clear about what the code does not describe:
| Situation | Why 90847 does not describe it | What it points to instead |
|---|---|---|
| The patient was not in the room | The descriptor requires the patient present | 90846 |
| Several unrelated patients treated together | Family psychotherapy is not group psychotherapy | 90853 |
| Several families treated together | Outside the conjoint family descriptor | 90849 |
| A care coordination call with a parent | Not a psychotherapy service | A care coordination or case management pathway |
| An initial assessment of the patient | Diagnostic evaluation is a separate service | 90791 |
| A crisis session requiring urgent assessment and disposition | Crisis psychotherapy has its own principal code | 90839, with 90840 for extra time |
How do you code a family session that changes shape partway through?
Real sessions do not hold still. A parent steps out, a sibling arrives late, the patient leaves early. The code follows the service that was actually delivered, and the note is what makes that legible to a reviewer who was not there.
| What happened in the room | What the note has to establish |
|---|---|
| Patient present throughout, family joins for the second half | Total minutes, who joined, when, and that family psychotherapy was delivered |
| Session starts with family only, patient joins later | The point at which the patient entered, and the minutes of each part |
| Patient leaves early, family work continues | The minutes the patient was present and what the remaining work addressed |
| Family attends but the patient never does | That the patient was absent, which points at 90846 rather than 90847 |
| Session runs under 26 minutes for any reason | The actual minutes, since the reporting floor was not met |
| Two family members attend on behalf of one patient | Both attendees named, still one unit under the identified patient |
The rule underneath all six rows is the same. Write what happened and the code follows. Choose the code first and the note becomes an argument you have to win later.
What separates a 90847 note that holds from one that does not?
| Line that will not survive review | Line that holds |
|---|---|
| Family session, 50 minutes | Conjoint family session, 11:02 to 11:54, 52 minutes total |
| Family present | Present: the patient, mother and stepfather |
| Good participation from all | The patient practised the agreed de escalation script with both parents |
| Discussed ongoing issues | Addressed treatment plan goal two, reducing conflict around school mornings |
| Will continue family work | Next conjoint session in two weeks to review the morning routine plan |
| Session held by video | Delivered by video, patient and both parents on camera for the full session |
| Patient doing better | Patient reported two mornings without escalation since the last session |
The left column is not wrong so much as unprovable. Each line on the right settles one of the facts that decides the claim: attendance, minutes, medical necessity, modality and progress.
What should you ask the payer before billing 90847?
Most of the uncertainty around this code is payer policy rather than CPT, so the cheapest fix is a short list of questions asked before the first session rather than after the first denial.
- Is family psychotherapy covered under this member's behavioral health benefit?
- Does the plan require prior authorisation for family psychotherapy?
- Do family sessions draw down the same visit allowance as individual sessions?
- What is the plan's policy on two psychotherapy services for one patient on one day?
- Which modifier and place of service does the plan expect for a telehealth family session?
- Are there licence type restrictions on who may bill family psychotherapy?
- Does the plan require the identified patient's diagnosis on every family claim?
- Where is the plan's psychotherapy policy document published?
Record the answer, the date and the name of the person who gave it. That record is what turns a denial into a winnable appeal.
What does the documentation look like across the psychotherapy codes?
| Requirement | 90846 | 90847 | 90837 |
|---|---|---|---|
| Name everyone present | Yes | Yes | Patient only |
| State whether the patient attended | Yes, absent | Yes, present | Not applicable |
| Record start and end times | Yes | Yes | Yes |
| Reporting floor to evidence | 26 minutes | 26 minutes | 53 minutes |
| Identified patient's diagnosis | Yes | Yes | Yes |
| Treatment plan goal addressed | Yes | Yes | Yes |
| Interventions delivered | To the family unit | To the family unit | To the patient |
90847 terms worth getting exact
| Term | What it means on a 90847 claim |
|---|---|
| Identified patient | The person whose record, diagnosis and benefit the claim sits under |
| Conjoint | Family psychotherapy delivered with the patient in the session |
| Reporting floor | The minimum session duration at which the code may be reported, 26 minutes here |
| Principal service | A code that can be reported on its own, as 90847 can |
| Add on code | A code reportable only alongside a listed primary procedure, as 90785 is |
| Medical necessity | The link between the session and the identified patient's treatment plan |
| Place of service | The code identifying where the service was delivered |
| Modifier | A suffix identifying a circumstance such as a telehealth delivery |
| Unit | One reportable instance of the service, one per 90847 session |
| Conversion factor | The annual multiplier applied to relative value units in the Medicare fee schedule |
What should you check before the claim goes out?
- The identified patient is named as present in the note.
- Start time, end time and total minutes are recorded.
- Total minutes reach the 26 minute floor.
- Every attendee is named with their relationship to the patient.
- The treatment plan goal addressed is stated by name.
- The diagnosis on the claim is the identified patient's.
- No add on code is attached that the primary code list does not support.
- Authorisation, where required, is on file and not exhausted.
- The modality is recorded, with the modifier and place of service the payer expects.
- The note is signed, credentialed and dated.
Attendance, minutes and plan goal captured as you work
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BOOK A FREE DEMO →90847 CPT code FAQ
What does CPT code 90847 mean?
CPT code 90847 means family psychotherapy, also called conjoint psychotherapy, delivered with the identified patient present, at a stated duration of 50 minutes.
How many minutes is a 90847 session?
The descriptor states 50 minutes, and the CPT time rule published by APA Services makes 90846 and 90847 reportable at 26 or more minutes. There is no upper tier.
What is the difference between 90847 and 90837?
90837 is individual psychotherapy at 60 minutes with a reporting floor of 53 minutes. 90847 is family psychotherapy with the patient present at 50 minutes with a reporting floor of 26 minutes. They describe different services, not different session lengths.
What is the difference between 90846 and 90847?
Whether the identified patient is in the room. 90846 is family psychotherapy without the patient present, 90847 is family psychotherapy with the patient present. Both are stated at 50 minutes and both are reportable at 26 or more minutes.
Can 90847 be billed alone?
Yes. 90847 is a principal psychotherapy service, not an add on code, so it does not require another service to be reported with it.
Can you bill 90837 and 90847 on the same day?
CPT does not set a single rule. Same day pairing is governed by payer policy and claim edits, so confirm the specific payer's psychotherapy policy and document each encounter separately with its own times and rationale.
Is 90847 covered for telehealth?
90847 appears on the CMS CY 2026 Final List of Medicare Telehealth Services with a status of Maintain. Commercial and Medicaid coverage is set separately by each payer.
Can 90785 be added to 90847?
APA Services lists 90785 as reportable with 90791, 90832, 90834, 90837 and 90853. 90846 and 90847 are not on that list.
What is the difference between 90834 and 90837?
Both are individual psychotherapy. Under the CPT time rule published by APA Services, 90834 covers sessions of 38 to 52 minutes and 90837 covers sessions of 53 minutes or more.
Is 90847 the same as couples therapy?
Not automatically. A couples session fits the 90847 descriptor when one member is the identified patient, the session treats that patient's condition and the partner participates in that treatment. Relationship counselling with no identified patient sits outside it.
How often can 90847 be billed?
CPT does not set a frequency limit. Visit allowances, authorisation requirements and frequency rules are set by the individual payer, so confirm them against the identified patient's plan.
For the individual psychotherapy codes alongside this one, see our pages on 90791, 90832, 90834 and 90837, and our overview of AI clinical documentation for behavioral health.
Streamline Your Practice
The 90847 cpt code rewards clinics whose notes settle attendance and minutes without anyone chasing them afterwards. mdhub captures both as part of the documentation workflow, so the claim goes out with the evidence already attached. Book a demo to see it against your own family session workflow.
