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Common billing issues with CPT code 90847

Code 90847 represents a session where the identified patient actively participates, giving the provider important visibility into the ways family interactions can contribute to or alleviate a patient’s condition.

December 21, 2023 • Updated on July 27, 2026

11 min read

Key insights

1

Code 90847 represents a 50-minute session of psychotherapy where the identified patient is present along with one or more members of their family (including a spouse or partner).

2

You might use code 90847 after meeting with an adolescent client and their parents, working with two romantic partners, or developing a treatment plan with loved ones.

3

Remember, you can only use code 90847 if the identified client is present and has a diagnosed mental health condition that warrants familial involvement in their care.

CPT code 90847 description

Code 90847 represents a 50-minute session of psychotherapy where the identified patient is present along with one or more members of their family (including a spouse or partner). 

This code reflects a more integrated and comprehensive approach to family therapy that goes beyond addressing family dynamics in the absence of the identified patient (as in the case of a 90846 session).

In order to be reimbursed by most payers for a 90847 session, the identified patient should have a confirmed clinical diagnosis that the session is helping to treat.

For example, in a family therapy session for a teenager recently diagnosed with major depressive disorder, a provider can help aid the teenager’s recovery by educating the family on ways to provide support, and facilitating open communication about the emotional challenges they are facing. The patient’s presence in the session can help the provider gain a deeper understanding of the family dynamics at hand in order to provide the most appropriate course of treatment. 

This is is how the American Medical Association defines 90847 in the official CPT codebook:

Family psychotherapy (conjoint psychotherapy) (with patient present), 50 minutes

Psychotherapy is the treatment of mental illness and behavioral disturbances in which the physician or other qualified health care professional, through definitive therapeutic communication, attempts to alleviate the emotional disturbances, reverse or change maladaptive patterns of behavior, and encourage personality growth and development.

Your documentation for family therapy should include all the standard elements of a progress note, including:

  • Session details: Including patient name and date of birth on every page, start and stop times, date, and place of service
  • Person-centered details
  • Patient-centered observations
  • Clinical interventions and evidence-based practices used during the session
  • Progress towards goals
  • Risk assessment
  • Clinical path forward

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It’s important to use the code that most accurately reflects the time you spent with the patient to treat their condition, and ensure that documentation for the session supports the chosen code. 

When to use CPT code 90847

The 90847 code is associated with a 50-minute session of psychotherapy, which is the clinical standard length for a family therapy session. At a minimum, coding guidelines state the session must include at least 26 minutes of documented face-to-face time.

Examples of sessions that might call for code 90847 include:

  • Meeting with the parents of an adolescent client, while your primary client is there
  • Couples therapy sessions where both partners are present, and at least one has a diagnosed mental health condition supported by couples therapy
  • Creating a treatment or safety plan with both your client and their loved one(s)

CPT code 90847 reimbursement rates

Reimbursement rates for sessions billed with 90847 will vary depending on the plan, your contract, your location, and your license type. Headway providers, for example, often receive higher-than-average reimbursement rates, thanks to our relationships with top payers. Nationally, the average reimbursement rate for code 90847 is around $100 to $120.

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What’s the difference between 90846 and 90847?

The only difference between 90846 and 90847 is whether or not the identified patient is present for a majority of the session.

If the identified patient is present for 16 minutes or more of the session, you would use the 90847 CPT code. If you’d like to see only the family member(s) or partner of your identified patient without the patient present, you’d use 90846. 

If you’re seeing the identified patient for a session apart from their partner or other family members, use an individual psychotherapy code, such as 90834 (for a 45-minute session). 

It’s important to establish the identified patient at the start of treatment, and ensure your documentation is consistent.

What’s the difference between 90847 and 90837?

CPT code 90837 refers to an individual 60-minute session of psychotherapy, where only the patient is present. While 90847 is a 50-minute family therapy session, where the patient is present along with their spouse, partner, or one or more members of their family

Common billing issues with CPT code 90847

At Headway, we know billing can be complex. That’s why we offer billing and claims support for all of our providers, making it simpler than ever to accept and bill insurance.

Billing also becomes easier when you know — and can avoid — potential pitfalls. For code 90847, these include:

  • Mixing up code 90846 (family therapy without the primary patient present) and code 90847 (family therapy with the patient present)
  • Mixing up code 90847 (single-family therapy with the patient present) and code 90849 (family therapy with multiple families present) 
  • Mixing up code 90847 and codes for individual therapy
  • Forgetting to keep track of time, since code 90847 can only be used for sessions that include at least 26 minutes of face-to-face therapy time

CPT code 90847 FAQs

When is it appropriate to bill 90847 instead of 90846?

If your identified patient is part of the session, use code 90847. If you are meeting with only your patient’s family members, use code 90846. 

Can I use 90847 for couples therapy?

Yes, as long as both partners are present in the session and at least one has a diagnosis that makes couples therapy medically necessary.

Does every person in the session need a diagnosis for 90847 to be billable?

No. Generally, the identified patient must have a diagnosis that makes family involvement in care medically necessary — but that doesn’t mean every person in the room needs to have a diagnosis.

Can 90847 be billed on the same day as an individual therapy session?

Often, yes, as long as your documentation shows that you completed two distinct sessions.

Whose insurance is billed for a 90847 session?

Generally, the identified patient’s — that is, the person with a diagnosed mental health condition and an active treatment plan.

Can I bill 90847 if couples therapy isn't explicitly covered under the client's plan?

Often, yes. But there’s an important distinction to keep in mind: You can only use code 90847 if the session supports at least one partner’s diagnosed mental health condition.

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Accepting and billing insurance is harder than it should be. At Headway, we’re out to change that. We offer a suite of free tools that streamline insurance billing, such as automatic benefits verification, compliant documentation templates, claim submission support, clawback protection, and guaranteed bi-weekly payments at enhanced reimbursement rates. We make your life easier, so you can make your clients’ lives better.

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Disclaimer: This document is intended for educational purposes only. It is designed to facilitate compliance with payer requirements and applicable law, but please note that the applicable laws and requirements vary from payer to payer and state to state. Please check with your legal counsel or state licensing board for specific requirements.

This content is for general informational and educational purposes only and does not constitute clinical, legal, financial, or professional advice. All decisions should be made at the discretion of the individual or organization, in consultation with qualified clinical, legal, or other appropriate professionals.

© 2026 Therapymatch, Inc. dba Headway. All rights reserved. No part of this publication may be reproduced without permission.

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