How long does a 90846 session need to be?

At least 26 minutes. CPT describes the code as 50 minutes, and the 26-minute threshold is the midpoint rule.

Whose insurance do I bill for 90846?

The identified client’s, even though the client isn’t in the session. The session has to serve that client’s treatment.

What is the difference between 90846 and 90847?

90846 is family therapy without the client present; 90847 is family therapy with the client present for all or part of the session.

CPT code reference for therapists

CPT 90846: Family psychotherapy without the client

90846 is family psychotherapy with family members but without the identified client in the room: for example, working with parents on how to respond to a child’s behavior, or with a partner on supporting the client’s treatment.

The session is billed under the identified client’s insurance, and it has to be about that client’s treatment, not the family members’ own problems.

Updated October 5, 2026

What it is: Family therapy, client not present
Time: About 50 minutes; at least 26
Billed under: The identified client
Client present: Use 90847

When to use 90846

A session with the client’s family members, without the client, that serves the client’s treatment plan.
Parent sessions in child and adolescent therapy where the child isn’t present.

Time rules

CPT describes 90846 as 50 minutes, and it can be billed once the session reaches 26 minutes.
Under 26 minutes, 90846 doesn’t apply.
Bill one 90846 per session, however many family members attend.

What to document

Who attended and their relationship to the client; note that the client was not present and why.
How the session relates to the client’s diagnosis and treatment plan goals.
Interventions used, family members’ responses, and the plan.
Start and stop times, or total time.

Billing rules and common denials

Not every plan covers 90846. Check benefits first; Medicare and many plans pay it only when the family work is needed for the client’s treatment.
Add-on 90785 (interactive complexity) isn’t reported with the family psychotherapy codes.
For telehealth, payers differ: Medicare uses place of service 10 or 02, while many commercial plans want the in-person place of service (usually 11) with modifier 95. Check each payer’s telehealth policy.

Telehealth modifiers

95: Live (synchronous) video visit. The modifier most commercial plans and Medicaid programs ask for.
GT: Older “via interactive audio and video” modifier. A few payers and some institutional claims still want it instead of 95.
93: Audio-only (phone) visit, where the payer covers it. Some payers ask for FQ instead.

Add-on 90785 (interactive complexity) is not reported with this code.

Typical place of service codes

11: Office. The usual in-person place of service for private practice.
10: Telehealth with the client in their home.
02: Telehealth with the client somewhere other than home (work, car, a clinic).
12: In person at the client’s home.
03: School.
53: Community mental health center.

Common questions

How long does a 90846 session need to be?: At least 26 minutes. CPT describes the code as 50 minutes, and the 26-minute threshold is the midpoint rule.
Whose insurance do I bill for 90846?: The identified client’s, even though the client isn’t in the session. The session has to serve that client’s treatment.
What is the difference between 90846 and 90847?: 90846 is family therapy without the client present; 90847 is family therapy with the client present for all or part of the session.

CPT® is a registered trademark of the American Medical Association. This page summarizes common billing practice in plain language and isn’t billing or legal advice; payer policies vary, so check each payer’s current rules.