CPT code 90846: Family psychotherapy, patient absent, 50 minutes2026 Medicare rate & RVUs in Maryland
Psychotherapy with a patient's family members or caregivers, without the patient present, is reported for a 50-minute session directed toward the patient's treatment.
Medicare pays $106.87–$113.31 for 90846 in the office in Maryland, from Rest of Maryland to Washington, DC area. Which amount applies depends on the service address.
Medicare allowed amount for participating (non-QP) physicians, before deductible, coinsurance and claim adjustments. Not a patient’s bill or a hospital charge.
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What 90846 covers
A clinician conducts psychotherapy with a patient's family members or caregivers while the patient is absent. The session addresses family interactions, communication, or responses to symptoms as part of treating the patient's mental health condition. For example, a therapist may work with a caregiver on responding to the patient's symptoms and supporting treatment goals. The service is performed in outpatient mental health settings and is distinct from counseling the family about its own concerns without a treatment focus on the patient.
Report 90846 for the 50-minute family psychotherapy service when the patient does not participate. The record should identify the family participants, the patient's condition and treatment goals, the psychotherapy interventions, the time spent, and how the session supports the patient's treatment. CMS coverage is restricted: payment is available only in specific circumstances, so documentation should make the connection to the patient's care clear. Choose a different psychotherapy code when the patient participates or when the service is group therapy.
This summary was written with AI assistance from CMS physician fee schedule data and checked against the CMS billing rules shown here. Rates on this page come directly from CMS files.
Billing guides for 90846: 90846 vs 90847 · Mental health billing
Where 90846 pays more and less in Maryland
The same RVUs, adjusted for each area’s costs. Open a locality for its calculation, history and nearby areas.
3 payment localities
$106.87 to $113.31
| Payment locality | Office | Facility |
|---|---|---|
| Baltimore area, MD | $108.56 | $101.39 |
| Rest of Maryland | $106.87 | $100.11 |
| Washington, DC area | $113.31 | $105.44 |
How the 90846 rate is calculated
Each of 90846’s three RVUs is multiplied by a geographic index (GPCI) for the payment locality, added up, and multiplied by the conversion factor. Drag the indexes or enter a ZIP to see what moves the rate.
How the rate is built · 90846
RVUs × geographic indexes × conversion factor
Work2.74
2.74 RVUs× 1.000 GPCI
Practice expense0.40
0.40 RVUs× 1.000 GPCI
Malpractice0.03
0.03 RVUs× 1.000 GPCI
Adjusted RVUs
3.1700
Conversion factor
$33.4009
Medicare rate
$105.88
Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.
Payment rules and modifiers for 90846
90846 has no global surgery period, no multiple-procedure, bilateral or assistant-at-surgery adjustment, and no professional/technical split. What changes the payment is where the service happens: the place of service on the claim decides whether Medicare pays the office or the facility rate.
Place of service · 90846
Which rate does Medicare pay?
The POS code on the claim line (CMS-1500 box 24B).
POS 11 · non-facility rate · national
$105.88
- Non-facility (office)
- $105.88
- Facility
- $99.20
Higher because the practice carries its own overhead.
90846 compared with similar codes
Compare codes · National
5 codes, side by side
How to choose
- 90847Family therapyPatient present, 50 minutes
- 90846 is family psychotherapy without the patient; 90847 is used when the patient participates in the session.
- 90849Family group therapyMultiple families
- 90849 is multiple-family group psychotherapy. Use 90846 for a session focused on one patient's family when that patient is absent.
- 90853Group psychotherapySingle-patient group session
- 90853 is group psychotherapy, not a family session focused on an individual patient's treatment.
- 90832Psychotherapy session30 minutes, without E/M
- 90832 reports individual psychotherapy with the patient. 90846 reports psychotherapy with the patient's family while the patient is absent.
90846 billing questions
How is 90846 different from 90847?
Use 90846 when the patient is absent from the family psychotherapy session. Use 90847 when the patient participates.
What should the note say when the patient is absent?
Identify the family participants, the patient's treatment goals, the interventions provided, and how the session supports treatment of the patient. Document the session time and the patient's absence.
Can 90846 be used for family counseling unrelated to a patient's treatment?
The service must be directed toward treating the patient's condition. CMS pays 90846 only in specific circumstances.
Should 90846 be reported for a session with several families?
No. 90846 describes psychotherapy with one patient's family while that patient is absent. Multiple-family group psychotherapy is a different service.
Can 90846 be reported when the patient joins for part of the session?
90846 is for family psychotherapy without the patient present. If the patient participates in the family psychotherapy, 90847 is the corresponding code.
Where these rates come from
FeeBase calculates base physician payments from CMS work, practice-expense and malpractice RVUs, adjusted by each locality’s geographic indexes and the conversion factor. Services without a published rate are labeled, never given a made-up amount. Amounts are Medicare allowed amounts before claim adjustments: not a patient’s bill or a commercial rate.
CMS RVU26D · effective Oct 1, 2026 through the day before Jan 1, 2027
Show the CMS file lines behind this rate
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