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CPT code 90849: Family group therapy, multiple families2026 Medicare rate & RVUs in Santa Clara County, CA

Report 90849 for a psychotherapy session in which a clinician works with members of multiple families together around shared behavioral or mental health concerns.

CMS RVU26DEffective Oct 1, 2026One payment locality490 Medicare services in 2024

In Santa Clara County, CA, Medicare pays $50.15 for 90849 in the office and $35.22 when it’s performed in a hospital or facility.

$50.15Office (non-facility)
$35.22Hospital or facility
+24.1%vs the national office rate ($40.42)

Check a contract rate as a % of Medicare · 90849 nationwide

Medicare allowed amount for participating (non-QP) physicians, before deductible, coinsurance and claim adjustments. Not a patient’s bill or a hospital charge.

We’ll open 90849 for the payment locality that covers the ZIP.

On this page 11 sections
  1. Rate in Santa Clara County, CA
  2. What 90849 covers
  3. Compared with other areas
  4. Rate map
  5. How it’s calculated
  6. Payment rules
  7. Related codes
  8. Rate history
  9. Where it applies
  10. Billing questions
  11. Sources

What 90849 covers

A mental health clinician leads psychotherapy with members of multiple families in the same session. The work may focus on recurring relationship patterns, family responses to a child’s behavioral or emotional difficulties, or coping approaches shared across families facing similar concerns. The session is psychotherapy, not simply a presentation or general support meeting. Psychiatrists, psychologists, and other qualified mental health clinicians may provide it in an office, clinic, or facility setting.

Choose 90849 when the treatment involves multiple family units participating together, rather than one family meeting with the clinician or a group of individual patients. Document the participating families, the clinical focus, and the therapeutic work performed. Report the session rather than separate units for each family or attendee. CMS assigns work, practice-expense, and malpractice RVUs; its office and facility practice-expense values are distinct.

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.

How Santa Clara County, CA compares for 90849

Across 109 of 109 payment localities, the office rate for 90849 runs from $37.64 in Arkansas to $52.43 in Alaska. Santa Clara County, CA pays $50.15. The RVUs are the same everywhere; the geographic indexes change the dollars.

90849 in Santa Clara County, CA vs other payment areas
  1. Santa Clara County, CA · this page$50.15
  2. Bakersfield, CA · California$42.25−$7.90
  3. Chico, CA · California$42.15−$8.00
  4. El Centro, CA · California$42.16−$7.99
  5. Fresno, CA · California$42.15−$8.00
  6. Hanford, CA · California$42.15−$8.00
  7. Los Angeles, CA · California$44.29−$5.86

Other areas in California first, then benchmark localities. Bars start at $0.

Every other payment area

90849 in every other Medicare payment locality
Payment localityOfficeFacility
Madera, CACalifornia$42.15$30.80
Merced, CACalifornia$42.15$30.80
Modesto, CACalifornia$42.15$30.80
Napa, CACalifornia$47.02$33.37
Oxnard, CACalifornia$43.95$31.71
Redding, CACalifornia$42.15$30.80
Rest of CaliforniaCalifornia$42.15$30.80
Riverside, CACalifornia$42.39$31.04

90849 rates by state

Office rate range in each state. Select a state to see its payment localities.

MEWIVTNHMTNDMNMINYMARIWAIDWYSDIAILINOHPANJCTORNVUTCONEMOKYWVVAMDDECAAZNMKSOKARTNNCSCDCTXLAMSALGAFLAKHI

Explore a state

Local rates. Clear comparisons.

Hover or focus a tile to see its rate range. Select it to open the state’s fee schedule.

$37.64

$52.43

Color shows the midpoint of each state’s locality range.

View every state and territory as a table
90849 office rate range by state
State / territoryOffice rate rangeLocalities
AK$52.431
AL$37.951
AR$37.641
AZ$39.781
CA$42.15–$50.2429
CO$41.651
CT$42.341
DC$44.791
DE$40.251
FL$39.99–$42.153
GA$38.67–$40.892
GU$42.511
HI$42.511
IA$38.541
ID$38.671
IL$39.28–$41.564
IN$38.801
KS$38.421
KY$38.431
LA$38.39–$39.482
MA$41.56–$44.632
MD$40.79–$44.793
ME$38.77–$40.012
MI$38.99–$40.272
MN$40.451
MO$38.00–$39.583
MS$37.831
MT$40.411
NC$39.011
ND$40.021
NE$38.661
NH$41.041
NJ$42.97–$44.652
NM$39.111
NV$40.321
NY$39.35–$45.705
OH$38.911
OK$38.411
OR$40.15–$42.532
PA$38.95–$41.662
PR$40.601
RI$41.341
SC$38.991
SD$39.971
TN$38.531
TX$38.80–$41.398
UT$39.301
VA$39.92–$44.792
VI$40.601
VT$39.911
WA$41.47–$45.352
WI$39.221
WV$38.431
WY$40.241

See 90849 in every payment locality

How the 90849 rate is calculated

Each of 90849’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 · 90849

RVUs × geographic indexes × conversion factor

Office or facility?

Work0.67

0.67 RVUs× 1.000 GPCI

Practice expense0.52

0.52 RVUs× 1.000 GPCI

Malpractice0.02

0.02 RVUs× 1.000 GPCI

Adjusted RVUs

1.2100

Conversion factor

$33.4009

Medicare rate

$40.42

Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.

The exact Santa Clara County, CA inputs and CMS source lines

PPRRVU2026_Oct_nonQPP.csv

11,540

Code
90849
Physician work
0.67
Practice expense
0.52
Malpractice
0.02

GPCI2026.csv

28

Locality
Santa Clara County, CA
Physician work
1.110
Practice expense
1.442
Malpractice
0.397
Office calculation for 90849 in Santa Clara County, CA
ComponentRVULocality factorAdjusted
Physician work0.67× 1.1100.7437
Practice expense0.52× 1.4420.7498
Malpractice0.02× 0.3970.0079
Total RVUs1.5015
Conversion factor× 33.4009

Office rate, Santa Clara County, CA$50.15

Office: (0.67 × 1.11 + 0.52 × 1.442 + 0.02 × 0.397) × $33.4009 = $50.15

Facility: (0.67 × 1.11 + 0.21 × 1.442 + 0.02 × 0.397) × $33.4009 = $35.22

Open 90849 in the RVU calculator

Payment rules and modifiers for 90849

90849 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 · 90849

Which rate does Medicare pay?

The POS code on the claim line (CMS-1500 box 24B).

POS 11 · non-facility rate · national

$40.42

Non-facility (office)
$40.42
Facility
$30.06

Higher because the practice carries its own overhead.

Codes related to 90849

Related codes aren’t interchangeable: bill the code that matches the service performed.

Codes related to 90849
CodeHow it relatesOffice range, Santa Clara County, CA
Used instead
90853Group psychotherapy, single-patient group sessionGroup psychotherapy for a group not structured as a multiple-family session.$36.05
90846Family psychotherapy, patient absent, 50 minutesFamily psychotherapy involving one family, with the patient absent.$121.25
90847Family therapy, patient present, 50 minutesFamily psychotherapy involving one family, with the patient present.$125.57
90832Psychotherapy session, 30 minutes, without E/MIndividual psychotherapy when treatment is provided to one patient rather than multiple families.$101.92

How 90849 has changed in Santa Clara County, CA

90849 · Office / nonfacility

$50.15

Effective 2026-10-01

The base rate is $4.01 higher than on 2025-10-01, moving from $46.14 to $50.15 (8.7%).

It is unchanged from the immediately preceding available release, effective 2026-07-01.

Base rate by release · bars start at $0 · select a bar to compare

One bar per available release, ordered by effective date. Missing rates remain gaps. These comparisons hold the code, setting and locality identifiers constant; they do not isolate which policy or input caused a change.

What changed, release by release

  1. January 1, 2026

    RVU26A

    $46.14changed to$50.15

    • Conversion factor 32.3465 changed to 33.4009
    • Work RVU 0.65 changed to 0.67
    • Practice expense RVU 0.49 changed to 0.52
    • Work GPCI 1.100 changed to 1.110
    • Practice expense GPCI 1.435 changed to 1.442
    • Malpractice GPCI 0.420 changed to 0.397

    Held through RVU26B, RVU26C, RVU26D.

  2. January 1, 2025

    RVU25A

    $46.39changed to$46.14

    • Conversion factor 33.2875 changed to 32.3465
    • Work RVU 0.62 changed to 0.65

    Held through RVU25B, RVU25C, RVU25D.

  3. March 9, 2024

    RVU24AR

    $45.63changed to$46.39

    • Conversion factor 32.7442 changed to 33.2875

    Held through RVU24B, RVU24C, RVU24D.

  4. January 1, 2024

    RVU24A

    $45.63changed to$45.63

    • Conversion factor 33.8872 changed to 32.7442
    • Work RVU 0.59 changed to 0.62
    • Work GPCI 1.098 changed to 1.100
    • Practice expense GPCI 1.409 changed to 1.435
    • Malpractice GPCI 0.417 changed to 0.420

  5. January 1, 2023

    RVU23A

    $42.29changed to$45.63

    • Conversion factor 34.6062 changed to 33.8872
    • Practice expense RVU 0.41 changed to 0.49
    • Work GPCI 1.096 changed to 1.098
    • Practice expense GPCI 1.383 changed to 1.409
    • Malpractice GPCI 0.414 changed to 0.417

    Held through RVU23B, RVU23C, RVU23D.

  6. January 1, 2022

    RVU22A

    $42.16changed to$42.29

    • Conversion factor 34.8931 changed to 34.6062
    • Practice expense RVU 0.40 changed to 0.41

    Held through RVU22B, RVU22C, RVU22D.

  7. January 1, 2021

    RVU21A

    $43.73changed to$42.16

    • Conversion factor 36.0896 changed to 34.8931
    • Practice expense RVU 0.41 changed to 0.40
    • Work GPCI 1.089 changed to 1.096
    • Practice expense GPCI 1.369 changed to 1.383
    • Malpractice GPCI 0.401 changed to 0.414

    Held through RVU21B, RVU21C, RVU21D.

  8. January 1, 2020

    RVU20A

    $50.63changed to$43.73

    • Conversion factor 36.0391 changed to 36.0896
    • Practice expense RVU 0.56 changed to 0.41
    • Work GPCI 1.083 changed to 1.089
    • Practice expense GPCI 1.354 changed to 1.369
    • Malpractice GPCI 0.388 changed to 0.401

    Held through RVU20B, RVU20C, RVU20D.

  9. January 1, 2019

    RVU19A

    $43.89changed to$50.63

    • Conversion factor 35.9996 changed to 36.0391
    • Practice expense RVU 0.42 changed to 0.56
    • Malpractice RVU 0.03 changed to 0.02

    Held through RVU19B, RVU19C, RVU19D.

  10. January 1, 2018

    RVU18AR1

    $40.88changed to$43.89

    • Conversion factor 35.8887 changed to 35.9996
    • Practice expense RVU 0.36 changed to 0.42
    • Work GPCI 1.086 changed to 1.083
    • Practice expense GPCI 1.351 changed to 1.354
    • Malpractice GPCI 0.402 changed to 0.388

    Held through RVU18B, RVU18C, RVU18D.

  11. January 1, 2017

    RVU17A

    $39.83changed to$40.88

    • Conversion factor 35.8043 changed to 35.8887
    • Practice expense RVU 0.34 changed to 0.36
    • Work GPCI 1.088 changed to 1.086
    • Practice expense GPCI 1.347 changed to 1.351
    • Malpractice GPCI 0.416 changed to 0.402

    Held through RVU17B, RVU17C, RVU17D.

  12. January 1, 2016

    RVU16A

    $41.42changed to$39.83

    • Conversion factor 35.9335 changed to 35.8043
    • Practice expense RVU 0.37 changed to 0.34

    Held through RVU16B, RVU16C, RVU16D.

  13. July 1, 2015

    RVU15C

    $41.22changed to$41.42

    • Conversion factor 35.7547 changed to 35.9335

    Held through RVU15D.

  14. January 1, 2015

    RVU15A

    $39.74changed to$41.22

    • Conversion factor 35.8228 changed to 35.7547
    • Practice expense RVU 0.34 changed to 0.37
    • Work GPCI 1.083 changed to 1.088
    • Practice expense GPCI 1.342 changed to 1.347
    • Malpractice GPCI 0.466 changed to 0.416

    Held through RVU15B.

  15. January 1, 2014

    RVU14A

    $39.43changed to$39.74

    • Conversion factor 34.0230 changed to 35.8228
    • Practice expense RVU 0.38 changed to 0.34
    • Work GPCI 1.077 changed to 1.083
    • Practice expense GPCI 1.337 changed to 1.342
    • Malpractice GPCI 0.516 changed to 0.466

    Held through RVU14B, RVU14C, RVU14D.

  16. October 1, 2013

    RVU13D

    No ratechanged to$39.43

  17. January 1, 2013

    RVU13AR

    Earliest loaded release: No rate

    Held through RVU13B, RVU13C.

Rates in every CMS release
Effective fromOfficeFacilityCMS release
2026-10-01$50.15$35.22RVU26D
2026-07-01$50.15$35.22RVU26C
2026-04-01$50.15$35.22RVU26B
2026-01-01$50.15$35.22RVU26A
2025-10-01$46.14$34.54RVU25D
2025-07-01$46.14$34.54RVU25C
2025-04-01$46.14$34.54RVU25B
2025-01-01$46.14$34.54RVU25A
2024-10-01$46.39$34.45RVU24D
2024-07-01$46.39$34.45RVU24C
2024-04-01$46.39$34.45RVU24B
2024-03-09$46.39$34.45RVU24AR
2024-01-01$45.63$33.88RVU24A
2023-10-01$45.63$33.69RVU23D
2023-07-01$45.63$33.69RVU23C
2023-04-01$45.63$33.69RVU23B
2023-01-01$45.63$33.69RVU23A
2022-10-01$42.29$32.71RVU22D
2022-07-01$42.29$32.71RVU22C
2022-04-01$42.29$32.71RVU22B
2022-01-01$42.29$32.71RVU22A
2021-10-01$42.16$32.50RVU21D
2021-07-01$42.16$32.50RVU21C
2021-04-01$42.16$32.50RVU21B
2021-01-01$42.16$32.50RVU21A
2020-10-01$43.73$33.85RVU20D
2020-07-01$43.73$33.85RVU20C
2020-04-01$43.73$33.85RVU20B
2020-01-01$43.73$33.85RVU20A
2019-10-01$50.63$35.99RVU19D
2019-07-01$50.63$35.99RVU19C
2019-04-01$50.63$35.99RVU19B
2019-01-01$50.63$35.99RVU19A
2018-10-01$43.89$36.58RVU18D
2018-07-01$43.89$36.58RVU18C
2018-04-01$43.89$36.58RVU18B
2018-01-01$43.89$36.58RVU18AR1
2017-10-01$40.88$36.03RVU17D
2017-07-01$40.88$36.03RVU17C
2017-04-01$40.88$36.03RVU17B
2017-01-01$40.88$36.03RVU17A
2016-10-01$39.83$35.01RVU16D
2016-07-01$39.83$35.01RVU16C
2016-04-01$39.83$35.01RVU16B
2016-01-01$39.83$35.01RVU16A
2015-10-01$41.42$36.58RVU15D
2015-07-01$41.42$36.58RVU15C
2015-04-01$41.22$36.40RVU15B
2015-01-01$41.22$36.40RVU15A
2014-10-01$39.74$34.93RVU14D
2014-07-01$39.74$34.93RVU14C
2014-04-01$39.74$34.93RVU14B
2014-01-01$39.74$34.93RVU14A
2013-10-01$39.43$32.15RVU13D
2013-07-01Rate data unavailableRate data unavailableRVU13C
2013-04-01Rate data unavailableRate data unavailableRVU13B
2013-01-01Rate data unavailableRate data unavailableRVU13AR

Price 90849 for an earlier date of service

Where the Santa Clara County, CA rate applies

Santa Clara County, CA is a Medicare payment area, not a city. Our Census mapping connects it to 24 cities and communities in California. Some span more than one payment area; confirm with the service ZIP.

  • San Jose
  • Santa Clara
  • Sunnyvale
  • Alum Rock
  • Burbank
  • Cambrian Park
  • Campbell
  • Cupertino

Browse all communities in California

90849 billing questions

How is 90849 different from group psychotherapy?

Use 90849 when multiple family units participate together in psychotherapy. Use 90853 for group psychotherapy that is not organized as a multiple-family session.

How many units should be reported?

Report the psychotherapy session, not a separate unit for each family or attendee. Document the group’s composition and the service provided.

How does 90849 differ from family psychotherapy?

90849 involves members of multiple families in the same session. Codes 90846 and 90847 describe family psychotherapy involving one family, with the patient absent or present, respectively.

What documentation supports 90849?

Record that multiple families participated, the clinical purpose of bringing them together, and the psychotherapy interventions provided. A general educational or informational meeting alone does not establish a psychotherapy service.

Is 90849 selected by session duration?

The code is not distinguished by a stated time increment. Document the service and session details in the clinical record.

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
RVUs for 90849PPRRVU2026_Oct_nonQPP.csv, line 11,540 (RVU26D)
Geographic factors for Santa Clara County, CAGPCI2026.csv, line 28 (RVU26D)

Open CMS sourceHow we calculate rates

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