CPT code 90849: Family group therapy, multiple families2026 Medicare rate & RVUs in Metropolitan Boston, MA
Report 90849 for a psychotherapy session in which a clinician works with members of multiple families together around shared behavioral or mental health concerns.
In Metropolitan Boston, MA, Medicare pays $44.63 for 90849 in the office and $32.27 when it’s performed in a hospital or facility.
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.
On this page 11 sections
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 Metropolitan Boston, MA 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. Metropolitan Boston, MA pays $44.63. The RVUs are the same everywhere; the geographic indexes change the dollars.
- Metropolitan Boston, MA · this page$44.63
- Rest of Massachusetts · Massachusetts$41.56−$3.07
- Los Angeles, CA · California$44.29−$0.34
- Washington, DC area · District of Columbia$44.79+$0.16
- Miami, FL · Florida$42.15−$2.48
- Chicago, IL · Illinois$41.52−$3.11
- Manhattan, NY · New York$45.05+$0.42
Other areas in Massachusetts first, then benchmark localities. Bars start at $0.
Every other payment area
| Payment locality | Office | Facility |
|---|---|---|
| AlaskaAlaska | $52.43 | $41.41 |
| AlabamaAlabama | $37.95 | $28.89 |
| ArkansasArkansas | $37.64 | $28.75 |
| ArizonaArizona | $39.78 | $29.75 |
| Bakersfield, CACalifornia | $42.25 | $30.90 |
| Chico, CACalifornia | $42.15 | $30.80 |
| El Centro, CACalifornia | $42.16 | $30.81 |
| Fresno, CACalifornia | $42.15 | $30.80 |
| Hanford, CACalifornia | $42.15 | $30.80 |
| 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 |
| Sacramento, CACalifornia | $43.74 | $31.70 |
| Salinas, CACalifornia | $43.56 | $31.56 |
| San Diego, CACalifornia | $44.18 | $31.80 |
| Marin County, CACalifornia | $49.30 | $34.70 |
| San Francisco, CACalifornia | $49.28 | $34.68 |
| San Benito County, CACalifornia | $50.24 | $35.31 |
| Santa Clara County, CACalifornia | $50.15 | $35.22 |
| San Luis Obispo, CACalifornia | $42.90 | $31.11 |
| Santa Cruz, CACalifornia | $44.31 | $31.73 |
| Santa Maria, CACalifornia | $43.61 | $31.54 |
| Santa Rosa, CACalifornia | $44.74 | $32.02 |
| Stockton, CACalifornia | $42.15 | $30.80 |
| Vallejo, CACalifornia | $46.99 | $33.34 |
| Visalia, CACalifornia | $42.15 | $30.80 |
| Yuba City, CACalifornia | $42.15 | $30.80 |
| ColoradoColorado | $41.65 | $30.63 |
| ConnecticutConnecticut | $42.34 | $31.19 |
| DelawareDelaware | $40.25 | $30.02 |
| Fort Lauderdale, FLFlorida | $41.18 | $30.69 |
| Rest of FloridaFlorida | $39.99 | $30.09 |
| Atlanta, GAGeorgia | $40.89 | $30.37 |
| Rest of GeorgiaGeorgia | $38.67 | $29.43 |
| Hawaii, Guam, HIHawaii | $42.51 | $30.74 |
| IowaIowa | $38.54 | $29.06 |
| IdahoIdaho | $38.67 | $29.15 |
| East St. Louis, ILIllinois | $39.70 | $30.18 |
| Rest of IllinoisIllinois | $39.28 | $29.83 |
| Suburban Chicago, ILIllinois | $41.56 | $30.92 |
| IndianaIndiana | $38.80 | $29.21 |
| KansasKansas | $38.42 | $29.06 |
| KentuckyKentucky | $38.43 | $29.23 |
| New Orleans, LALouisiana | $39.48 | $29.74 |
| Rest of LouisianaLouisiana | $38.39 | $29.23 |
| Baltimore area, MDMaryland | $42.20 | $31.09 |
| Rest of MarylandMaryland | $40.79 | $30.31 |
| Rest of MaineMaine | $38.77 | $29.25 |
| Southern Maine, MEMaine | $40.01 | $29.75 |
| Detroit, MIMichigan | $40.27 | $30.27 |
| Rest of MichiganMichigan | $38.99 | $29.54 |
| MinnesotaMinnesota | $40.45 | $29.79 |
| Metropolitan Kansas City, MOMissouri | $39.34 | $29.62 |
| Metropolitan St. Louis, MOMissouri | $39.58 | $29.73 |
| Rest of MissouriMissouri | $38.00 | $29.08 |
| MississippiMississippi | $37.83 | $28.91 |
| MontanaMontana | $40.41 | $30.06 |
| North CarolinaNorth Carolina | $39.01 | $29.35 |
| North DakotaNorth Dakota | $40.02 | $29.66 |
| NebraskaNebraska | $38.66 | $29.11 |
| New HampshireNew Hampshire | $41.04 | $30.26 |
| Northern New JerseyNew Jersey | $44.65 | $32.64 |
| Rest of New JerseyNew Jersey | $42.97 | $31.67 |
| New MexicoNew Mexico | $39.11 | $29.61 |
| NevadaNevada | $40.32 | $29.96 |
| NYC suburbs and Long Island, NYNew York | $45.70 | $33.39 |
| Poughkeepsie and northern NYC suburbs, NYNew York | $43.21 | $31.87 |
| Queens, NYNew York | $45.30 | $33.06 |
| Rest of New YorkNew York | $39.35 | $29.51 |
| OhioOhio | $38.91 | $29.46 |
| OklahomaOklahoma | $38.41 | $29.16 |
| Portland, OROregon | $42.53 | $31.03 |
| Rest of OregonOregon | $40.15 | $29.83 |
| Metropolitan Philadelphia, PAPennsylvania | $41.66 | $30.88 |
| Rest of PennsylvaniaPennsylvania | $38.95 | $29.45 |
| Puerto RicoPuerto Rico | $40.60 | $30.13 |
| Rhode IslandRhode Island | $41.34 | $30.65 |
| South CarolinaSouth Carolina | $38.99 | $29.43 |
| South DakotaSouth Dakota | $39.97 | $29.62 |
| TennesseeTennessee | $38.53 | $29.11 |
| Austin, TXTexas | $41.39 | $30.44 |
| Beaumont, TXTexas | $38.80 | $29.38 |
| Brazoria, TXTexas | $40.29 | $30.03 |
| Dallas, TXTexas | $40.45 | $30.14 |
| Fort Worth, TXTexas | $40.29 | $30.08 |
| Galveston, TXTexas | $40.36 | $30.08 |
| Houston, TXTexas | $40.72 | $30.44 |
| Rest of TexasTexas | $39.46 | $29.64 |
| UtahUtah | $39.30 | $29.57 |
| VirginiaVirginia | $39.92 | $29.75 |
| Virgin Islands, VIUnited States Virgin Islands | $40.60 | $30.13 |
| VermontVermont | $39.91 | $29.66 |
| Rest of WashingtonWashington | $41.47 | $30.56 |
| King County, WAWashington | $45.35 | $32.65 |
| WisconsinWisconsin | $39.22 | $29.30 |
| West VirginiaWest Virginia | $38.43 | $29.43 |
| WyomingWyoming | $40.24 | $29.89 |
90849 rates by state
Office rate range in each state. Select a state to see its payment localities.
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
| State / territory | Office rate range | Localities |
|---|---|---|
| AK | $52.43 | 1 |
| AL | $37.95 | 1 |
| AR | $37.64 | 1 |
| AZ | $39.78 | 1 |
| CA | $42.15–$50.24 | 29 |
| CO | $41.65 | 1 |
| CT | $42.34 | 1 |
| DC | $44.79 | 1 |
| DE | $40.25 | 1 |
| FL | $39.99–$42.15 | 3 |
| GA | $38.67–$40.89 | 2 |
| GU | $42.51 | 1 |
| HI | $42.51 | 1 |
| IA | $38.54 | 1 |
| ID | $38.67 | 1 |
| IL | $39.28–$41.56 | 4 |
| IN | $38.80 | 1 |
| KS | $38.42 | 1 |
| KY | $38.43 | 1 |
| LA | $38.39–$39.48 | 2 |
| MA | $41.56–$44.63 | 2 |
| MD | $40.79–$44.79 | 3 |
| ME | $38.77–$40.01 | 2 |
| MI | $38.99–$40.27 | 2 |
| MN | $40.45 | 1 |
| MO | $38.00–$39.58 | 3 |
| MS | $37.83 | 1 |
| MT | $40.41 | 1 |
| NC | $39.01 | 1 |
| ND | $40.02 | 1 |
| NE | $38.66 | 1 |
| NH | $41.04 | 1 |
| NJ | $42.97–$44.65 | 2 |
| NM | $39.11 | 1 |
| NV | $40.32 | 1 |
| NY | $39.35–$45.70 | 5 |
| OH | $38.91 | 1 |
| OK | $38.41 | 1 |
| OR | $40.15–$42.53 | 2 |
| PA | $38.95–$41.66 | 2 |
| PR | $40.60 | 1 |
| RI | $41.34 | 1 |
| SC | $38.99 | 1 |
| SD | $39.97 | 1 |
| TN | $38.53 | 1 |
| TX | $38.80–$41.39 | 8 |
| UT | $39.30 | 1 |
| VA | $39.92–$44.79 | 2 |
| VI | $40.60 | 1 |
| VT | $39.91 | 1 |
| WA | $41.47–$45.35 | 2 |
| WI | $39.22 | 1 |
| WV | $38.43 | 1 |
| WY | $40.24 | 1 |
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
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 Metropolitan Boston, MA 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
62
- Locality
- Metropolitan Boston, MA
- Physician work
- 1.041
- Practice expense
- 1.194
- Malpractice
- 0.890
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 0.67 | × 1.041 | 0.6975 |
| Practice expense | 0.52 | × 1.194 | 0.6209 |
| Malpractice | 0.02 | × 0.890 | 0.0178 |
| Total RVUs | 1.3362 | ||
| Conversion factor | × 33.4009 | ||
Office rate, Metropolitan Boston, MA$44.63
Office: (0.67 × 1.041 + 0.52 × 1.194 + 0.02 × 0.89) × $33.4009 = $44.63
Facility: (0.67 × 1.041 + 0.21 × 1.194 + 0.02 × 0.89) × $33.4009 = $32.27
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.
How 90849 has changed in Metropolitan Boston, MA
90849 · Office / nonfacility
$44.63
Effective 2026-10-01
The base rate is $3.17 higher than on 2025-10-01, moving from $41.46 to $44.63 (7.6%).
It is unchanged from the immediately preceding available release, effective 2026-07-01.
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
January 1, 2026
RVU26A
$41.46changed to$44.63
- 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 1.042 changed to 1.041
- Practice expense GPCI 1.197 changed to 1.194
- Malpractice GPCI 0.894 changed to 0.890
Held through RVU26B, RVU26C, RVU26D.
January 1, 2025
RVU25A
$41.62changed to$41.46
- Conversion factor 33.2875 changed to 32.3465
- Work RVU 0.62 changed to 0.65
Held through RVU25B, RVU25C, RVU25D.
March 9, 2024
RVU24AR
$40.94changed to$41.62
- Conversion factor 32.7442 changed to 33.2875
Held through RVU24B, RVU24C, RVU24D.
January 1, 2024
RVU24A
$41.41changed to$40.94
- Conversion factor 33.8872 changed to 32.7442
- Work RVU 0.59 changed to 0.62
- Work GPCI 1.045 changed to 1.042
- Practice expense GPCI 1.200 changed to 1.197
- Malpractice GPCI 0.868 changed to 0.894
January 1, 2023
RVU23A
$39.07changed to$41.41
- Conversion factor 34.6062 changed to 33.8872
- Practice expense RVU 0.41 changed to 0.49
- Work GPCI 1.049 changed to 1.045
- Practice expense GPCI 1.203 changed to 1.200
- Malpractice GPCI 0.842 changed to 0.868
Held through RVU23B, RVU23C, RVU23D.
January 1, 2022
RVU22A
$38.97changed to$39.07
- Conversion factor 34.8931 changed to 34.6062
- Practice expense RVU 0.40 changed to 0.41
Held through RVU22B, RVU22C, RVU22D.
January 1, 2021
RVU21A
$40.48changed to$38.97
- Conversion factor 36.0896 changed to 34.8931
- Practice expense RVU 0.41 changed to 0.40
- Work GPCI 1.041 changed to 1.049
- Practice expense GPCI 1.191 changed to 1.203
- Malpractice GPCI 0.952 changed to 0.842
Held through RVU21B, RVU21C, RVU21D.
January 1, 2020
RVU20A
$46.52changed to$40.48
- Conversion factor 36.0391 changed to 36.0896
- Practice expense RVU 0.56 changed to 0.41
- Work GPCI 1.033 changed to 1.041
- Practice expense GPCI 1.179 changed to 1.191
- Malpractice GPCI 1.061 changed to 0.952
Held through RVU20B, RVU20C, RVU20D.
January 1, 2019
RVU19A
$40.91changed to$46.52
- 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.
January 1, 2018
RVU18AR1
$37.74changed to$40.91
- Conversion factor 35.8887 changed to 35.9996
- Practice expense RVU 0.36 changed to 0.42
- Work GPCI 1.025 changed to 1.033
- Practice expense GPCI 1.171 changed to 1.179
- Malpractice GPCI 0.839 changed to 1.061
Held through RVU18B, RVU18C, RVU18D.
January 1, 2017
RVU17A
$36.30changed to$37.74
- Conversion factor 35.8043 changed to 35.8887
- Practice expense RVU 0.34 changed to 0.36
- Work GPCI 1.017 changed to 1.025
- Practice expense GPCI 1.163 changed to 1.171
- Malpractice GPCI 0.617 changed to 0.839
Held through RVU17B, RVU17C, RVU17D.
January 1, 2016
RVU16A
$37.69changed to$36.30
- Conversion factor 35.9335 changed to 35.8043
- Practice expense RVU 0.37 changed to 0.34
Held through RVU16B, RVU16C, RVU16D.
July 1, 2015
RVU15C
$37.50changed to$37.69
- Conversion factor 35.7547 changed to 35.9335
Held through RVU15D.
January 1, 2015
RVU15A
$36.31changed to$37.50
- Conversion factor 35.8228 changed to 35.7547
- Practice expense RVU 0.34 changed to 0.37
- Work GPCI 1.016 changed to 1.017
- Practice expense GPCI 1.156 changed to 1.163
- Malpractice GPCI 0.704 changed to 0.617
Held through RVU15B.
January 1, 2014
RVU14A
No ratechanged to$36.31
Held through RVU14B, RVU14C, RVU14D.
January 1, 2013
RVU13AR
Earliest loaded release: No rate
Held through RVU13B, RVU13C, RVU13D.
| Effective from | Office | Facility | CMS release |
|---|---|---|---|
| 2026-10-01 | $44.63 | $32.27 | RVU26D |
| 2026-07-01 | $44.63 | $32.27 | RVU26C |
| 2026-04-01 | $44.63 | $32.27 | RVU26B |
| 2026-01-01 | $44.63 | $32.27 | RVU26A |
| 2025-10-01 | $41.46 | $31.78 | RVU25D |
| 2025-07-01 | $41.46 | $31.78 | RVU25C |
| 2025-04-01 | $41.46 | $31.78 | RVU25B |
| 2025-01-01 | $41.46 | $31.78 | RVU25A |
| 2024-10-01 | $41.62 | $31.66 | RVU24D |
| 2024-07-01 | $41.62 | $31.66 | RVU24C |
| 2024-04-01 | $41.62 | $31.66 | RVU24B |
| 2024-03-09 | $41.62 | $31.66 | RVU24AR |
| 2024-01-01 | $40.94 | $31.15 | RVU24A |
| 2023-10-01 | $41.41 | $31.24 | RVU23D |
| 2023-07-01 | $41.41 | $31.24 | RVU23C |
| 2023-04-01 | $41.41 | $31.24 | RVU23B |
| 2023-01-01 | $41.41 | $31.24 | RVU23A |
| 2022-10-01 | $39.07 | $30.74 | RVU22D |
| 2022-07-01 | $39.07 | $30.74 | RVU22C |
| 2022-04-01 | $39.07 | $30.74 | RVU22B |
| 2022-01-01 | $39.07 | $30.74 | RVU22A |
| 2021-10-01 | $38.97 | $30.58 | RVU21D |
| 2021-07-01 | $38.97 | $30.58 | RVU21C |
| 2021-04-01 | $38.97 | $30.58 | RVU21B |
| 2021-01-01 | $38.97 | $30.58 | RVU21A |
| 2020-10-01 | $40.48 | $31.88 | RVU20D |
| 2020-07-01 | $40.48 | $31.88 | RVU20C |
| 2020-04-01 | $40.48 | $31.88 | RVU20B |
| 2020-01-01 | $40.48 | $31.88 | RVU20A |
| 2019-10-01 | $46.52 | $33.78 | RVU19D |
| 2019-07-01 | $46.52 | $33.78 | RVU19C |
| 2019-04-01 | $46.52 | $33.78 | RVU19B |
| 2019-01-01 | $46.52 | $33.78 | RVU19A |
| 2018-10-01 | $40.91 | $34.55 | RVU18D |
| 2018-07-01 | $40.91 | $34.55 | RVU18C |
| 2018-04-01 | $40.91 | $34.55 | RVU18B |
| 2018-01-01 | $40.91 | $34.55 | RVU18AR1 |
| 2017-10-01 | $37.74 | $33.53 | RVU17D |
| 2017-07-01 | $37.74 | $33.53 | RVU17C |
| 2017-04-01 | $37.74 | $33.53 | RVU17B |
| 2017-01-01 | $37.74 | $33.53 | RVU17A |
| 2016-10-01 | $36.30 | $32.14 | RVU16D |
| 2016-07-01 | $36.30 | $32.14 | RVU16C |
| 2016-04-01 | $36.30 | $32.14 | RVU16B |
| 2016-01-01 | $36.30 | $32.14 | RVU16A |
| 2015-10-01 | $37.69 | $33.51 | RVU15D |
| 2015-07-01 | $37.69 | $33.51 | RVU15C |
| 2015-04-01 | $37.50 | $33.34 | RVU15B |
| 2015-01-01 | $37.50 | $33.34 | RVU15A |
| 2014-10-01 | $36.31 | $32.17 | RVU14D |
| 2014-07-01 | $36.31 | $32.17 | RVU14C |
| 2014-04-01 | $36.31 | $32.17 | RVU14B |
| 2014-01-01 | $36.31 | $32.17 | RVU14A |
| 2013-10-01 | Rate data unavailable | Rate data unavailable | RVU13D |
| 2013-07-01 | Rate data unavailable | Rate data unavailable | RVU13C |
| 2013-04-01 | Rate data unavailable | Rate data unavailable | RVU13B |
| 2013-01-01 | Rate data unavailable | Rate data unavailable | RVU13AR |
Where the Metropolitan Boston, MA rate applies
Metropolitan Boston, MA is a Medicare payment area, not a city. Our Census mapping connects it to 60 cities and communities in Massachusetts. Some span more than one payment area; confirm with the service ZIP.
- Boston
- Arlington
- Ayer
- Bellingham
- Belmont
- Braintree Town
- Brookline
- Burlington
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
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