CPT code 90849: Family group therapy, multiple families2026 Medicare rate & RVUs in Montana

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 Montana, Medicare pays $40.41 for 90849 in the office and $30.06 when it’s performed in a hospital or facility.

$40.41Office (non-facility)
$30.06Hospital or facility
−0.0%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 Montana
  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 Montana 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. Montana pays $40.41. The RVUs are the same everywhere; the geographic indexes change the dollars.

90849 in Montana vs other payment areas
  1. Montana · this page$40.41
  2. Los Angeles, CA · California$44.29+$3.88
  3. Washington, DC area · District of Columbia$44.79+$4.38
  4. Miami, FL · Florida$42.15+$1.74
  5. Chicago, IL · Illinois$41.52+$1.11
  6. Manhattan, NY · New York$45.05+$4.64
  7. Alaska · Alaska$52.43+$12.02

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

Every other payment area

90849 in every other Medicare payment locality
Payment localityOfficeFacility
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

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
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 Montana 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

71

Locality
Montana
Physician work
1.000
Practice expense
1.000
Malpractice
0.998
Office calculation for 90849 in Montana
ComponentRVULocality factorAdjusted
Physician work0.67× 1.0000.6700
Practice expense0.52× 1.0000.5200
Malpractice0.02× 0.9980.0200
Total RVUs1.2100
Conversion factor× 33.4009

Office rate, Montana$40.41

Office: (0.67 × 1 + 0.52 × 1 + 0.02 × 0.998) × $33.4009 = $40.41

Facility: (0.67 × 1 + 0.21 × 1 + 0.02 × 0.998) × $33.4009 = $30.06

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.

How 90849 has changed in Montana

90849 · Office / nonfacility

$40.41

Effective 2026-10-01

The base rate is $2.90 higher than on 2025-10-01, moving from $37.51 to $40.41 (7.7%).

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

    $37.51changed to$40.41

    • 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
    • Malpractice GPCI 0.978 changed to 0.998

    Held through RVU26B, RVU26C, RVU26D.

  2. January 1, 2025

    RVU25A

    $37.60changed to$37.51

    • 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

    $36.99changed to$37.60

    • Conversion factor 32.7442 changed to 33.2875

    Held through RVU24B, RVU24C, RVU24D.

  4. January 1, 2024

    RVU24A

    $37.26changed to$36.99

    • Conversion factor 33.8872 changed to 32.7442
    • Work RVU 0.59 changed to 0.62
  5. January 1, 2023

    RVU23A

    $35.28changed to$37.26

    • Conversion factor 34.6062 changed to 33.8872
    • Practice expense RVU 0.41 changed to 0.49
    • Malpractice GPCI 0.977 changed to 0.978

    Held through RVU23B, RVU23C, RVU23D.

  6. January 1, 2022

    RVU22A

    $35.23changed to$35.28

    • 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

    $37.03changed to$35.23

    • Conversion factor 36.0896 changed to 34.8931
    • Practice expense RVU 0.41 changed to 0.40
    • Malpractice GPCI 1.304 changed to 0.977

    Held through RVU21B, RVU21C, RVU21D.

  8. January 1, 2020

    RVU20A

    $42.62changed to$37.03

    • Conversion factor 36.0391 changed to 36.0896
    • Practice expense RVU 0.56 changed to 0.41
    • Malpractice GPCI 1.631 changed to 1.304

    Held through RVU20B, RVU20C, RVU20D.

  9. January 1, 2019

    RVU19A

    $38.12changed to$42.62

    • 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

    $35.63changed to$38.12

    • Conversion factor 35.8887 changed to 35.9996
    • Practice expense RVU 0.36 changed to 0.42
    • Malpractice GPCI 1.429 changed to 1.631

    Held through RVU18B, RVU18C, RVU18D.

  11. January 1, 2017

    RVU17A

    $34.61changed to$35.63

    • Conversion factor 35.8043 changed to 35.8887
    • Practice expense RVU 0.34 changed to 0.36
    • Malpractice GPCI 1.226 changed to 1.429

    Held through RVU17B, RVU17C, RVU17D.

  12. January 1, 2016

    RVU16A

    $35.82changed to$34.61

    • 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

    $35.64changed to$35.82

    • Conversion factor 35.7547 changed to 35.9335

    Held through RVU15D.

  14. January 1, 2015

    RVU15A

    $34.57changed to$35.64

    • Conversion factor 35.8228 changed to 35.7547
    • Practice expense RVU 0.34 changed to 0.37
    • Malpractice GPCI 1.165 changed to 1.226

    Held through RVU15B.

  15. January 1, 2014

    RVU14A

    $34.13changed to$34.57

    • Conversion factor 34.0230 changed to 35.8228
    • Practice expense RVU 0.38 changed to 0.34
    • Malpractice GPCI 1.103 changed to 1.165

    Held through RVU14B, RVU14C, RVU14D.

  16. January 1, 2013

    RVU13AR

    Earliest loaded release: $34.13

    Held through RVU13B, RVU13C, RVU13D.

Rates in every CMS release
Effective fromOfficeFacilityCMS release
2026-10-01$40.41$30.06RVU26D
2026-07-01$40.41$30.06RVU26C
2026-04-01$40.41$30.06RVU26B
2026-01-01$40.41$30.06RVU26A
2025-10-01$37.51$29.42RVU25D
2025-07-01$37.51$29.42RVU25C
2025-04-01$37.51$29.42RVU25B
2025-01-01$37.51$29.42RVU25A
2024-10-01$37.60$29.28RVU24D
2024-07-01$37.60$29.28RVU24C
2024-04-01$37.60$29.28RVU24B
2024-03-09$37.60$29.28RVU24AR
2024-01-01$36.99$28.80RVU24A
2023-10-01$37.26$28.79RVU23D
2023-07-01$37.26$28.79RVU23C
2023-04-01$37.26$28.79RVU23B
2023-01-01$37.26$28.79RVU23A
2022-10-01$35.28$28.36RVU22D
2022-07-01$35.28$28.36RVU22C
2022-04-01$35.28$28.36RVU22B
2022-01-01$35.28$28.36RVU22A
2021-10-01$35.23$28.25RVU21D
2021-07-01$35.23$28.25RVU21C
2021-04-01$35.23$28.25RVU21B
2021-01-01$35.23$28.25RVU21A
2020-10-01$37.03$29.81RVU20D
2020-07-01$37.03$29.81RVU20C
2020-04-01$37.03$29.81RVU20B
2020-01-01$37.03$29.81RVU20A
2019-10-01$42.62$31.81RVU19D
2019-07-01$42.62$31.81RVU19C
2019-04-01$42.62$31.81RVU19B
2019-01-01$42.62$31.81RVU19A
2018-10-01$38.12$32.72RVU18D
2018-07-01$38.12$32.72RVU18C
2018-04-01$38.12$32.72RVU18B
2018-01-01$38.12$32.72RVU18AR1
2017-10-01$35.63$32.04RVU17D
2017-07-01$35.63$32.04RVU17C
2017-04-01$35.63$32.04RVU17B
2017-01-01$35.63$32.04RVU17A
2016-10-01$34.61$31.03RVU16D
2016-07-01$34.61$31.03RVU16C
2016-04-01$34.61$31.03RVU16B
2016-01-01$34.61$31.03RVU16A
2015-10-01$35.82$32.22RVU15D
2015-07-01$35.82$32.22RVU15C
2015-04-01$35.64$32.06RVU15B
2015-01-01$35.64$32.06RVU15A
2014-10-01$34.57$30.98RVU14D
2014-07-01$34.57$30.98RVU14C
2014-04-01$34.57$30.98RVU14B
2014-01-01$34.57$30.98RVU14A
2013-10-01$34.13$28.68RVU13D
2013-07-01$34.13$28.68RVU13C
2013-04-01$34.13$28.68RVU13B
2013-01-01$34.13$28.68RVU13AR

Price 90849 for an earlier date of service

Where the Montana rate applies

Montana is a Medicare payment area, not a city. Our Census mapping connects it to 497 cities and communities in Montana. Some span more than one payment area; confirm with the service ZIP.

  • Absarokee
  • Acton
  • Alberton
  • Alder
  • Alzada
  • Amsterdam
  • Anaconda-Deer Lodge County
  • Antelope

Browse all communities in Montana

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 MontanaGPCI2026.csv, line 71 (RVU26D)

Open CMS sourceHow we calculate rates

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