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

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 Nevada, Medicare pays $40.32 for 90849 in the office and $29.96 when it’s performed in a hospital or facility.

$40.32Office (non-facility)
$29.96Hospital or facility
−0.2%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 Nevada
  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 Nevada 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. Nevada pays $40.32. The RVUs are the same everywhere; the geographic indexes change the dollars.

90849 in Nevada vs other payment areas
  1. Nevada · this page$40.32
  2. Los Angeles, CA · California$44.29+$3.97
  3. Washington, DC area · District of Columbia$44.79+$4.47
  4. Miami, FL · Florida$42.15+$1.83
  5. Chicago, IL · Illinois$41.52+$1.20
  6. Manhattan, NY · New York$45.05+$4.73
  7. Alaska · Alaska$52.43+$12.11

Other areas in Nevada 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 Nevada 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

73

Locality
Nevada
Physician work
1.000
Practice expense
1.001
Malpractice
0.833
Office calculation for 90849 in Nevada
ComponentRVULocality factorAdjusted
Physician work0.67× 1.0000.6700
Practice expense0.52× 1.0010.5205
Malpractice0.02× 0.8330.0167
Total RVUs1.2072
Conversion factor× 33.4009

Office rate, Nevada$40.32

Office: (0.67 × 1 + 0.52 × 1.001 + 0.02 × 0.833) × $33.4009 = $40.32

Facility: (0.67 × 1 + 0.21 × 1.001 + 0.02 × 0.833) × $33.4009 = $29.96

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 Nevada

90849 · Office / nonfacility

$40.32

Effective 2026-10-01

The base rate is $2.90 higher than on 2025-10-01, moving from $37.42 to $40.32 (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

    $37.42changed to$40.32

    • 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
    • Practice expense GPCI 1.000 changed to 1.001
    • Malpractice GPCI 0.844 changed to 0.833

    Held through RVU26B, RVU26C, RVU26D.

  2. January 1, 2025

    RVU25A

    $37.51changed to$37.42

    • 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

    $36.90changed to$37.51

    • Conversion factor 32.7442 changed to 33.2875

    Held through RVU24B, RVU24C, RVU24D.

  4. January 1, 2024

    RVU24A

    $37.34changed to$36.90

    • Conversion factor 33.8872 changed to 32.7442
    • Work RVU 0.59 changed to 0.62
    • Malpractice GPCI 1.098 changed to 0.844
  5. January 1, 2023

    RVU23A

    $35.64changed to$37.34

    • Conversion factor 34.6062 changed to 33.8872
    • Practice expense RVU 0.41 changed to 0.49
    • Work GPCI 1.005 changed to 1.000
    • Malpractice GPCI 1.351 changed to 1.098

    Held through RVU23B, RVU23C, RVU23D.

  6. January 1, 2022

    RVU22A

    $35.59changed to$35.64

    • 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

    $36.99changed to$35.59

    • Conversion factor 36.0896 changed to 34.8931
    • Practice expense RVU 0.41 changed to 0.40
    • Work GPCI 1.004 changed to 1.005
    • Malpractice GPCI 1.130 changed to 1.351

    Held through RVU21B, RVU21C, RVU21D.

  8. January 1, 2020

    RVU20A

    $42.49changed to$36.99

    • Conversion factor 36.0391 changed to 36.0896
    • Practice expense RVU 0.56 changed to 0.41
    • Work GPCI 1.002 changed to 1.004
    • Practice expense GPCI 1.017 changed to 1.000
    • Malpractice GPCI 0.909 changed to 1.130

    Held through RVU20B, RVU20C, RVU20D.

  9. January 1, 2019

    RVU19A

    $37.64changed to$42.49

    • 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

    $35.64changed to$37.64

    • Conversion factor 35.8887 changed to 35.9996
    • Practice expense RVU 0.36 changed to 0.42
    • Work GPCI 1.004 changed to 1.002
    • Practice expense GPCI 1.034 changed to 1.017
    • Malpractice GPCI 0.946 changed to 0.909

    Held through RVU18B, RVU18C, RVU18D.

  11. January 1, 2017

    RVU17A

    $35.08changed to$35.64

    • Conversion factor 35.8043 changed to 35.8887
    • Practice expense RVU 0.34 changed to 0.36
    • Work GPCI 1.005 changed to 1.004
    • Practice expense GPCI 1.051 changed to 1.034
    • Malpractice GPCI 0.982 changed to 0.946

    Held through RVU17B, RVU17C, RVU17D.

  12. January 1, 2016

    RVU16A

    $36.34changed to$35.08

    • 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

    $36.16changed to$36.34

    • Conversion factor 35.7547 changed to 35.9335

    Held through RVU15D.

  14. January 1, 2015

    RVU15A

    $35.20changed to$36.16

    • Conversion factor 35.8228 changed to 35.7547
    • Practice expense RVU 0.34 changed to 0.37
    • Work GPCI 1.001 changed to 1.005
    • Practice expense GPCI 1.055 changed to 1.051
    • Malpractice GPCI 1.107 changed to 0.982

    Held through RVU15B.

  15. January 1, 2014

    RVU14A

    $35.01changed to$35.20

    • Conversion factor 34.0230 changed to 35.8228
    • Practice expense RVU 0.38 changed to 0.34
    • Work GPCI 1.000 changed to 1.001
    • Practice expense GPCI 1.058 changed to 1.055
    • Malpractice GPCI 1.232 changed to 1.107

    Held through RVU14B, RVU14C, RVU14D.

  16. October 1, 2013

    RVU13D

    No ratechanged to$35.01

  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$40.32$29.96RVU26D
2026-07-01$40.32$29.96RVU26C
2026-04-01$40.32$29.96RVU26B
2026-01-01$40.32$29.96RVU26A
2025-10-01$37.42$29.33RVU25D
2025-07-01$37.42$29.33RVU25C
2025-04-01$37.42$29.33RVU25B
2025-01-01$37.42$29.33RVU25A
2024-10-01$37.51$29.19RVU24D
2024-07-01$37.51$29.19RVU24C
2024-04-01$37.51$29.19RVU24B
2024-03-09$37.51$29.19RVU24AR
2024-01-01$36.90$28.71RVU24A
2023-10-01$37.34$28.87RVU23D
2023-07-01$37.34$28.87RVU23C
2023-04-01$37.34$28.87RVU23B
2023-01-01$37.34$28.87RVU23A
2022-10-01$35.64$28.72RVU22D
2022-07-01$35.64$28.72RVU22C
2022-04-01$35.64$28.72RVU22B
2022-01-01$35.64$28.72RVU22A
2021-10-01$35.59$28.61RVU21D
2021-07-01$35.59$28.61RVU21C
2021-04-01$35.59$28.61RVU21B
2021-01-01$35.59$28.61RVU21A
2020-10-01$36.99$29.77RVU20D
2020-07-01$36.99$29.77RVU20C
2020-04-01$36.99$29.77RVU20B
2020-01-01$36.99$29.77RVU20A
2019-10-01$42.49$31.49RVU19D
2019-07-01$42.49$31.49RVU19C
2019-04-01$42.49$31.49RVU19B
2019-01-01$42.49$31.49RVU19A
2018-10-01$37.64$32.15RVU18D
2018-07-01$37.64$32.15RVU18C
2018-04-01$37.64$32.15RVU18B
2018-01-01$37.64$32.15RVU18AR1
2017-10-01$35.64$31.93RVU17D
2017-07-01$35.64$31.93RVU17C
2017-04-01$35.64$31.93RVU17B
2017-01-01$35.64$31.93RVU17A
2016-10-01$35.08$31.32RVU16D
2016-07-01$35.08$31.32RVU16C
2016-04-01$35.08$31.32RVU16B
2016-01-01$35.08$31.32RVU16A
2015-10-01$36.34$32.56RVU15D
2015-07-01$36.34$32.56RVU15C
2015-04-01$36.16$32.40RVU15B
2015-01-01$36.16$32.40RVU15A
2014-10-01$35.20$31.42RVU14D
2014-07-01$35.20$31.42RVU14C
2014-04-01$35.20$31.42RVU14B
2014-01-01$35.20$31.42RVU14A
2013-10-01$35.01$29.25RVU13D
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 Nevada rate applies

Nevada is a Medicare payment area, not a city. Our Census mapping connects it to 138 cities and communities in Nevada. Some span more than one payment area; confirm with the service ZIP.

  • Alamo
  • Amargosa Valley
  • Austin
  • Baker
  • Battle Mountain
  • Beatty
  • Beaverdam
  • Bennett Springs

Browse all communities in Nevada

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 NevadaGPCI2026.csv, line 73 (RVU26D)

Open CMS sourceHow we calculate rates

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