Billing code 90849: Family group therapyMedicare rate & RVUs
Report 90849 for a psychotherapy session in which a clinician works with members of multiple families together around shared behavioral or mental health concerns.
Medicare pays $40.42 for 90849 nationally in the office and $30.06 in a hospital or facility. Local office rates run $37.64–$52.43.
Medicare rate · 90849
Family group therapy
- Work RVUs
- 0.67
- Total RVUs
- 1.21
- Global days
- XXX
National rate · 2026
$40.42
Office setting, before claim adjustments.
See every locality for 90849 →Billed by an NP, PA or therapist? →
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 10 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.
Where 90849 pays more and less
The same RVUs, adjusted for each area’s costs. Open a locality for its calculation, history and nearby areas.
109 payment localities
$37.64 to $52.43
109 of 109 payment localities
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.
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.
90849 compared with similar codes
Compare codes · National
4 codes, side by side
How to choose
- 90853Group psychotherapy
- 90849 is for psychotherapy with multiple families participating together. 90853 is group psychotherapy without that multiple-family structure.
- 90846Family psytx w/o pt 50 min
- 90846 describes psychotherapy with one family when the patient is absent; 90849 brings multiple families together in one session.
- 90847Family therapy
- 90847 describes psychotherapy with one family when the patient is present. Choose 90849 when members of multiple families participate together.
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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