Billing code 90847: Family therapyMedicare rate & RVUs in Guam
Report 90847 for a 50-minute family psychotherapy session involving the patient and family members to address the patient’s behavioral health treatment needs.
Medicare pays $111.10 for 90847 in the office in Guam (Hawaii, Guam). Which amount applies depends on the service address.
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 9 sections
What 90847 covers
This service is conjoint psychotherapy: the patient participates with one or more family members, such as a spouse, parent, or caregiver. The clinician works with the family on interaction patterns, communication, or other relationship issues relevant to the patient’s mental health treatment. Psychiatrists, psychologists, clinical social workers, and other qualified behavioral health clinicians may provide it in office or facility settings. A typical situation is a session with a patient and parent focused on family responses affecting the patient’s symptoms or treatment progress.
Report 90847 when the patient is present and the session is family psychotherapy, rather than individual therapy with a relative merely providing collateral information. The record should identify participants, document the therapeutic focus and interventions, connect the work to the patient’s treatment, and support the session duration. Choose 90846 when the patient is absent; choose group codes when treatment is delivered to multiple families or a psychotherapy group. The service is reported for the family psychotherapy session, not separately for each participant.
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.
90847 in Hawaii, Guam
| Payment locality | Office | Facility |
|---|---|---|
| Hawaii, Guam | $111.10 | $103.51 |
How the 90847 rate is calculated
Each of 90847’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 · 90847
RVUs × geographic indexes × conversion factor
Work2.86
2.86 RVUs× 1.000 GPCI
Practice expense0.40
0.40 RVUs× 1.000 GPCI
Malpractice0.02
0.02 RVUs× 1.000 GPCI
Adjusted RVUs
3.2800
Conversion factor
$33.4009
Medicare rate
$109.55
Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.
Payment rules and modifiers for 90847
90847 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 · 90847
Which rate does Medicare pay?
The POS code on the claim line (CMS-1500 box 24B).
POS 11 · non-facility rate · national
$109.55
- Non-facility (office)
- $109.55
- Facility
- $102.87
Higher because the practice carries its own overhead.
90847 compared with similar codes
Compare codes · National
5 codes, side by side
How to choose
- 90846Family psytx w/o pt 50 min
- Use 90847 when the patient participates in family psychotherapy; use 90846 when the family session occurs without the patient.
- 90849Family group therapy
- 90849 is for psychotherapy involving multiple families together. 90847 is for the patient and the patient’s family.
- 90853Group psychotherapy
- 90853 describes group psychotherapy, not a conjoint session focused on the patient and the patient’s family.
- 90834Psychotherapy session
- 90834 is individual psychotherapy with the patient. 90847 is family psychotherapy with the patient and family members participating.
90847 billing questions
Must the patient be present for 90847?
Yes. The patient participates in the family psychotherapy session. When the family meets with the clinician without the patient, consider 90846 instead.
How does 90847 differ from 90846?
90847 is for family psychotherapy with the patient present; 90846 is for family psychotherapy without the patient.
Should the code be reported once for each family member?
No. Report one service for the family psychotherapy session, rather than separate units for each participant.
What should the note support?
Document who attended, the family-focused therapeutic work, its relationship to the patient’s treatment, and the session duration.
When is 90849 a better fit?
Use 90849 when psychotherapy is conducted with multiple families together. 90847 describes a session with the patient and the patient’s family.
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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