Billing code 90849: Family group therapyMedicare rate & RVUs in Illinois
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 $39.28–$41.56 for 90849 in the office in Illinois, from Rest Of Illinois to Suburban Chicago. 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 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 in Illinois
The same RVUs, adjusted for each area’s costs. Open a locality for its calculation, history and nearby areas.
4 payment localities
$39.28 to $41.56
| Payment locality | Office | Facility |
|---|---|---|
| Chicago | $41.52 | $31.12 |
| East St. Louis | $39.70 | $30.18 |
| Rest Of Illinois | $39.28 | $29.83 |
| Suburban Chicago | $41.56 | $30.92 |
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
Swap in your local Medicare rate.
Work 0.67Practice expense 0.52Malpractice 0.02
All indexes start 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).
Non-facility (office) rate · national
$40.42
The facility rate would be $30.06 (+$10.36). In a facility, the facility bills its own costs separately.
90849 compared with similar codes
Compare codes
90849 vs 90853 vs 90846 vs 90847: national Medicare rates
Swap in your local Medicare rate.
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
Fee sheets
Put 90849 and the rest of your codes on one sheet
Build a fee sheet from your own code list at your locality, put your payer contracts beside Medicare, and see what changed each quarter.
Build my fee sheetOr price your code list free →