| Category | Amount |
|---|---|
| Medicare Allowed Rate What Medicare approves for this service | $103.72 |
| Typical Billed Amount What providers commonly charge | $130 – $300 |
| Potential Markup How much more you might pay vs. Medicare rate | 189% above Medicare |
What CPT Code 90846 Means and When It's Used
CPT code 90846 represents a 50-minute family psychotherapy session where you, the patient, are not present. During these sessions, your therapist works directly with your family members, spouse, or other significant people in your life to address issues related to your mental health treatment.
Your therapist might use this approach when family dynamics are affecting your progress, when loved ones need guidance on how to support you, or when family members are struggling to cope with your condition. These sessions are particularly common in treating conditions like addiction, eating disorders, depression, or behavioral issues in children and teens.
It's important to note that even though you're not in the room, these sessions are still part of your treatment plan and require your consent. The therapist will typically share relevant insights from these sessions with you during your individual appointments.
How Billing Works for CPT Code 90846
When you see CPT code 90846 on your medical bill, you're being charged for a 50-minute family therapy session. The Medicare reimbursement rate for this service is $103.72, though you'll typically see charges ranging from $130 to $300 depending on your location and provider.
Your insurance coverage for family therapy sessions varies by plan. Some insurance companies cover these sessions at the same rate as individual therapy, while others may have different copays or require higher deductibles. It's worth checking with your insurance provider about your specific benefits for family therapy services.
You should expect to see this charge appear on your bill even if you didn't attend the session yourself, since the service is still part of your treatment plan. The billing will typically show your name as the patient, the date of service, and the CPT code 90846 with the associated charge.
How to Verify Your CPT 90846 Charges Are Correct
To check if your CPT 90846 billing is accurate, first confirm that a family therapy session actually took place on the date listed. Check your appointment records or ask your family members who attended the session. The session should have lasted approximately 50 minutes to justify this specific code.
Compare the charged amount to typical rates in your area. If you're seeing charges significantly above $300 or if multiple CPT 90846 codes appear for the same date, contact your provider's billing department for clarification. Sometimes billing errors occur when similar codes like 90847 (family therapy with patient present) are confused.
If you believe you've been incorrectly billed, gather your documentation including appointment schedules and insurance information, then contact your provider's billing department first. If the issue isn't resolved, you can also reach out to your insurance company for assistance. Keep detailed records of all communications about billing disputes, including dates, names of representatives you spoke with, and reference numbers.