How To Use CPT Code 90846

CPT 90846 refers to family psychotherapy without the patient present, focusing on counseling the family on psychological issues affecting the patient. This article will cover the description, procedure, qualifying circumstances, usage, documentation requirements, billing guidelines, historical information, similar codes, and examples of CPT 90846.

1. What is CPT 90846?

CPT 90846 is a code used to describe family psychotherapy sessions where the patient is not present. The primary focus of these sessions is to counsel the family members on the psychological issues affecting the patient and how their responses and interactions can either negatively or positively impact the patient’s well-being. This type of therapy aims to improve the patient’s care and treatment by involving the family in the therapeutic process.

2. 90846 CPT code description

The official description of CPT code 90846 is: “Family psychotherapy (without the patient present), 50 minutes.”

3. Procedure

The 90846 procedure involves the following steps:

  1. The therapist conducts an initial assessment of the family’s needs and dynamics.
  2. Therapist and family members discuss the patient’s psychological issues and their impact on the family.
  3. The therapist educates the family on effective communication and conflict resolution strategies.
  4. Family members are encouraged to share their feelings and experiences related to the patient’s condition.
  5. The therapist helps the family develop a plan to support the patient’s treatment and recovery.
  6. Regular follow-up sessions are scheduled to monitor progress and address any ongoing concerns.

4. Qualifying circumstances

Individuals eligible to receive CPT code 90846 services include family members, significant others involved in the patient’s care, or live-in companions. The patient must have a diagnosed mental or emotional health condition that requires family involvement in the treatment process. The therapist providing the service must be a qualified psychotherapist or healthcare provider with appropriate training and experience in family psychotherapy.

5. When to use CPT code 90846

It is appropriate to bill the 90846 CPT code when a qualified provider conducts a family psychotherapy session without the patient present, focusing on the psychological issues affecting the patient and the family’s role in the patient’s treatment. The session must last for at least 50 minutes to qualify for billing under this code.

6. Documentation requirements

To support a claim for CPT 90846, the following information must be documented:

  • Patient’s diagnosis and the need for family involvement in treatment
  • Names and relationships of the family members present during the session
  • Date, duration, and location of the session
  • Specific issues discussed during the session and their relevance to the patient’s treatment
  • Interventions and strategies provided by the therapist
  • Progress made during the session and any follow-up plans

7. Billing guidelines

When billing for CPT code 90846, ensure that the session meets the required 50-minute duration and is conducted by a qualified provider. It is essential to maintain accurate and detailed documentation of the session, including the patient’s diagnosis, family members present, and the specific issues addressed. Additionally, be aware of any payer-specific guidelines or requirements related to billing for family psychotherapy services.

8. Historical information

CPT 90846 was added to the Current Procedural Terminology system on January 1, 1990. The code was updated on January 1, 2017, with the previous descriptor being “Family psychotherapy (without the patient present).”

9. Similar codes to CPT 90846

Five similar codes to CPT 90846 include:

  • CPT 90847: Family psychotherapy with the patient present, focusing on both the patient and family members’ psychological issues.
  • CPT 90832: Individual psychotherapy, 30 minutes, addressing the patient’s specific mental health concerns.
  • CPT 90834: Individual psychotherapy, 45 minutes, providing a longer session for more in-depth exploration of the patient’s issues.
  • CPT 90837: Individual psychotherapy, 60 minutes, offering an extended session for complex cases or intensive treatment needs.
  • CPT 90853: Group psychotherapy, involving multiple patients with similar issues, providing peer support and shared learning experiences.

10. Examples

Here are 10 detailed examples of CPT code 90846 procedures:

  1. A therapist meets with the parents of a child diagnosed with ADHD to discuss strategies for managing the child’s behavior at home and school.
  2. A provider counsels the spouse of a patient with depression on how to support their partner’s recovery and maintain their own well-being.
  3. A therapist meets with the adult children of an elderly patient with dementia to address concerns about caregiving and long-term care planning.
  4. A provider conducts a session with the siblings of a patient with an eating disorder to discuss the impact of the disorder on family dynamics and relationships.
  5. A therapist meets with the parents of a teenager with substance abuse issues to develop a plan for supporting the teen’s recovery and preventing relapse.
  6. A provider counsels the family of a patient with bipolar disorder on effective communication strategies and coping mechanisms for managing mood swings.
  7. A therapist meets with the parents of a child with autism to address concerns about social skills development and educational support.
  8. A provider conducts a session with the family of a patient with PTSD to discuss the impact of trauma on the family and strategies for supporting the patient’s healing process.
  9. A therapist meets with the spouse and adult children of a patient with schizophrenia to address concerns about medication management and crisis intervention.
  10. A provider counsels the family of a patient with an anxiety disorder on strategies for managing stress and promoting a supportive home environment.

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