How To Use CPT Code 90846

CPT 90846 refers to family psychotherapy conducted without the patient present, lasting for 50 minutes. This therapeutic approach is designed to engage family members in discussions about the psychological issues affecting the patient, providing them with insights and strategies to support the patient’s mental health. The absence of the patient allows family members to express their concerns and feelings freely, fostering a supportive environment for understanding and healing.

1. What is CPT code 90846?

CPT code 90846 represents a specific type of psychotherapy focused on the family unit rather than the individual patient. This code is utilized when a qualified mental health provider meets with the family of a patient to discuss the psychological challenges faced by the patient and how these issues impact the family dynamics. The primary purpose of this session is to educate and counsel family members, helping them understand the patient’s condition and the role they can play in the patient’s treatment and recovery. This form of therapy recognizes that mental health issues often affect not just the individual but also their loved ones, making family involvement crucial in the therapeutic process.

2. Qualifying Circumstances

This CPT code can be used in situations where family members require guidance on how to support a patient dealing with mental health issues. It is appropriate when the patient is unable to attend the session, whether due to their condition, logistical issues, or other reasons. The provider must ensure that the focus remains on the family’s understanding and involvement in the patient’s care. However, it is important to note that this code should not be used if the patient is present during the session, as the dynamics and focus would differ significantly. Additionally, this code is not applicable for individual therapy sessions or when the provider is addressing issues unrelated to the patient’s mental health.

3. When To Use CPT 90846

CPT 90846 is used when a provider conducts a psychotherapy session specifically with the family of a patient, without the patient being present. This code is particularly relevant in cases where family dynamics are contributing to the patient’s mental health challenges, or when the family needs support in understanding the patient’s condition. It is essential to document the session’s focus on the family’s role in the patient’s treatment. This code should not be used in conjunction with codes that indicate individual therapy sessions, as the therapeutic focus and objectives differ significantly. Providers must ensure that the session is dedicated to family counseling and not a substitute for individual therapy.

4. Official Description of CPT 90846

Official Descriptor: Family psychotherapy (without the patient present), 50 minutes.

5. Clinical Application

CPT 90846 is applied in clinical settings where family involvement is crucial for the patient’s mental health treatment. The session aims to address the psychological issues affecting the patient while simultaneously educating family members on how their interactions and support can influence the patient’s recovery. This approach acknowledges the interconnectedness of family relationships and mental health, emphasizing the importance of a supportive environment for the patient. By engaging family members in therapy, providers can facilitate better communication, understanding, and conflict resolution within the family, ultimately benefiting the patient’s overall treatment plan.

5.1 Provider Responsibilities

During the session, the provider’s responsibilities include creating a safe and supportive environment for family members to express their thoughts and feelings. The provider will guide the discussion, focusing on the patient’s psychological issues and how family dynamics may contribute to or alleviate these challenges. The provider may utilize various therapeutic techniques to facilitate communication among family members, helping them understand their roles in the patient’s care. Additionally, the provider will assess the family’s needs and concerns, offering strategies for effective support and interaction with the patient.

5.2 Unique Challenges

One of the unique challenges associated with family psychotherapy is managing differing perspectives and emotions among family members. Each individual may have their own experiences and feelings regarding the patient’s condition, which can lead to conflict or misunderstanding. The provider must navigate these complexities, ensuring that all voices are heard while maintaining a focus on the patient’s well-being. Additionally, the absence of the patient can sometimes lead to discussions that may not fully capture the patient’s perspective, making it essential for the provider to encourage open communication and honesty among family members.

5.3 Pre-Procedure Preparations

Before conducting a session under CPT 90846, the provider should gather relevant information about the patient’s mental health history and current challenges. This may involve reviewing previous treatment notes, assessments, and any other documentation that can inform the discussion. The provider may also need to prepare the family by explaining the purpose of the session and what to expect, ensuring that they feel comfortable and ready to engage in the therapeutic process.

5.4 Post-Procedure Considerations

After the session, the provider should document the key points discussed, including family members’ concerns and any strategies or recommendations provided. Follow-up may be necessary to assess the family’s progress in implementing the discussed strategies and to address any new issues that may arise. The provider may also recommend additional sessions if needed, to continue supporting the family and enhancing their involvement in the patient’s treatment.

6. Relevant Terminology

Psychotherapy: A therapeutic interaction between a trained professional and a patient, focusing on issues related to mood, behavior, feelings, and thoughts. It aims to improve the patient’s mental health through various techniques and discussions.

Family Dynamics: The patterns of interaction and relationships among family members, which can significantly influence an individual’s mental health and well-being.

Conflict Resolution: The process of resolving disagreements or conflicts among individuals, often involving communication and negotiation skills to reach a mutually acceptable solution.

7. Clinical Examples

1. A mother and father attend a session to discuss their teenage daughter’s anxiety, exploring how their parenting styles may contribute to her stress.

2. Siblings meet with a therapist to understand their brother’s depression and learn how to support him without enabling negative behaviors.

3. A partner seeks guidance on how to communicate effectively with their spouse, who is struggling with substance abuse issues.

4. A family discusses the impact of a recent divorce on their child’s emotional health and strategies to provide stability during the transition.

5. Parents attend a session to learn about the effects of their conflict on their child’s mental health and how to co-parent effectively.

6. A family meets to address the challenges of caring for an elderly relative with dementia, focusing on communication and support strategies.

7. A therapist facilitates a discussion among family members about the stigma surrounding mental health issues and how it affects their loved one.

8. A family explores their cultural beliefs about mental health and how these beliefs impact their understanding of the patient’s condition.

9. A session is held to help a family navigate the complexities of a member’s recent diagnosis of bipolar disorder, discussing treatment options and support systems.

10. A family discusses the emotional toll of caregiving for a relative with a chronic illness, focusing on self-care and coping strategies.