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Family Therapy codes changing

sandy 3 years ago in Codes/Rates/Diagnosis Modules updated by anonymous 3 years ago 9

Does anyone know what the "time based code" changes are for family therapy?


Billing changes for family psychotherapy: Effective January 1, 2017, CPT codes 90846 (family psychotherapy without patient present) and 90847 (family psychotherapy with patient present) have changed to a time based code. Review CPT code guidelines for additional information. The calendar year limits for these services remain the same. Authorization is required if a person needs more than the yearly threshold.

I was looking into this also. I don't think DHS has updated all their information so I would watch for more information. They have not updated their fee schedule to show this change but did somewhat update if you look in the provider manual under Psychotherapy.

The time is 50 minutes for both 90846 and 90847.

Blue Cross and Blue Shield of MN Medical Policy reads:

90847  This code is billed for family therapy when the patient is present. There may be specific contract exclusions for some self-insured groups.  This code should be billed under the specific patient, not under the subscriber.  Bill one unit per session regardless of total time.  This code must be billed with a behavioral health diagnosis.


90846  This code is billed for family therapy when the patient is not present. There may be specific contract exclusions for some self-insured groups.  This code should be billed under the specific patient, not under the subscriber.  Bill one unit per session regardless of total time.  This code must be billed with a behavioral health diagnosis


Found here: https://www.bluecrossmn.com/healthy/public/portalcomponents/PublicContentServlet?contentId=P11GA_12397421

I am looking at the 2017 CPT coding changes on the Federal site and this isn't listed. This is the first we have heard of it.

Its actually states that it has to be a minimum of 26 minutes to bill the 50 minute code.

Psychotherapy coding changes 2017

There are two changes in the psychiatry section of CPT for 2017. The first is the description of psychotherapy codes were revised to remove the words “and/or family.” In 2016, CPT code 90832 was defined as “Psychotherapy, 30 minutes with patient and/or family member.” In 2017 the definition is “Psychotherapy, 30 minutes with patient.” Codes 90833, 90834, 90836, 90837, 90838, and 90839 were similarly revised.

The CPT Changes Insider’s View 2017 notes that although another person may be in the room (and they label this person as an “informant”) the individual psychotherapy codes are for individual treatment and the patient must be in the room “for all or a majority of the service.” The therapy focus is on the individual, not the family, even if the family member is present for part of the session and provides information. Therapy focused on the family should be reported with family therapy codes. According to CPT, individual and family therapy may be reported on the same day, although your payer may not follow that coding rule.

CPT code 90846 was revised from “Family psychotherapy (without the patient present),” to “Family psychotherapy (without the patient present), 50 minutes.”

CPT code 90847 was revised from “Family psychotherapy (conjoint therapy) (with the patient present),” to “Family psychotherapy (conjoint therapy) (with the patient present), 50 minutes.”

Psychotherapy codes follow the CPT time rule, which is that in order to bill the service, the clinician must meet the mid point of time. In this case, in order to bill either 90846 or 90847, the family therapy must be at least 26 minutes. As always, document time in the medical record when time is a descriptor.

As long as were talking about this topic, CPT's and length of session, does anyone know if there is any "time" assigned to an Intake 90791? I have yet to find one.

There is no time specifications for DA's (90791). Only that Extended DA's require 3 separate documented sessions; standard DA's require at least 1 documented session.

90791: Psychiatric diagnostic evaluation There is no time associated with this code for it is treated like a per diem code in the sense no time is associated like you would find for 90837 or 90847.