CPT 90846: Family Psychotherapy Without Patient Present
Medicare pays $109 and commercial payers pay $252 on average nationally for this procedure.
CPT code 90846 describes a family psychotherapy session conducted by a behavioral health provider with family members present and the patient absent, used to address psychological and interpersonal issues affecting the patient and family; this service is typically outpatient family psychotherapy and is delivered in clinic or office-based behavioral health settings as a psychotherapeutic counseling encounter focused on family dynamics and communication.
For related coverage guidance, see recent payer policy updates: Kentucky Medicaid program changes and related fiscal provisions (HB 695/HCS1), New Technology and Miscellaneous Services (Category III CPT® Codes), Consultation Services - Professional.
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National Reimbursement Benchmarks
Medicare's mean rate for CPT 90846 stands at $108.80, while BUCA's mean commercial rate is substantially higher at $251.70, highlighting a clear gap between public and average commercial reimbursement for this code. The median for Medicare is $107 and its interquartile spread (P75–P25) is $3, indicating very tight clustering around the mean across its 47 localities; BUCA's interquartile values (P75 $313.50, P25 $178.40) imply a wider central distribution with an IQR of $135.10.
Comparing interquartile ranges across payers, Blue Cross Blue Shield exhibits the widest IQR at $181.80 (P75 $425.70 minus P25 $240.90), followed by UnitedHealth Group with an IQR of $94.80 and Cigna at $71.20. Aetna shows a relatively narrow IQR of $51.30. These differences indicate substantial variation in commercial reimbursement concentration: Blue Cross Blue Shield and BUCA have broader middle spreads, while Medicare and Aetna are among the tightest.