CPT 90849: Multiple-Family Group Psychotherapy Session
Medicare pays $42 and commercial payers pay $99 on average nationally for this procedure.
CPT code 90849 describes a psychotherapy service delivered as a multiple-family group session involving families of patients, typically billed for group psychotherapy provided in outpatient behavioral health settings such as community mental health clinics or hospital outpatient departments; the code represents a structured therapeutic encounter focused on family systems and relational interventions rather than individual therapy.
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 of $41.7 sits well below BUCA’s average commercial mean of $99.2, highlighting a substantial gap between public and this set of commercial benchmarks for CPT 90849. The median and quartile values for Medicare are tightly clustered around the low $40s (P25 $40, P50 $41, P75 $43), whereas BUCA’s interquartile cluster (P25 $71.4, P50 $88.5, P75 $120.2) indicates higher central tendency and wider commercial pricing pressure.
Comparing interquartile dispersion (P75 minus P25) across payers, Blue Cross Blue Shield shows the widest IQR at $67.7 ($167.6 - $100.9), followed by BUCA at $48.8 ($120.2 - $71.4) and UnitedHealth Group at $32.7 ($63.9 - $33.2). Cigna’s IQR is $26.4 ($60 - $34.8) and Aetna is the tightest among listed commercial payers with an IQR of $19.0 ($47 - $28). Medicare’s IQR is very narrow at $3 ($43 - $40).