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CPT 90849: Multiple-Family Group Psychotherapy
CPT code 90849 represents psychotherapy provided to a multiple-family group and is used to bill for therapeutic sessions that involve several families participating together. Nationally, this code captures services that address family dynamics, communication, and social support across multiple households and is relevant to outpatient behavioral health delivery. Coverage and reimbursement policies for this code affect access to family-based interventions, clinician billing practices, and program planning for community mental health services.
Key payers included in this analysis are Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find a concise overview of clinical context for multiple-family psychotherapy, comparisons to related group therapy codes, and payer coverage considerations. The publication outlines common billing modifiers and relevant clinical diagnoses associated with this service, and it highlights typical provider taxonomies that bill for family group psychotherapy.
This resource is intended to inform billing staff, practice administrators, and policy analysts about the code’s clinical application, typical sites of service, and how major payers commonly approach coverage. It also provides pointers to related services for coding alignment and operational planning. Data not available in the input is noted where applicable.
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Billing Code Overview
CPT code 90849 describes a psychotherapy session conducted with multiple families (a multiple-family group). The service is a structured therapeutic intervention focused on family systems, communication, and support among several patient families.
Typical site of service for this procedure is an outpatient behavioral health setting such as a clinic, community mental health center, or other ambulatory mental health practice where group family therapy is delivered.
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).