CPT 90846
Global XXXFamily psytx w/o pt 50 min
CPT 90846 Billing & Documentation Guide
CPT code 90846 (Family psytx w/o pt 50 min) is classified under Psychiatry with a global period indicator of XXX. The 2026 Medicare Physician Fee Schedule assigns a work RVU of 2.74, a non-facility practice expense RVU of 0.4, and a malpractice RVU of 0.03, a total non-facility RVU of 3.17 and facility RVU of 2.97. With the current conversion factor of $33.4009, the national average non-facility reimbursement is approximately $108.19, though rates vary from $103.51 to $152.06 based on MAC locality and Geographic Practice Cost Indices (GPCIs).
When billing 90846, ensure documentation supports medical necessity and the specific components required for the code's level of service. For E/M codes, document MDM (medical decision-making) elements: problems addressed, data reviewed, and risk. For procedural codes, document the indication, technique, and any complications. Always verify NCCI edits before bundling 90846 with related codes; this code has 10 PTP bundling relationships on file (see table below).
Payment Status & Global Period
Restricted coverage (special situations)
No global period (E/M and other non-procedural services)
MUE Limit (Medically Unlikely Edits)
Submitting more than 1 units of 90846 for the same patient on the same date triggers automatic line denial unless an appropriate modifier and supporting documentation justify the higher quantity.
RVU Breakdown, CPT 90846
| Component | Non-Facility | Facility |
|---|---|---|
| Work RVU | 2.74 | 2.74 |
| Practice Expense RVU | 0.4 | 0.2 |
| Malpractice RVU | 0.03 | 0.03 |
| Total RVU | 3.17 | 2.97 |
| Conversion Factor | $33.4009 | |
2026 Medicare Reimbursement by State, CPT 90846
State-level averages across all MAC localities. Non-facility rates typically apply to office-based services; facility rates apply to hospital outpatient / inpatient.
| State | Non-Facility | Facility | Range (Non-Fac) | Localities |
|---|---|---|---|---|
| California | $111.15 | $103.24 | $108.25 - $121.39 | 29 |
| Florida | $106.87 | $100.17 | $105.8 - $107.96 | 3 |
| Georgia | $105.6 | $99.23 | $104.63 - $106.57 | 2 |
| Illinois | $106.66 | $100.21 | $105.28 - $107.89 | 4 |
| Michigan | $105.48 | $99.2 | $104.85 - $106.1 | 2 |
| North Carolina | $104.62 | $98.39 | $104.62 - $104.62 | 1 |
| New York | $112.12 | $104.67 | $104.92 - $115.12 | 5 |
| Ohio | $104.73 | $98.63 | $104.73 - $104.73 | 1 |
| Pennsylvania | $106.5 | $99.96 | $104.73 - $108.27 | 2 |
| Texas | $106.11 | $99.53 | $104.61 - $106.9 | 8 |
Source: CMS PFSRVU 2026 · Updated 2026-04-01. Full locality-level detail available for all 53 states, contact us for custom reports.
NCCI Bundling Edits, CPT 90846
Procedure-to-procedure (PTP) edits. If you bill any of these codes with 90846 on the same date of service, review the modifier indicator and payer policy before submission.
| Partner Code | Relationship | Modifier Allowed | Rationale |
|---|---|---|---|
| 0115T | Column 1 (primary), can be billed with modifier | Yes | Misuse of Column Two code with Column One code |
| 0116T | Column 1 (primary), can be billed with modifier | Yes | Misuse of Column Two code with Column One code |
| 0359T | Column 1 (primary), can be billed with modifier | No | CPT Manual or CMS manual coding instruction |
| 0360T | Column 1 (primary), can be billed with modifier | No | CPT Manual or CMS manual coding instruction |
| 0361T | Column 1 (primary), can be billed with modifier | No | CPT Manual or CMS manual coding instruction |
| 0362T | Column 1 (primary), can be billed with modifier | No | CPT Manual or CMS manual coding instruction |
| 0362T | Column 1 (primary), can be billed with modifier | No | CPT Manual or CMS manual coding instruction |
| 0363T | Column 1 (primary), can be billed with modifier | No | CPT Manual or CMS manual coding instruction |
| 0364T | Column 1 (primary), can be billed with modifier | No | CPT Manual or CMS manual coding instruction |
| 0365T | Column 1 (primary), can be billed with modifier | No | CPT Manual or CMS manual coding instruction |
Frequently Asked Questions, CPT 90846
What does CPT code 90846 mean? +
CPT code 90846 represents: Family psytx w/o pt 50 min. It's in the Psychiatry category with a global period of XXX.
What is the Medicare reimbursement for CPT 90846? +
The 2026 Medicare national average non-facility payment for CPT 90846 is $108.19. Rates range from $103.51 to $152.06 across 53 states depending on MAC locality and GPCIs.
What modifiers can I use with CPT 90846? +
Medicine section spans a wide range: therapy services use GP/GO/GN (PT/OT/SLP plans of care) and KX (above cap with documentation). Drug administration uses JW (waste) and JZ (no waste). Professional/technical split applies to some diagnostic codes.
What bundling edits apply to CPT 90846? +
This code has 10 NCCI PTP bundling relationships. See the NCCI Bundling section below for full list.
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Reviewed by the PayerReady Medical Coding Team
Verified against the CMS 2026 code set on May 31, 2026.
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