Family (Conjoint) Psychotherapy

For HMSA's non-Medicare-based plans, family psychotherapy has one identified person/patient who is the focus of the session, who has a diagnosis, and for whom the family therapy session is held to address a particular issue/problem that is included on the identified patient's problem list. Therefore, a bill can be submitted for only one person for each family session.

The identified person/patient for whom the session was called is the person for whom a claim is to be submitted. The other persons involved are not patients; they are family members.

If other family members need treatment, they would need to have a diagnosis, have a separate chart, problems list, and treatment plan. They also would need a separate session, which can be a family session for which they are the focus of treatment.

Family Member Coaching Sessions

Occasionally, sessions are conducted in which children who are your patients are present with their parents and coaching to family members occurs. Again, only one identified patient is to be billed for each session. Treating a number of identified patients within one session brings up a complicated dilemma of having a single provider for multiple persons and possible conflict of interest issues involving confidentiality, perceived alliances, taking sides, sharing of information and diluting focus.

Billing for Family (Conjoint) Psychotherapy

CPT code 90847 can be billed for family therapy on a claim for the single patient who is the focus of the session. The ICD-9-CM or ICD-10-CM code appropriate to that patient should be used.

Family Therapy Billing for HMSA's Medicare-Based Plan

HMSA's Medicare Advantage plan follows Medicare's guidelines for billing and payment.

Revision History