How much does Medicare pay for CPT 90846?

Medicare allowed an average of $83.43 per service and paid $62.60 of that, the balance being the patient's coinsurance and deductible (2024 data). Providers submitted an average of $218.33, which is what they billed rather than what they received — Medicare pays its fee schedule regardless of the charge.

What is CPT code 90846?

Family psychotherapy without patient, 50 minutes. It was billed 6,912 times to 3,357 Medicare beneficiaries by 108 providers in 2024.

Does 90846 pay differently in an office than a hospital?

Yes. The allowed amount averaged $84.01 in an office setting and $81.57 in a facility. The office rate is generally higher because the practice supplies the room, staff and equipment out of that single payment; in a hospital those are billed separately by the facility.

Which specialty bills 90846 most?

Licensed Clinical Social Worker, with 3,702 services from 56 clinicians. Next are Psychiatry, Psychologist, Clinical, Nurse Practitioner.

CPT 90846

Family psychotherapy without patient, 50 minutes

$83.43Medicare-allowed amount per service, averaged across 6,912 services

Providers submitted

$218.33

Asking price, not received

Medicare allowed

$83.43

The fee schedule figure

Medicare paid

$62.60

Balance is patient coinsurance

Providers submitted an average of $218.33 for this code and Medicare allowed $83.43 — 2.6× less. That gap is normal and means nothing on its own: Medicare pays its fee schedule regardless of what is billed, so the submitted figure describes a hospital chargemaster, not a price anyone paid. Of the allowed amount Medicare paid $62.60 (75%); the rest is the patient’s coinsurance and deductible.

Office pays differently to hospital

Office / non-facility: $84.01
Hospital / facility: $81.57

The office rate is higher because the practice supplies the room, staff and equipment out of that payment. In a hospital the facility bills those separately, so the clinician's share is smaller — the total cost to Medicare is usually higher, not lower. 5,263 services were billed in an office setting and 1,649 in a facility.

Services: 6,912
Beneficiaries: 3,357
Providers billing it: 108
Total allowed: $576,668

What Medicare pays for CPT 90846

Across 6,912 services billed by 108 providers to 3,357 beneficiaries, Medicare allowed an average of $83.43 per service. That is 2.1 services per beneficiary, so this is a code patients typically receive more than once. The allowed amount is the figure that matters: it is what Medicare and the patient together owe, set by the fee schedule and adjusted for local practice costs. What a provider chose to submit has no bearing on it.

Who bills 90846

Specialty	Services	Beneficiaries	Avg allowed	Providers
Licensed Clinical Social Worker	3,702	1,859	$74.24	56
Psychiatry	1,359	637	$96.44	17
Psychologist, Clinical	1,248	493	$99.70	17
Nurse Practitioner	405	235	$72.39	10
Certified Clinical Nurse Specialist	126	73	$80.99	3
Geriatric Psychiatry	45	36	$99.85	3
Licensed Professional Counselor	14	13	$79.28	1
Internal Medicine	13	11	$92.63	1

90846 reimbursement by state

Two different numbers. Allowed is what Medicare actually allowed in that state, which includes the local practice-cost adjustment. Standardized strips that geographic adjustment out of the payment, so it is the column to use when comparing states — a difference there reflects how the code was billed, not what it costs to run a practice locally.

State	Services	Allowed	Standardized pmt	Providers
California	1,394	$91.23	$67.88	9
New Jersey	1,232	$78.51	$57.82	16
New York	902	$100.17	$72.07	13
Illinois	579	$77.09	$54.49	11
Arizona	504	$71.76	$52.56	8
Texas	492	$83.08	$63.55	10
Massachusetts	348	$88.07	$64.11	7
Georgia	243	$72.75	$51.59	3
Kentucky	199	$61.02	$56.49	2
Vermont	185	$70.97	$48.04	3
Pennsylvania	156	$76.73	$58.97	4
Florida	135	$91.62	$69.96	4
Ohio	96	$74.67	$58.66	2
Connecticut	84	$84.80	$57.64	3
Washington	82	$75.74	$54.67	1
New Hampshire	66	$76.65	$54.22	2
Michigan	64	$78.14	$61.80	3
Nevada	47	$80.40	$64.31	1
Virginia	33	$71.41	$50.31	1
Colorado	21	$73.14	$51.53	1
Maryland	14	$95.66	$70.65	1
Idaho	13	$93.33	$76.17	1
New Mexico	12	$80.99	$54.26	1
South Carolina	11	$93.85	$69.08	1

Related codes

90837Psychotherapy$127.42
90834Psychotherapy$88.04
90832Psychotherapy$65.95
90833Psychotherapy$64.86
90836Psychotherapy$88.70
90868Treatment using magnetic field to stimulate nerve cells in brain, subs$183.83
90853Group psychotherapy$23.01
90870Therapy using electrical currents$103.73
90838Psychotherapy$113.05
90847Family psychotherapy$92.01
90839Psychotherapy for crisis$113.12
90867Treatment using magnetic field to stimulate nerve cells in brain, init$285.49

Billing this code is not the same as earning it

An allowed amount is revenue to a practice, not income to a clinician. It funds staff, premises, equipment and supplies before anyone is paid. What clinicians actually earn is published separately by the Department of Labor, and what industry pays them is published separately again by CMS — this site carries both.

What doctors are paid →·Look up a clinician →·All procedure codes →

Where this comes from. CMS Medicare Physician & Other Practitioners, by Provider and Service, 2024. It covers fee-for-service Original Medicare Part B only — not Medicare Advantage, not Medicaid, and not commercial insurance, which typically pays more for the same code.

How it is averaged. CMS publishes one average per provider per code. Every figure here is re-weighted by the number of services, so a clinician who billed the code 4,000 times counts 4,000 times more than one who billed it twice. CMS also suppresses any provider-code pair with fewer than 11 beneficiaries, so low-volume practice is missing from these totals by design.