CPT 90847 + ICD-10 F43.10: Post-traumatic stress disorder, unspecified
Family psychotherapy with patient present billed with Post-traumatic stress disorder, unspecified — documentation requirements, denial reasons, modifiers, and reimbursement context.
CPT Code
90847
Family psychotherapy with patient present
ICD-10 Code
F43.10
Post-traumatic stress disorder, unspecified
Compatibility Notes
Appropriate when trauma-focused family therapy is conducted with the identified PTSD patient and at least one family member present. Common in child and adolescent trauma cases or when family-of-origin work is part of the treatment plan. The diagnosis must be assigned to the identified patient (not the family). Some payers require that the patient be explicitly listed as the identified patient on the claim.
Documentation Required
- ✓Session start and stop times (no time floor for 90847, but thorough notes required)
- ✓Names of all participants and each individual's relationship to the identified patient
- ✓PTSD symptoms of the identified patient as the clinical focus
- ✓Family dynamics and their relationship to trauma recovery addressed in session
- ✓Therapeutic interventions targeting both the patient and family system
Common Denial Reasons
- ✗Patient not present — if the identified patient is absent, 90846 must be used instead of 90847
- ✗Diagnosis assigned to the family unit rather than the identified patient
- ✗Notes do not document each participant and their role
- ✗Payer does not cover family therapy for PTSD without prior authorization
Applicable Modifiers
Reimbursement Notes
UCR for 90847 is typically $125–$200 OON. Reimbursement is slightly lower than 90837 despite often requiring more clinical coordination. Some plans apply the same rate; others discount family codes.
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