CPT 90847 + ICD-10 F84.0: Autistic disorder
Family psychotherapy with patient present billed with Autistic disorder — documentation requirements, denial reasons, modifiers, and reimbursement context.
CPT Code
90847
Family psychotherapy with patient present
ICD-10 Code
F84.0
Autistic disorder
Compatibility Notes
Appropriate for family sessions where the ASD child is the identified patient and caregiver skills training or family adjustment is the focus. The identified patient must be present. Caregiver involvement is central to evidence-based ASD treatment. The diagnosis must be attributed to the child, not the family unit.
Documentation Required
- ✓Identified ASD patient (child) present in session
- ✓All participants named with relationship
- ✓ASD-specific family therapy goals (caregiver skills, family adaptation)
- ✓ASD diagnosis attributed to identified patient
Common Denial Reasons
- ✗Child not present — use 90846 for parent-only caregiver training
- ✗Diagnosis attributed to family rather than child
- ✗Notes describe ABA-type behavioral intervention billed under psychotherapy code
Applicable Modifiers
Reimbursement Notes
OON UCR $125–$200. ASD family therapy coverage varies by state ASD mandate. Document caregiver-inclusive treatment goals explicitly.
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