What insurance policy changes affect CPT 90849?

There are 8 tracked policy changes affecting CPT 90849, including updates from MassHealth, SC Medicaid - SCDHHS, Harvard Pilgrim Health Care. Each change may modify coverage criteria, reimbursement rates, or prior-authorization requirements.

Which payers have updated policy for CPT 90849?

Payers that have issued tracked updates for CPT 90849 include: MassHealth, SC Medicaid - SCDHHS, Harvard Pilgrim Health Care, Nevada Medicaid, Alaska Medicaid.

How do I get notified when CPT 90849 policy changes?

Create a free account at PolicyChanges.app and save a search filtered to CPT 90849. You will receive a daily digest email whenever a new policy change references this code.

Why do payers change policies for CPT 90849?

Payers revise policies for individual billing codes to align with updated clinical guidelines, CMS rule changes, fraud and abuse prevention measures, or network cost-management goals. Changes can affect medical necessity criteria, place-of-service restrictions, bundling rules, or whether a code requires prior authorization.

90849 — A therapy session involving multiple families meeting together with a psychotherapist to work on relationship and communication issues.: Insurance Policy Changes

90849 Insurance Policy Changes

CPT 90849, in plain terms, covers A therapy session involving multiple families meeting together with a psychotherapist to work on relationship and communication issues. CPT 90849 is referenced in 8 tracked payer policy changes from MassHealth, SC Medicaid - SCDHHS, and 3 other payers. For billers and coders, staying current on payer-specific coverage criteria, reimbursement rules, and prior-authorization requirements for CPT 90849 is critical to clean claim submission. Each entry below links to the full policy analysis with effective dates and action steps.

Medium impact

Attention Provider Types 20 (Physician, M.D., Osteopath, D.O.), 24 (Advanced Practice Registered Nurses), 26 (Psychologist), and 77 (Physician’s Assistant): Behavioral Health Procedure Codes Open for Billing

Nevada Medicaid·Effective Feb 9, 2026

Nevada Medicaid has opened specific behavioral health procedure codes for billing by physicians, APRNs, psychologists, and physician assistants effective February 9, 2026. The newly billable codes include multiple-family group psychotherapy, alcohol/drug assessments, telehealth fees, and intensive outpatient psychiatric services, with specific service limitations and prior authorization requirements.

90849 Insurance Policy Changes

Community Health Center Bulletin 125: Preventive Behavioral Health Services for Members Younger than 21

Rehabilitative Behavioral Health and Substance Use Services Rate Increases

Billing updates for mental health centers

Managed Care Entity Bulletin 135: Mental Health Center Policy Updates

Attention Provider Types 20 (Physician, M.D., Osteopath, D.O.), 24 (Advanced Practice Registered Nurses), 26 (Psychologist), and 77 (Physician’s Assistant): Behavioral Health Procedure Codes Open for Billing

Billing update for CHCs providing youth preventive BH services

Managed Care Entity Bulletin 143: Preventive Behavioral Health Services for Members Younger than 21

Tribal FQHC FAQs Updated