ARTICLE

Behavioral Health

Author:
Brellium

CPT Code 90853: Group Psychotherapy Billing Guide

CPT code 90853 is used to bill for group psychotherapy sessions, making it essential for providers treating multiple patients together in a therapeutic setting. It's commonly used in outpatient mental health, substance use treatment, and intensive outpatient programs (IOPs).

In this guide, you’ll learn:

  • What CPT 90853 covers

  • When to use it

  • Documentation best practices

  • Typical reimbursement rates

  • Common billing mistakes to avoid

What is CPT Code 90853?

CPT 90853 refers to group psychotherapy, where a clinician facilitates a therapeutic session for multiple patients at the same time. These sessions involve structured, evidence-based treatment rather than casual support groups or educational seminars.

A typical 90853 session includes:

  • 60-minute clinician-led therapy

  • Psychotherapeutic techniques (e.g., CBT, DBT, trauma-informed therapy)

  • Group discussion centered on shared mental health goals

Note: This code does not cover family therapy, psychoeducation, or social skills groups unless they include structured psychotherapy.

When to Use CPT Code 90853

Use 90853 when:

  • The session includes 2 or more patients, typically 6–12

  • A licensed clinician leads structured psychotherapy, not just education

  • Each participant has a mental health diagnosis

  • The session focuses on treatment, not case management or support

Examples of appropriate use:

  • DBT skills group for clients with borderline personality disorder

  • Group CBT for depression or anxiety

  • Relapse prevention groups in SUD programs

Documentation Requirements

Each patient in the group must have separate documentation that includes:

  • Time and date of session

  • Group topic and therapeutic approach

  • Patient’s participation level and response

  • Connection to individual treatment plan

  • Group size and duration (usually 45–60 minutes)

Tip: Avoid copy-pasting identical notes across patients—insurers often flag this in audits.

Reimbursement Rates for 90853

Medicare reimbursement for CPT 90853 typically ranges from $25 to $40 per patient per session. Commercial insurance may offer higher rates, especially in intensive outpatient settings or behavioral health programs.

Reimbursement is per participant, not per group.

Common Billing Errors to Avoid

  • Missing documentation for individual patients

  • No documented mental health diagnosis

  • Using 90853 for educational or peer support groups

  • Improper group size (very large or very small groups may be scrutinized)

  • Telehealth billing without correct modifiers (use modifier 95 if allowed by payer)

Final Thoughts

CPT 90853 is a valuable code for delivering effective, scalable mental health care in group settings. By documenting each participant’s engagement and linking it to their treatment goals, you can bill confidently—and get reimbursed accurately.

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Automate clinical & payor compliance

Automate clinical & payor compliance