CPT Code 90853: Complete Guide to Group Psychotherapy Billing

CPT 90853 covers group psychotherapy – therapeutic sessions where multiple patients (who are not from the same family) participate together under the guidance of a therapist. Group therapy is a powerful and cost-effective treatment modality supported by extensive research.

Group therapy offers unique therapeutic factors not available in individual therapy, including universality (realizing others share similar struggles), interpersonal learning, group cohesion, and altruism (helping others in the group). These "therapeutic factors" identified by Irvin Yalom form the foundation of group therapy's effectiveness.

N/A – billing code. Requirements:

• Multiple patients participating (not family members – that's 90846/90847)
• Therapeutic in nature (not psychoeducation-only)
• Led by a qualified mental health professional
• Each patient must have a documented mental health diagnosis
• Group must have therapeutic goals aligned with individual treatment plans

For each patient in the group, document:

• Date, start and stop times, and total duration
• Group topic or theme for the session
• List of participants (first names or initials for confidentiality)
• The individual patient's participation and engagement level
• Specific therapeutic interventions used in the group
• The patient's individual response and progress
• How group work relates to the patient's individual treatment goals
• Any safety concerns or critical incidents
• Plan for continued group participation

N/A – billing code. Distinguish from:

• 90837 – individual therapy (even discussing group-related topics)
• 90847 – family therapy with patient (family members, not unrelated patients)
• 90846 – family therapy without patient
• H0004/H0005 – some Medicaid programs use HCPCS codes for group services
• Psychoeducational classes – may not qualify as group psychotherapy

Effective group therapy modalities:

• DBT Skills Training Groups
• CBT-based groups (depression, anxiety, insomnia)
• Process-oriented psychotherapy groups
• Trauma-focused groups (with careful screening)
• Substance use recovery groups
• Social skills training groups
• Grief and loss groups
• Anger management groups
• Mindfulness-based stress reduction (MBSR)

Document how group participation supports each patient's individual treatment goals.

Critical billing information:

• Bill separately for each patient in the group
• Reimbursement is per patient: typically $30-55 per patient per session
• Revenue adds up with multiple patients (e.g., 8 patients × $40 = $320/session)
• Some payers limit group size (check contracts)
• Cannot bill individual therapy and group therapy for the same patient on the same day
• Medicaid may use different codes (H0004, H0005) – verify with your state
• Some payers require group therapy to be in the treatment plan
• Telehealth group therapy policies vary by payer

Stay current with:

• Telehealth regulations for group therapy delivery
• Payer-specific group size requirements
• Changes in group therapy reimbursement rates
• New evidence supporting group therapy for specific conditions
• HIPAA considerations for virtual group sessions

Common errors:

• Writing identical notes for all group members (each note must be individualized)
• Not documenting individual patient participation and response
• Billing for patients who were absent
• Failing to connect group work to individual treatment plans
• Not maintaining proper group therapy consent forms
• Forgetting confidentiality agreements for group members
• Billing group and individual therapy on the same day for the same patient