CPT Code 90853: Group psychotherapy

Understand how to document and bill CPT code 90853 for group psychotherapy, including medical necessity criteria, billing rules, and related CPT codes.

Use Code

What is CPT code 90853?

CPT code 90853 is used to report group psychotherapy services provided by qualified mental health professionals, such as psychiatrists, psychologists, clinical social workers, or licensed professional counselors. This code applies to group therapy sessions that involve psychotherapeutic interaction among multiple patients, facilitated by a clinician, with a focus on improving coping skills, emotional regulation, or interpersonal relationships.

The 90853 CPT code description refers specifically to non-family, face-to-face group therapy, typically involving 6 to 12 patients who share similar therapeutic needs. The therapist leads the session, offering structured interventions, feedback, and guidance during these group therapy services. This code does not apply to multiple-family group psychotherapy (see CPT 90849) or sessions solely focused on educational or supportive content without psychotherapeutic intent.

Documentation requirements

Thorough and specific documentation is essential to support medical necessity and ensure compliance with insurance requirements when billing for group psychotherapy services.

Medical necessity and clinical indication

The medical record should include the patient’s mental health diagnosis and a clear clinical rationale for participation in group therapy. Justification may include conditions such as depression, anxiety, trauma, or substance use disorders, for which group interaction is therapeutically beneficial.

Description of services provided

Progress notes must reflect the therapeutic goals, the focus of the group session, the interventions employed, and the patient's active participation. Documentation should also include any observations about the patient’s progress or response to treatment.

Session details

Each note should specify the date and time of the group psychotherapy session, its duration, the number of participants, and the name and credentials of the provider. If the same patient is seen in multiple sessions, separate documentation must be provided for each.

Billing guidelines

Proper coding and group therapy billing of CPT 90853 are critical for appropriate reimbursement and to avoid group therapy claims denials.

One unit per patient, per session

CPT 90853 is billed once per patient per session, regardless of the number of participants. The code reflects an individual’s participation in a shared therapeutic environment, not time-based billing.

Provider qualifications and payer rules

Only qualified mental health providers (e.g., clinical psychologists, licensed social workers, psychiatrists) may bill 90853, and providers must check whether group therapy is a covered service under the patient’s plan. Interactive complexity (CPT 90785) is generally not billable in addition to 90853.

Same-day services

If group psychotherapy is provided on the same day as other mental health services (e.g., individual or family therapy), documentation must support that the services were distinct and non-duplicative. Some payers may deny claims if multiple therapy codes are billed without clinical justification.

Telehealth and in-person sessions

Many insurers now allow billing for 90853 via telehealth if the platform meets HIPAA requirements and the session is interactive. Verify with each insurance company for their specific telehealth billing guidelines and documentation requirements.

Other relevant CPT codes

  • 90832–90838 – Individual psychotherapy (30–60 minutes)
  • 90846 – Family psychotherapy without the patient present
  • 90847 – Family psychotherapy with the patient present
  • 90849 – Multiple-family group psychotherapy
  • 90791 – Psychiatric diagnostic evaluation

Frequently asked questions

What is the difference between CPT 90853 and 90849?

CPT 90853 covers standard group psychotherapy sessions involving unrelated individuals, while 90849 is used for multiple family therapy sessions for psychotherapy, where families participate together in treatment.

Can a provider bill 90853 and 90847 on the same day?

Yes, but only when the sessions are distinct, medically necessary, and clearly documented as addressing different therapeutic goals. Payers may require modifiers or supporting notes.

Is CPT 90853 reimbursable through insurance?

Most insurance plans, including Medicare and Medicaid, cover CPT 90853 when it meets medical necessity criteria and is rendered by a qualified provider. Always verify the patient's benefits and coverage limits.

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