2025 CPT code 90853
(Active) Effective Date: N/A Revision Date: N/A Mental Health Therapeutic Services - Group Psychotherapy Medicine Services and Procedures > Psychiatry Services and Procedures Feed
Group psychotherapy (other than of a multiple-family group), per session.
Modifiers may apply depending on the circumstances (e.g., 59 for distinct procedural services, -99 for multiple modifiers).
Medical necessity for group psychotherapy is established through a documented diagnosis, assessment of the patient’s needs, and a treatment plan demonstrating that group therapy is the appropriate and most effective intervention for the patient's condition.Documentation should show that the individual would benefit from the group interaction.
A qualified mental health professional (e.g., psychiatrist, psychologist, licensed clinical social worker, etc.) leads and facilitates the group therapy sessions, ensuring a safe and therapeutic environment. They guide discussions, manage group dynamics, and provide support and interventions as needed.
- Medicine Services and Procedures > Psychiatry Services and Procedures
- Psychiatry Services and Procedures
In simple words: This code is for billing group therapy sessions where a therapist helps a group of people who aren't usually together but have similar problems. The session typically lasts about an hour and focuses on improving mental well-being.This isn't for families or couples therapy.
This CPT code, 90853, represents group psychotherapy services provided to a group of patients (excluding multiple-family groups) who are not typically acquainted but share similar psychological issues.A qualified mental health professional leads sessions lasting approximately 45-60 minutes. The sessions focus on therapeutic goals, exploring personal and group dynamics to foster emotional catharsis, instruction, insight, and support.The code is reported once per patient per day and cannot be reported with specific other codes (97151, 97152, 97153, 97154, 97155, 97156, 97157, 97158, 0362T, 0373T). Add-on code 90785 may be used with 90853 if interactive complexity is involved.
Example 1: A group of 6 adults with anxiety disorders meet weekly for 50-minute group therapy sessions facilitated by a licensed clinical psychologist.Code 90853 is used to bill for each session., A group of 4 adolescents struggling with depression participates in a 60-minute group therapy session once a week. A licensed professional counselor leads the group. Code 90853 is used for billing., A therapist uses code 90853 to bill for a 45 minute group session where a group of 8 adults experiencing grief after the loss of a loved one attend.The sessions help these patients cope with their grief through sharing, support, and therapeutic guidance.
Detailed session notes are essential for each group therapy session.Documentation should include the date, time, duration, attendees' names, the session's focus, key discussion points, therapeutic interventions used, and any relevant observations regarding patient progress.
** Always verify the payer's specific requirements for group therapy before submitting claims.Accurate documentation is crucial for successful reimbursement.
- Revenue Code: M5B (Specialist - Psychiatry)
- RVU: RVUs vary based on geographic location and other factors. Consult the CMS website for the most up-to-date information.
- Global Days: Not applicable to this code.Global surgical periods are relevant to surgical procedures, not psychotherapy sessions.
- Payment Status: Active
- Modifier TC rule: Not applicable.Technical component modifiers (TC) are typically not used with psychotherapy codes.
- Fee Schedule: Fee schedules vary by payer and geographic location.Consult publicly available fee schedules or payer websites for this information. Historical data can be researched using archived medical billing resources.
- Specialties:Psychiatry, Psychology, Social Work, Counseling
- Place of Service:Office, Inpatient Hospital, Outpatient Hospital, Community Mental Health Center, Other Place of Service (depending on setting)