What Is CPT 90853?
CPT 90853 is the billing code for group psychotherapy. A qualified provider leads a therapy session with multiple patients simultaneously, typically 2 to 12 participants. Sessions run 45 to 90 minutes. Each patient in the group is billed individually under their own insurance using 90853. Reimbursement ranges from $25 to $55 per patient per session.
Billing Rules
- Bill 90853 once per patient per group session. Each patient's claim uses their own diagnosis code and insurance information.
- Minimum group size is typically 2 patients. Some payers require 3 or more. Check payer policy before scheduling.
- Session length is not time-defined in CPT, but most payers expect 45-90 minutes. Document actual start and end times.
- Do not bill 90853 on the same day as individual therapy (90834/90837) unless the sessions are at separate times with separate documentation and modifier 59.
Documentation Requirements
Each patient's chart must include: date, group session start and end time, number of participants, the patient's specific diagnosis, the patient's individual treatment goals addressed in group, the patient's response and participation level, and plan for continued treatment. Generic group notes applied to all patients trigger audit flags.
Common Denials
| CARC Code | Reason | Fix |
|---|---|---|
| CO-39 | Session limit exceeded | Request additional sessions citing medical necessity |
| CO-50 | Not covered | Verify group therapy is a covered benefit under the patient's plan |
| PR-1 | Missing info | Include individual patient documentation, not just group notes |
Common Questions About CPT 90853
Is there a maximum group size for billing?
CPT does not set a maximum, but most payers cap at 12 patients per group session. Larger groups raise audit concerns about whether each patient received adequate therapeutic attention.
Can different diagnoses be in the same group?
Yes. Each patient is billed with their own diagnosis code. A group for anxiety management can include patients with F41.1 (generalized anxiety), F32.1 (major depression), and F43.10 (PTSD) as long as the treatment modality addresses shared therapeutic goals.
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This reference is for informational purposes. Always verify against current payer policies, CPT guidelines, and CMS documentation. Last updated: 2026-04-06.