Dialectical Behavior Therapy (DBT) bills using two standard CPT codes with no DBT-specific modifier. Individual sessions use CPT 90837 (60-minute individual psychotherapy). Group skills training uses CPT 90853 (90-minute group psychotherapy), billed per participant per session. DBT does not create a separate coding pathway; the modality is documented in the clinical note, not the CPT code. Typical DBT programs include weekly individual therapy, skills groups, and phone coaching. Only individual and group sessions are billable.
Bill individual DBT sessions as 90837. Sessions must be 52-60 minutes to qualify; shorter sessions are 90834 (45 min). Group skills training bills as 90853 per participant regardless of group size. For a group of eight patients, you bill 90853 eight times (once per patient). Do not prorate group billing if attendance varies. Phone coaching, text check-ins, and consultation calls are not separately billable—they are part of the therapeutic alliance. Therapist consultation teams are also non-billable. Include the patient's primary diagnosis (e.g., borderline personality disorder, F60.3) on the claim; DBT is the treatment modality, not the diagnosis.
Most payers cover DBT when indicated for borderline personality disorder or chronic suicidality. Prior auth is often required. Submit documentation showing the patient's diagnosis, baseline suicide risk assessment, and treatment plan (typically 12 months of weekly therapy plus group). Payers approve standard DBT at 1 individual + 1 group per week. Some plans limit group training to certain durations. Verify coverage before enrollment. Payers track the number of billable contacts to prevent overbilling; track your own coding internally to match payer records.
Do not bill individual DBT therapy and group training on the same day; they are distinct codes but the same modality. If a session runs over 60 minutes (70+ min), use add-on code 90838 for each additional 30 minutes. Do not use modifiers 25, 26, or 59 with DBT codes. When DBT occurs alongside psychiatric medication management, bill the medication E/M separately only if it is a distinct visit on a different day or with distinct documentation. Same-day billing of both requires separate, documented services with clear intent.
Document the patient's primary diagnosis (e.g., borderline personality disorder), suicide risk assessment at intake and ongoing, treatment goals, skills taught in group sessions, behavioral homework assignments, and progress toward dialectical change. Record session length, modality (individual vs. group), and whether the patient is engaging. Note any crisis contacts or hospitalizations. Track attendance and engagement; poor attendance may trigger payer reviews. For group sessions, document the topics covered (emotion regulation, distress tolerance, mindfulness, interpersonal effectiveness) and each patient's participation level.
Borderline personality disorder (F60.3) is the primary indication. Chronic suicidality or self-harm (T82.xxx codes) also qualifies. Some payers extend coverage to bipolar disorder, depression with suicidality, or eating disorders. Check your patient's plan. Submit clinical justification with the prior auth request if the diagnosis is atypical.
Yes, absolutely. Bill 90837 for individual (once per week) and 90853 for group (once per week). These are distinct services. Do not bill both on the same calendar day unless they are truly separate sessions with separate documentation.
Consultation team meetings are not billable to insurance. They are treated as clinical supervision. If your practice charges a separate fee to patients for team costs, that's an internal practice decision, but it does not come from payer billing.
Altair validates DBT coding and compliance rules before submission. See how it works.
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