CPT code 90853 is the standard billing code for group psychotherapy. It is billed per participant — not per group — and has specific documentation requirements that differ from individual therapy.
What Is CPT Code 90853?
90853 (Group Psychotherapy, other than multiple-family group) covers interactive group psychotherapy where a therapist facilitates therapeutic work with multiple unrelated clients simultaneously. Key rules:
- Each participant is billed separately — if 8 clients attend, you submit 8 claims each with 90853
- The session must be primarily psychotherapeutic in nature (not purely psychoeducational)
- No minimum or maximum group size is specified in CPT, but most groups run 4–12 participants
- The 45-minute rule: while CPT does not specify a minimum time, most payers expect a group session to run at least 45 minutes to support 90853
Typical Fees and Reimbursement
Group therapy fees are lower per-person than individual therapy, reflecting the shared therapist time:
- Private pay fee: $40–$80 per participant per session
- Medicare 2025 rate: approximately $30–$35 per participant
- OON commercial reimbursement: 50–70% of the plan's allowed amount, which is typically lower for group than individual therapy
Note: OON reimbursement for group therapy is inconsistent. Some plans reimburse group therapy at the same rate as individual sessions; others apply lower allowed amounts. Advise clients to call and verify their OON group therapy benefits before enrolling.
Documentation Requirements for 90853
Documentation for group therapy must be more detailed than individual session notes because it covers multiple clients:
- Attendance: Record who was present (use first names or client IDs to protect confidentiality)
- Therapeutic topics and interventions: What was the focus of the group session? What techniques were used (CBT, DBT skills, process group, etc.)?
- Individual participation: A brief note for each participant — how they engaged, what they shared, how they responded to the group process
- Progress toward treatment goals: Each client should have a treatment plan that references the group as a modality
- Next session plan: What will the group focus on next?
90853 vs 90849 — Multiple Family Group
90853 is used for groups of unrelated individuals. 90849 (Multiple-Family Group Psychotherapy) is used when family units participate together in a group setting — for example, an eating disorder program where multiple families attend a therapeutic group simultaneously. Use 90849 only when identifiable family groups are treated together.
How to Format a Superbill for Group Therapy
A superbill for a group therapy client looks similar to an individual therapy superbill with these specifics:
- CPT code: 90853
- ICD-10 code: The individual client's diagnosis (not the group topic)
- Fee charged: The per-person fee (e.g., $60), not the total group revenue
- Place of service: 11 (office) or 10 (telehealth — client in home)
- Units: 1 (even if the session is 90 minutes — 90853 is a per-session code, not time-based)
Each client gets their own superbill showing their individual fee. Superbilled generates per-client superbills for group therapy — set up each client once and generate superbills for each session they attend.
Telehealth Group Therapy
90853 can be billed for telehealth group sessions. Use POS 10 (client in home) and the GT or 95 modifier as required by the payer. All participants must be in secure, private locations. Document the platform used (e.g., "HIPAA-compliant video conferencing").