CPT Code 97154: Group adaptive behavior treatment

When to Use CPT 97154

Use CPT code 97154 when billing for group adaptive behavior treatment. This code is used by licensed therapists (LCSW, LPC, MFT, Psychologist) for outpatient sessions.

Adding CPT 97154 to a Superbill

When generating a superbill with CPT 97154, include the ICD-10 diagnosis code, date of service, fee charged, amount paid, and your NPI number. Superbilled pre-fills common therapy CPT codes automatically.

Common ICD-10 Pairings

These diagnosis codes are frequently used alongside CPT 97154:

Documentation Requirements

Document group size, each patient target behaviors, and individual data collection. Justify group format for each patient treatment goals.

Common Denial Reasons

• ✗ Group size does not meet payer requirements
• ✗ Individual patient data not collected during group session
• ✗ Group format not justified in the treatment plan

Reimbursement Expectations

OON reimbursement typically 35-55% of UCR. Expect $18-$55 per patient per hour.