CPT 90853 + ICD-10 F33.1: Major depressive disorder, recurrent, moderate
Group psychotherapy billed with Major depressive disorder, recurrent, moderate — documentation requirements, denial reasons, modifiers, and reimbursement context.
CPT Code
90853
Group psychotherapy
ICD-10 Code
F33.1
Major depressive disorder, recurrent, moderate
Compatibility Notes
Applicable for structured group therapy targeting moderate recurrent depression — including interpersonal therapy groups, behavioral activation groups, and CBT-D groups. F33.1 indicates recurrent MDD at moderate severity (PHQ-9 scores 10–14). This is a well-supported combination; most payers accept it without prior authorization for outpatient group settings.
Documentation Required
- ✓Per-patient attendance and diagnosis on each claim
- ✓Group session theme and therapeutic modality
- ✓Individual progress notes noting each patient's participation and symptom status
- ✓PHQ-9 or equivalent tracked per patient at regular intervals
- ✓Risk screen for each participant (suicidal ideation is common in MDD groups)
Common Denial Reasons
- ✗Per-patient documentation lacking individualized content
- ✗Diagnosis severity inconsistent with moderate specifier — if PHQ-9 suggests mild (5–9) or severe (20+), update the code
- ✗Same-day billing conflict: 90853 and individual therapy (90832/90834/90837) on the same day requires modifier 59 on the individual code
Applicable Modifiers
Reimbursement Notes
OON UCR per patient is $50–$90. Group therapy for depression is well-covered by most commercial plans. Carve-out behavioral health plans (Optum, Beacon) may have separate group therapy fee schedules.
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