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CPT 90853 + ICD-10 F40.10: Social anxiety disorder (social phobia), unspecified

Group psychotherapy billed with Social anxiety disorder (social phobia), unspecified — documentation requirements, denial reasons, modifiers, and reimbursement context.

CPT Code
90853
Group psychotherapy
ICD-10 Code
F40.10
Social anxiety disorder (social phobia), unspecified
Common Modifiers

Compatibility Notes

Group therapy is a particularly effective format for social anxiety disorder — the group setting itself is a graduated exposure environment. CBT group programs for social anxiety (Clark and Wells, CBGT) are evidence-based. Per-participant billing required. Most payers accept this combination for outpatient group therapy.

Documentation Required

  • Per-participant attendance and social anxiety diagnosis
  • LSAS or equivalent per participant
  • Group session exposure component documented
  • Individual progress notes with social anxiety symptom status

Common Denial Reasons

  • Group billed as single claim
  • Notes do not document evidence-based group format for social anxiety
  • Group size too large for social anxiety group (typically 4–8 participants)

Applicable Modifiers

Reimbursement Notes

OON UCR $50–$90 per participant. Social anxiety group therapy has strong evidence; document the CBT group format and exposure components explicitly.

Related Billing Guides

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