CPT 90853 + ICD-10 F43.10: Post-traumatic stress disorder, unspecified
Group psychotherapy billed with Post-traumatic stress disorder, unspecified — documentation requirements, denial reasons, modifiers, and reimbursement context.
CPT Code
90853
Group psychotherapy
ICD-10 Code
F43.10
Post-traumatic stress disorder, unspecified
Compatibility Notes
Used for group therapy sessions targeting PTSD — such as Seeking Safety, Trauma Recovery and Empowerment Model (TREM), or CPT group formats. 90853 is billed per participant with each patient's individual diagnosis. Group size should be documented. Most payers cover PTSD group therapy without prior authorization for outpatient settings.
Documentation Required
- ✓Per-participant attendance and PTSD diagnosis on each claim
- ✓Group session theme and trauma-focused modality
- ✓Individual participant notes documenting session engagement and symptom status
- ✓PCL-5 or equivalent tracked per patient
- ✓Safety screen for each participant
Common Denial Reasons
- ✗Single group claim rather than per-patient claims
- ✗Notes identical for all participants without individualized observations
- ✗Group size exceeds payer maximum
- ✗No trauma-specific modality documented
Applicable Modifiers
Reimbursement Notes
OON UCR $50–$90 per participant. PTSD group therapy offers favorable revenue per session-hour when groups are full. Per-patient documentation requirements add overhead but are required by all payers.
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