CPT 90853 + ICD-10 F43.12: Post-traumatic stress disorder, chronic
Group psychotherapy billed with Post-traumatic stress disorder, chronic — documentation requirements, denial reasons, modifiers, and reimbursement context.
CPT Code
90853
Group psychotherapy
ICD-10 Code
F43.12
Post-traumatic stress disorder, chronic
Compatibility Notes
Used for trauma-focused group therapy where participants carry chronic PTSD diagnoses. Preferred over the unspecified F43.10 when participants have documented chronic presentations. Evidence-based trauma group formats include Seeking Safety and CPT group. Per-participant billing required.
Documentation Required
- ✓Per-participant attendance and chronic PTSD diagnosis
- ✓Trauma onset confirming chronicity per patient
- ✓Group trauma-focused modality documented
- ✓PCL-5 per participant at outcome intervals
- ✓Safety screen per participant
Common Denial Reasons
- ✗Chronic specifier not supported by documented trauma timeline
- ✗Group billed as single claim
- ✗No individualized progress notes
Applicable Modifiers
Reimbursement Notes
OON UCR $50–$90 per participant. Chronic PTSD group therapy is well-supported by most commercial payers when evidence-based modalities are documented.
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