CPT 90853 + ICD-10 F84.0: Autistic disorder
Group psychotherapy billed with Autistic disorder — documentation requirements, denial reasons, modifiers, and reimbursement context.
Compatibility Notes
Social skills groups and psychotherapy groups for ASD patients. Group therapy for ASD must be distinguished from ABA group therapy (which requires different billing). Per-participant billing required. Group format for ASD requires documentation of psychotherapy content, not just behavioral skill practice.
Documentation Required
- ✓Per-participant attendance and ASD diagnosis
- ✓Psychotherapy content documented (not ABA-only behavioral skill practice)
- ✓Group social skills or therapy goals per participant
- ✓Individual participant progress notes
Common Denial Reasons
- ✗ABA-type behavioral group billed under psychotherapy code
- ✗Group billed as single claim
- ✗Notes do not reflect psychotherapy content
Applicable Modifiers
Reimbursement Notes
OON UCR $50–$90 per participant. ASD group therapy coverage varies by state mandate. Ensure psychotherapy content is documented and distinguished from ABA services.
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