90853 — Group Psychotherapy
Group psychotherapy session with multiple clients (typically 2-12 members, though specific group size requirements vary by payer). The therapist provides psychotherapy to the group as a whole. Each member of the group is billed separately under their own insurance.
Time Requirements
Typically 45-90 minutes for the group session. Per-member time is calculated as total session time — each member bills the same code regardless of individual speaking time.
Modifiers
| Code | Description |
|---|---|
| 95 | Synchronous telemedicine service. |
| HQ | Group setting (required by some Medicaid programs). |
When to Use
- Structured group therapy (DBT skills, CBT groups, process groups)
- Support groups led by a licensed clinician with therapeutic intent
- Psychoeducation groups with a psychotherapy component
- Substance abuse group therapy
When Not to Use
- Individual therapy with a single client — use 90832/90834/90837
- Family therapy — use 90846 or 90847
- Psychoeducation classes without a psychotherapy component
- Peer support groups without a licensed clinician leading
Common Denial Reasons
- Group size outside payer requirements (too few or too many members)
- Documentation does not reflect psychotherapy (reads as a class or lecture)
- Individual progress notes not maintained for each group member
- Missing group therapy documentation (topics, interventions, member participation)
Payer Notes
Each group member is billed separately. Most payers require individual progress notes per member documenting their participation and response. Some Medicaid programs require modifier HQ. Group size requirements vary (Medicare typically requires 2+ clients).
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