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CPT 90853: Group Psychotherapy, 45-60 Minutes

CPT code 90853 represents group psychotherapy: a clinician-led therapeutic intervention for up to 12 unrelated participants, lasting 45–60 minutes. This code is widely used across outpatient behavioral health settings and matters nationally because group psychotherapy addresses common mental health needs at scale, influences care access, and factors into reimbursement and service delivery planning.

Key payers covered in this analysis include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find an overview of clinical context for 90853, guidance on typical sites of service, and explanations of how this code interacts with related psychiatric evaluation and crisis psychotherapy codes. The publication outlines payer coverage patterns, common billing considerations, and limitations tied to specific diagnoses that affect eligibility for psychotherapy services.

The content is intended to help billing managers, compliance officers, clinicians, and policy analysts quickly understand the clinical definition and billing context of CPT code 90853, identify common coding conflicts with related services, and locate the operational elements that influence when and where group psychotherapy can be billed.

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Billing Code Overview

CPT code 90853 describes group psychotherapy provided to a group of patients who are not members of the same family and who commonly share similar psychological issues. The service is led by a licensed psychotherapist and includes up to 12 participants for a session lasting 45 to 60 minutes.

Service type: Group psychotherapy.

Typical site of service: Outpatient behavioral health settings, including clinic or community mental health program group rooms and other ambulatory care locations where multiple patients can participate in a facilitated group session.

National Reimbursement Benchmarks

National averages place Blue Cross Blue Shield and BUCA well above Medicare for CPT 90853: BUCA’s mean of $92.9 is nearly three times Medicare’s mean of $31.4, and Blue Cross Blue Shield’s mean of $131.5 is over four times Medicare. This gap highlights substantially higher average commercial reimbursements versus Medicare for group psychotherapy.

Dispersion varies notably across payers. Blue Cross Blue Shield shows the widest interquartile spread (P75–P25 = $62.8), followed by UnitedHealth Group (P75–P25 = $22.3) and BUCA (P75–P25 = $47.5). Aetna and Cigna exhibit tighter IQRs (Aetna = $26.0, Cigna = $20.3), indicating more concentrated commercial contract levels for those carriers.

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CPT 90853: Group Psychotherapy, 45-60 Minutes

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Billing Code Overview

Service type: Group psychotherapy.

National Reimbursement Benchmarks

National Payer Mean Reimbursement Rates

Clinical & Coding Specifications

Clinical Context

A 28-year-old woman with generalized anxiety disorder attends a weekly outpatient group psychotherapy session led by a licensed clinical psychologist. The clinician schedules and conducts a 50-minute structured group meeting in a clinic conference room with nine unrelated participants who share anxiety-related symptoms. Each session follows an intake assessment (completed previously under 90791) and focuses on cognitive-behavioral strategies, peer support, and skills practice. The clinical workflow includes pre-session preparation (reviewing group notes and treatment plan), check-in and brief symptom rating for each member, 45–60 minutes of therapist-led group psychotherapy activities, documentation of individual attendance and group progress in the medical record, and follow-up scheduling. Billing is submitted under 90853 for the group psychotherapy encounter; individual diagnostic evaluations or medication management visits (e.g., 90792 or a separately billed psychiatric medication visit) are documented and billed separately. Patients with diagnosis codes F72, F73, or F79 are not appropriate for psychotherapy services billed with 90853; alternative service types or accommodations are documented when intellectual disability precludes standard group psychotherapy.

Coding Specifications

Modifier	Description	When to Use
`25`	Significant, separately identifiable E/M service by the same physician on the same day	Use when a separate, significant individual E/M visit occurs the same day as the group psychotherapy session and must be reported in addition to `90853`.
`26`	Professional component	Use when billing only the professional component of a split or shared group service (rare for psychotherapy but applicable in multi-component arrangements).
`59`	Distinct procedural service	Use to indicate a distinct service not normally billed together with `90853` when clinical circumstances justify separate billing.
`52`	Reduced services	Use when the group session is provided for a shorter period or with reduced intensity versus the standard service.
`53`	Discontinued procedure	Use if a scheduled group session is started but discontinued due to unforeseen circumstances.
`59`	Distinct procedural service	Use when a distinct, separately identifiable service is provided on the same day (avoid overlap with crisis codes like `90839`).
`76`	Repeat procedure or service by same provider	Use when the same provider repeats a group psychotherapy service within the global/time period and separate reporting is required.
`77`	Repeat procedure by another provider	Use when a second provider repeats the group psychotherapy service during the same encounter timeframe.
`GT`	Via interactive audio and video telecommunication (telehealth)	Use when `90853` is delivered synchronously via real-time audio-video telehealth platforms.
`95`	Synchronous telemedicine service rendered via real-time interactive audio and video	Alternate telehealth modifier used by some payors when `GT` is not accepted.
`59`	Distinct procedural service (listed again to emphasize common use)	Use cautiously; ensure documentation supports distinctness from psychotherapy crisis codes.
`52`	Reduced services (listed again for emphasis)	Use when the session is truncated but still billable as a reduced service.
`22`	Increased procedural services	Use when group psychotherapy requires substantially greater effort or time due to complexity; documentation must justify additional resource use.
`24`	Unrelated E/M service during postoperative period	Not typically applicable but included when an unrelated E/M is provided during a global period and reported with `90853` (use only if relevant).

Taxonomy Code	Specialty	Notes
`2084P0800X`	Clinical Child & Adolescent Psychology	Providers treating pediatric/adolescent groups; applicable when group members are children or adolescents.
`2084P0802X`	Clinical Psychology	Common provider type for leading group psychotherapy sessions in outpatient settings.
`2084P0200X`	Clinical Social Work	Licensed clinical social workers frequently conduct and bill for group therapy services.
`208D00000X`	Psychiatry & Neurology	Psychiatrists may lead or co-lead groups, particularly when integrated with medication management or complex psychiatric care.

Related Diagnoses

ICD-10 Code	Description	Clinical Relevance
`F72`	Severe intellectual disabilities (NOT covered for psychotherapy services including `90853`)	Indicates severe intellectual disability; documentation must reflect that standard group psychotherapy is not an appropriate billed service under `90853` for these patients.
`F73`	Profound intellectual disabilities (NOT covered for psychotherapy services including `90853`)	Indicates profound intellectual disability; not appropriate to bill `90853` for psychotherapy services for these individuals.
`F79`	Unspecified intellectual disabilities (NOT covered for psychotherapy services including `90853`)	Unspecified intellectual disability warning that `90853` is not covered when intellectual disability prevents effective psychotherapy participation.

Related CPT Codes

CPT Code	Description	Relationship to This Procedure
`90839`	Psychotherapy for crisis; first 60 minutes	Crisis psychotherapy is a stand-alone service and may NOT be billed with `90853`; if a group member requires crisis intervention, `90839` may be billed separately for the individual crisis session but not concurrently with group therapy.
`90840`	Psychotherapy for crisis; each additional 30 minutes	Add-on to `90839` for extended crisis psychotherapy; may NOT be billed with `90853`.
`90791`	Psychiatric diagnostic evaluation	Distinct initial diagnostic evaluation commonly performed before enrollment in group psychotherapy; billed separately from `90853`.
`90792`	Psychiatric diagnostic evaluation with medical services	Diagnostic evaluation including medical/psychotropic assessment; billed separately when medication management or medical assessment is provided in addition to group therapy.

CPT 90845: Psychodynamic Insight-Oriented Psychotherapy

CPT-90846-FAMILY-PSYCHOTHERAPY-WITHOUT-PATIENT

CPT 90846: Family Psychotherapy Without Patient Present

CPT-90847-FAMILY-PSYCHOTHERAPY-PATIENT-PRESENT

CPT 90847: Family Psychotherapy With Patient Present

CPT-90849-MULTIPLE-FAMILY-PSYCHOTHERAPY-GROUP

CPT 90849: Multiple-Family Group Psychotherapy

References

1.CPT® Codes and Descriptions. AAPC. Retrieved Aug 11, 2026.Maintains the CPT code set's official descriptions and guidelines, licensed from the American Medical Association, used as the definitional source for CPT codes on this page.
2.HCPCS Quarterly Update. Centers for Medicare & Medicaid Services (CMS). Retrieved Aug 11, 2026.CMS's quarterly release of HCPCS Level II codes and short/long descriptors, the source for HCPCS code definitions and update history.
3.ICD-10-CM Full Code List. Centers for Medicare & Medicaid Services (CMS). Retrieved Aug 11, 2026.CMS's complete ICD-10-CM diagnosis code list, used to cross-reference diagnosis codes associated with this procedure or service.

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Clinical & Coding Specifications

Clinical Context

Coding Specifications

Modifier	Description	When to Use
`25`	Significant, separately identifiable E/M service by the same physician on the same day	Use when a separate, significant individual E/M visit occurs the same day as the group psychotherapy session and must be reported in addition to `90853`.
`26`	Professional component	Use when billing only the professional component of a split or shared group service (rare for psychotherapy but applicable in multi-component arrangements).
`59`	Distinct procedural service	Use to indicate a distinct service not normally billed together with `90853` when clinical circumstances justify separate billing.
`52`	Reduced services	Use when the group session is provided for a shorter period or with reduced intensity versus the standard service.
`53`	Discontinued procedure	Use if a scheduled group session is started but discontinued due to unforeseen circumstances.
`59`	Distinct procedural service	Use when a distinct, separately identifiable service is provided on the same day (avoid overlap with crisis codes like `90839`).
`76`	Repeat procedure or service by same provider	Use when the same provider repeats a group psychotherapy service within the global/time period and separate reporting is required.
`77`	Repeat procedure by another provider	Use when a second provider repeats the group psychotherapy service during the same encounter timeframe.
`GT`	Via interactive audio and video telecommunication (telehealth)	Use when `90853` is delivered synchronously via real-time audio-video telehealth platforms.
`95`	Synchronous telemedicine service rendered via real-time interactive audio and video	Alternate telehealth modifier used by some payors when `GT` is not accepted.
`59`	Distinct procedural service (listed again to emphasize common use)	Use cautiously; ensure documentation supports distinctness from psychotherapy crisis codes.
`52`	Reduced services (listed again for emphasis)	Use when the session is truncated but still billable as a reduced service.
`22`	Increased procedural services	Use when group psychotherapy requires substantially greater effort or time due to complexity; documentation must justify additional resource use.
`24`	Unrelated E/M service during postoperative period	Not typically applicable but included when an unrelated E/M is provided during a global period and reported with `90853` (use only if relevant).

Taxonomy Code	Specialty	Notes
`2084P0800X`	Clinical Child & Adolescent Psychology	Providers treating pediatric/adolescent groups; applicable when group members are children or adolescents.
`2084P0802X`	Clinical Psychology	Common provider type for leading group psychotherapy sessions in outpatient settings.
`2084P0200X`	Clinical Social Work	Licensed clinical social workers frequently conduct and bill for group therapy services.
`208D00000X`	Psychiatry & Neurology	Psychiatrists may lead or co-lead groups, particularly when integrated with medication management or complex psychiatric care.

Related Diagnoses

ICD-10 Code	Description	Clinical Relevance
`F72`	Severe intellectual disabilities (NOT covered for psychotherapy services including `90853`)	Indicates severe intellectual disability; documentation must reflect that standard group psychotherapy is not an appropriate billed service under `90853` for these patients.
`F73`	Profound intellectual disabilities (NOT covered for psychotherapy services including `90853`)	Indicates profound intellectual disability; not appropriate to bill `90853` for psychotherapy services for these individuals.
`F79`	Unspecified intellectual disabilities (NOT covered for psychotherapy services including `90853`)	Unspecified intellectual disability warning that `90853` is not covered when intellectual disability prevents effective psychotherapy participation.

Related CPT Codes

CPT Code	Description	Relationship to This Procedure
`90839`	Psychotherapy for crisis; first 60 minutes	Crisis psychotherapy is a stand-alone service and may NOT be billed with `90853`; if a group member requires crisis intervention, `90839` may be billed separately for the individual crisis session but not concurrently with group therapy.
`90840`	Psychotherapy for crisis; each additional 30 minutes	Add-on to `90839` for extended crisis psychotherapy; may NOT be billed with `90853`.
`90791`	Psychiatric diagnostic evaluation	Distinct initial diagnostic evaluation commonly performed before enrollment in group psychotherapy; billed separately from `90853`.
`90792`	Psychiatric diagnostic evaluation with medical services	Diagnostic evaluation including medical/psychotropic assessment; billed separately when medication management or medical assessment is provided in addition to group therapy.

CPT 90845: Psychodynamic Insight-Oriented Psychotherapy

CPT-90846-FAMILY-PSYCHOTHERAPY-WITHOUT-PATIENT

CPT 90846: Family Psychotherapy Without Patient Present

CPT-90847-FAMILY-PSYCHOTHERAPY-PATIENT-PRESENT

CPT 90847: Family Psychotherapy With Patient Present

CPT-90849-MULTIPLE-FAMILY-PSYCHOTHERAPY-GROUP

CPT 90849: Multiple-Family Group Psychotherapy

References

1.CPT® Codes and Descriptions. AAPC. Retrieved Aug 11, 2026.Maintains the CPT code set's official descriptions and guidelines, licensed from the American Medical Association, used as the definitional source for CPT codes on this page.
2.HCPCS Quarterly Update. Centers for Medicare & Medicaid Services (CMS). Retrieved Aug 11, 2026.CMS's quarterly release of HCPCS Level II codes and short/long descriptors, the source for HCPCS code definitions and update history.
3.ICD-10-CM Full Code List. Centers for Medicare & Medicaid Services (CMS). Retrieved Aug 11, 2026.CMS's complete ICD-10-CM diagnosis code list, used to cross-reference diagnosis codes associated with this procedure or service.

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CPT 90853: Group Psychotherapy, 45-60 Minutes

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Billing Code Overview

National Reimbursement Benchmarks

OpenPayer

CPT 90853: Group Psychotherapy, 45-60 Minutes

Sign up for cpt 90853 policy alerts

Billing Code Overview

National Reimbursement Benchmarks

Clinical & Coding Specifications

Clinical Context

Coding Specifications

Related Diagnoses

Related CPT Codes

Related Codes

References

Clinical & Coding Specifications

Clinical Context

Coding Specifications

Related Diagnoses

Related CPT Codes

Related Codes

References