Summary & Overview
HCPCS C7903: Remote Group Psychotherapy by Hospital Mental Health Staff
HCPCS Level II code C7903 designates group psychotherapy services provided remotely by hospital-employed, state-licensed mental health staff when the patient is in their home and there is no associated professional service. This code captures a growing category of telebehavioral health as hospitals extend group-based therapy into patients’ residences, reflecting shifts in access and delivery of mental health and substance use care nationwide. Key payers examined include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find a concise explanation of the service captured by C7903, payer coverage patterns where available, common modifier usage, and the clinical context for remote group psychotherapy. The publication outlines benchmarks and policy considerations relevant to reimbursement and billing practice, highlights coding nuances for hospital staff–delivered telebehavioral group services, and summarizes how C7903 fits within the broader telehealth and behavioral health payment landscape. Data not available in the input will be flagged accordingly.
Billing Code Overview
HCPCS Level II code C7903 describes group psychotherapy services delivered remotely by hospital-employed staff who are licensed to provide mental health services under applicable state law(s). The service is provided when the patient is located in their home and there is no associated professional service billed alongside the group psychotherapy.
Service Type: Telebehavioral Health — Group Psychotherapy
Typical Site of Service: Patient's home (telehealth/remote delivery through hospital staff)
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Clinical & Coding Specifications
Clinical Context
A 38-year-old patient with recurrent major depressive disorder and co-occurring alcohol use disorder participates in a hospital-delivered group psychotherapy session conducted remotely while the patient is at home. The hospital’s licensed behavioral health staff (for example, a licensed clinical social worker or licensed psychologist employed by the hospital) convene a 50-minute structured therapeutic group via a secure telehealth platform. The session focuses on cognitive-behavioral strategies, relapse prevention, and peer support and does not include any separate physician or psychiatrist professional service billed concurrently. Clinical workflow: prior to the session the hospital schedules the remote group, obtains informed consent for telehealth, verifies patient identity and location, confirms licensure and scope of practice for the delivering staff, documents attendance and a group treatment note including goals, interventions, patient responses, and any safety concerns, and captures the service under the hospital outpatient billing system using the remote group psychotherapy HCPCS Level II code C7903 when all program and payer rules are met.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
00 | No modifier — default submission | Use as the primary billing without an additional modifier when no special circumstances apply |