Summary & Overview
HCPCS G0410: Group Psychotherapy in PHP/IOP, 45–50 Minutes
HCPCS Level II code G0410 denotes a 45–50 minute session of group psychotherapy (excluding multiple-family groups) provided within partial hospitalization programs (PHP) or intensive outpatient programs (IOP). This code captures a common modality of structured behavioral health treatment used for patients requiring more intensive outpatient care than standard office-based therapy. Nationally, accurate use of G0410 matters for program-level reporting, care coordination, and payment consistency for behavioral health services delivered in higher-acuity outpatient settings.
Key payers included in this analysis are Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find a concise overview of the clinical context for group psychotherapy in PHP/IOP settings, common billing considerations, and the types of benchmarks and policy updates typically reviewed when evaluating utilization of this service. The publication outlines typical service definitions, sites of service, and the categories of information payers and providers commonly reference when reconciling coverage and claims for intensive outpatient behavioral health care.
Data not available in the input: associated taxonomies, specific ICD-10 diagnoses, related codes, and payer-specific reimbursement rates.
Billing Code Overview
HCPCS Level II code G0410 represents group psychotherapy other than of a multiple-family group, delivered in a partial hospitalization or intensive outpatient program. The service is typically provided in a structured behavioral health setting and describes a clinician-led group session that lasts approximately 45 to 50 minutes.
Service type: Group psychotherapy
Typical site of service: Partial hospitalization program (PHP) or intensive outpatient program (IOP)
Clinical & Coding Specifications
Clinical Context
A 32-year-old patient diagnosed with recurrent major depressive disorder participates in a structured group psychotherapy session delivered in a partial hospitalization program (PHP). The patient attends an approximately 45–50 minute G0410 group psychotherapy session, led by a licensed clinical psychologist or psychiatrist, focused on coping skills, cognitive restructuring, and relapse prevention. The clinical workflow begins with intake assessment and treatment planning during PHP admission, daily multidisciplinary team rounds to review progress, scheduled group sessions documented in the medical record with attendance and therapeutic content, and periodic outcome measurement (PHQ-9, GAD-7). Billing uses G0410 for each qualifying 45–50 minute group psychotherapy encounter occurring as part of the partial hospitalization or intensive outpatient program, with appropriate modifiers appended when indicated (for example, unusual procedural service or telehealth). Progress notes include start and stop times, group size, treatment modality, clinician credentials, and goals addressed.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
25 | Significant, separately identifiable evaluation and management service by the same physician on the same day of the procedure or other service | When a separate E/M visit is provided the same day as the group psychotherapy and is clearly significant and documented separately |