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Billing and coding

Billing group psychotherapy with CPT code 90853 & 90849

Here’s how to properly document and bill group therapy sessions.

Even if individual therapy may be the crux of your practice, you may facilitate therapy in group settings from time to time. Just as you’ll need particular skills to lead a group of clients, it’s also important to learn about how to properly document and bill these sessions. Understanding the CPT codes commonly involved with group psychotherapy is the first step.

Below, learn more about billing group psychotherapy with CPT code 90853 & 90849.

When should you use a group therapy code?

Group therapy codes are used when you’re providing psychotherapy to a group of individuals who don’t have a previous relationship. These individuals typically share experiences, symptoms, or diagnoses. For example, you could use a group therapy code when you’re facilitating a small group of clients who have depression, but not for a couples or family therapy session. For information on how to bill couples or family therapy, see our CPT code 90847 guide.

Which group therapy code should you use?

Code 90853 is used for standard group therapy sessions where a therapist treats multiple unrelated clients at once, focusing on shared therapeutic goals — for example, treating a group of clients who want to improve their depression symptoms.  

In contrast, 90849 is used for multi-family group therapy, where more than one family participates together to work through systemic issues, often in settings like family-based treatment or substance use programs.

CPT code 90853 definition and description

CPT code 90853 is used for group psychotherapy, which is when a therapist facilitates therapy with several clients who share an experience, symptom, or diagnosis. Group psychotherapy typically includes at least three clients and one psychotherapist. For example, 90853 may represent a therapy session with a group of young adults who want to improve their depression symptoms. 

CPT code 90849 definition and description

Additionally, CPT code 90849 is used for multiple family group psychotherapy, which is a blend of group therapy and family therapy. For example, 90849 may represent a therapy group with families of someone who has a substance use disorder. However, it’s uncommon and is typically only used in higher levels of care.

Documentation requirements

Along with being complete and legible, group therapy documentation should include: 

  • First and last name of participants
  • Date of service
  • Identity of the provider with credentials
  • Subject covered in group
  • Therapy intervention techniques
  • Client progress and response to treatment
  • Changes in treatment and revision of diagnosis (when applicable)


Further, each client should have their own treatment plan, with unique goals. Unlike with couples therapy, which is typically billed as one unit, each participant in group therapy needs their own individual record and documentation outlining how they participated in the group. 

Detailed documentation is one of the most important components of successful billing. Including all the necessary information to serve as justification for your insurance claim — including diagnosis, treatment goals, and treatment plan — can prevent clawbacks or delays in payment. Headway provides documentation templates that makes note-taking and billing easier and ensures proper compliances.

Time frame

Headway group therapy sessions are usually conducted for a minimum of 45 minutes. Your therapy may vary according to factors such as your insurance contract, the therapy modality you’re using, and how often you meet as a group. You may need to use an add-on code if your group session is longer than 45 minutes.

When coordinating sessions, keep in mind some groups opt to meet on an open-ended basis, while others meet for a particular number of weeks before terminating. Insurance companies may limit the number of sessions covered, so this is something to take into account when setting clients up in a group.

CPT code 90853 & 90849 reimbursement rates

Reimbursement rates vary widely depending on your contract with the payer. Typically, these group therapy codes are flat rates, so you need to meet the minimum time element to bill the agreed-upon, contracted amount.

At Headway, providers know exactly what to expect when it comes to getting paid. Along with making it easy and fast to file insurance claims, Headway guarantees payment within two weeks.

Find out your rates with Headway

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This document is intended for educational purposes only. It is designed to facilitate compliance with payer requirements and applicable law, but please note that the applicable laws and requirements vary from payer to payer and state to state. Please check with your legal counsel or state licensing board for specific requirements.

Billing and coding