Expanding beyond individual therapy? Group (90853) and Family (90847) therapy are powerful modalities, but they have distinct billing rules that are not time-based. Understanding the "per-patient" vs. "per-session" model is critical for correct reimbursement.

Group Psychotherapy (90853)

CPT 90853 (Group psychotherapy):

• This code is billed per patient, per session.
• It is not time-based, though sessions are typically 45-90 minutes.
• Documentation must list all participants and the group's theme/focus. Each patient's note should reflect their participation.

Family Psychotherapy (90846 & 90847)

• CPT 90847: Family/couples therapy with the patient present.
• CPT 90846: Family therapy without the patient present (e.g., counseling parents about a child's treatment plan).
• These codes are billed per session, not per person.
• An "identified patient" must have a mental health diagnosis. You cannot bill 90847 for a non-diagnosed patient's "relationship problems."

"Per-Patient" vs. "Per-Session"