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"
"The biggest error: 90853 (Group) is billed per patient. If 8 patients attend, you submit 8 claims for 90853. In contrast, 90847 (Family) is billed once per session, regardless of whether 2, 3, or 5 family members are in the room."
