The 90853 CPT code is group psychotherapy. You bill it once for each patient in the group, on that patient's own claim. A session with six members is six claims and six notes.
In 2026 Medicare pays USD 30.39 per patient nationally at the non facility rate (USD 24.38 at the facility rate). The code has no time in its descriptor. It can carry the interactive complexity add-on for one member, and it is on the 2026 Medicare telehealth list.
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The Medicare contractor billing guide for LCD L34616 (last revised 2016) says it in six words: "CPT code 90853 represents group therapy." One clinician treats several patients at once. Family sessions have their own codes, 90846 and 90847.
Older guides sometimes call it interactive group psychotherapy. That was a separate code, and it no longer exists. The American Psychiatric Association sheet on interactive complexity records that the interactive versions of the evaluation, individual and group codes were deleted. When a group session is harder to run because of how people communicate, you now add 90785 to 90853 for that patient.
90853 at a glance
| 90853 | |
|---|---|
| Unit | One claim per patient per session |
| 2026 Medicare, national | USD 30.39 non facility, USD 24.38 facility, per patient |
| Time in descriptor | None (90832, 90834 and 90837 carry 30, 45 and 60 minutes) |
| Add-on | 90785 for a specified patient only |
| Same day | Once per day unless a separate, distinct group session |
| Telehealth | On the CY 2026 Medicare telehealth list |
Does 90853 have a time requirement?
Not in the code. The individual psychotherapy codes are written around minutes, and the CMS short descriptors still read "Psytx w pt 30 minutes", "45 minutes" and "60 minutes". The 90853 descriptor reads "Group psychotherapy" and stops there.
That does not make the session length irrelevant. Some Medicaid plans and commercial payers set a minimum length, a maximum group size or both in their own policies. Read the payer's behavioral health manual before you set up a group schedule. Record the start and end time for every session anyway. If a patient arrives late or leaves early, write that down in their note.
How much does 90853 pay in 2026?
Medicare pays USD 30.39 per patient nationally at the non facility rate and USD 24.38 at the facility rate. That is 0.91 and 0.73 relative value units times the 2026 conversion factor of 33.4009, from the CMS relative value file. Your contractor's local amount is what pays, and Medicaid and commercial plans set their own rates.
Because the code pays per patient, the revenue from one hour depends on how many members attend and how many of their claims go through:
| One session | 2026 Medicare, national, non facility |
|---|---|
| 4 patients, 90853 | USD 121.56 |
| 6 patients, 90853 | USD 182.34 |
| 8 patients, 90853 | USD 243.12 |
| 10 patients, 90853 | USD 303.90 |
| 1 patient, 90837 (60 min) | USD 167.00 |
National rates, before locality adjustment. One bad note pattern in a group repeats across every member's claim.
Who can bill 90853?
For Medicare, the contractor guide counts physicians and non physicians, "such as clinical psychologists, independent psychologists, nurse practitioners, clinical nurse specialists," and physician assistants, when the service is within the scope of their state license. The guide does not name social workers, counselors or marriage and family therapists. Medicaid programs and commercial plans each keep their own list, so check credentialing for every payer the group will bill.
Can you bill 90853 and individual therapy on the same day?
Yes, when they are two separate sessions. The L34616 guide says 90853 "should also not be billed more than once per day for the same beneficiary unless he/she has participated in a separate and distinct group therapy session." When a patient has an individual session and a group session on the same day, "modifier -59 should be appended to the CPT code for the second session."
Each session needs its own note with its own times. A single note that covers both will not support two codes.
Can you add 90785 to 90853?
Yes, for one patient at a time. APA Services says 90785 can be reported with 90853 "for a specified patient when group psychotherapy includes interactive complexity" and "should not be reported for every patient participating in the group service." The contractor guide also allows the add-on with 90853 "when medically indicated."
Say one member's caregiver kept disrupting the session, or one member disclosed abuse that you had to report. 90785 goes on that member's claim, and the reason goes in that member's note. The other members' claims stay as plain 90853.
How should you document group therapy for each patient?
Write one note per patient. The claim is per patient, so the note has to show what this patient did and how it connects to their treatment plan. A group summary with the name changed will read the same for every member, and a reviewer will see that.
A note that holds up usually records:
- The date, start and end time, and the number of members present.
- The group's topic or method, in a line or two. This part can be shared.
- What this patient said or did, and how they responded to the others.
- Progress against this patient's own goals, and the plan for the next session.
- For 90785, the specific communication factor and what it did to the session.
Example: Attended full 60 minute session, 7 members present. Topic: relapse triggers. Patient named Friday paydays as her main trigger for the first time and asked another member how he plans those evenings. Goal 2 (identify high risk situations) partly met. Next session: rehearse a Friday plan.
Our guide to psychotherapy notes covers where these notes sit in the record and who can see them.
Why do 90853 claims get denied?
The usual reasons are below. Set them as edits in your billing system, or check them by hand before claims go out:
| What went out | Fix |
|---|---|
| 90853 twice on one day with no second session | Bill once, unless the patient attended a separate, distinct group |
| Individual and group on one day, no modifier | Append 59 to the code for the second session |
| 90785 on every member of the group | Only the member the factor applied to |
| Notes identical across members | Write each member's participation and progress |
| Group billed for a family session | Use 90846 or 90847 |
| Payer limit on group size or length missed | Check the payer's behavioral health policy first |
More on working the ones that do come back in our guides to denial management and claim scrubbing. For telehealth groups, our place of service codes guide covers POS 02 and 10.
Sources
- Medicare contractor Billing and Coding Guidelines, Psychiatry and Psychology Services, LCD L34616, last revised 2016
- APA Services, 2022 guidelines for reporting interactive complexity, January 28, 2022
- American Psychiatric Association, Interactive Complexity, revised November 3, 2012
- CMS 2026 physician fee schedule relative value file and CY 2026 Medicare telehealth list
Streamline Your Practice
A group of eight means eight notes, each written about one person, usually at the end of a long day. mdhub drafts notes from your sessions for your clinician to review and sign. Each draft starts from what was said in the room. For the codes that sit next to 90853, see our pages on 90785, 90834, 90837 and 90847. Start a free trial, or book a demo if you run a clinic with 10 or more clinicians.
90853 CPT code FAQ
Group psychotherapy. It is billed once per patient per session, on each patient's own claim.
Medicare pays USD 30.39 per patient nationally at the non facility rate and USD 24.38 at the facility rate, before locality adjustment.
The code descriptor names no time. Some payers set a minimum length or a maximum group size in their own policies.
The L34616 guide allows it for two separate, distinct sessions, with modifier 59 on the second. Check your own payer's rule.
Yes, on the claim of the one patient whose session had interactive complexity. The other members bill 90853 alone.
Only when the patient attended a separate and distinct group session.
It is on the CY 2026 Medicare telehealth list. Medicaid and commercial plans set their own rules.
For Medicare, the contractor guide names physicians, psychologists, nurse practitioners, clinical nurse specialists and physician assistants within their state license. Check each payer's credentialing list for other clinician types.
