One Common Insurance Billing Code Mistake for Non-Intensive Outpatient Groups in Behavioral Health

One common code for non-intensive outpatient groups, whether for mental health or substance abuse diagnoses, is CPT code 90853.

This code is used to bill for group psychotherapy services, which involve treating two or more patients in a group setting.

To use this code for insurance billing for substance abuse, the mental health provider must conduct a group therapy session that is typically around 60 minutes in length. During the session, the provider works with the group members to address mental health concerns, such as depression, anxiety, or substance use disorders.

It’s important to note that the use of this code is typically limited to certain mental health diagnoses, such as those listed in the Diagnostic and Statistical Manual of Mental Disorders (DSM-5). Additionally, insurance companies may have specific requirements or limitations on the use of this code, so it’s always best to check with the patient’s insurance provider before submitting a claim.

CPT code 90853 applies to group therapy sessions conducted in an outpatient setting, provided by a licensed mental health professional such as a psychologist, social worker, or counselor.

CPT code 90853 is used for group therapy sessions that typically last for about an hour and are attended by several patients with similar mental health issues. These therapy sessions may focus on a specific mental health diagnosis or issue, such as depression, anxiety, or addiction.

When billing for non-intensive outpatient group therapy using CPT code 90853, the mental health professional must provide documentation that includes the date and duration of the session, the number of patients in attendance, the diagnosis or issue addressed during the session, and a description of the therapy provided.

Insurance coverage for mental health services varies by plan, so verify coverage and reimbursement rates before billing. Mental health professionals should also be familiar with the specific billing and documentation requirements set forth by insurance companies and regulatory agencies.