One common code for non-intensive outpatient groups for Mental Health or insurance billing for 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.
Here is the common mistake, not adding the correct modifier. Often times it could possibly be done to use modifier 59 to do 2 groups on the same day, however most carriers don’t allow for the same code on the same day.
Again, The billing code for non-intensive outpatient group therapy for mental health diagnoses is known as CPT code 90853. This code is used to bill for group therapy sessions that are conducted in an outpatient setting, and the therapy is 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.
It’s important to note that insurance coverage for mental health services varies by plan, so it’s important to verify coverage and reimbursement rates before billing for services. Additionally, mental health professionals should be familiar with the specific requirements and guidelines for billing and documentation set forth by insurance companies and regulatory agencies.