Group Therapy Billing — 2026 Rules for 90853 + T1015

Group therapy is one of the most under-billed BH modalities because clinicians and billers get the codes wrong. CPT 90853 (group psychotherapy) and HCPCS T1015 (clinic visit) rules differ by payer.

90853 Rules 2026

• Group psychotherapy — 2+ clients per session (excluding therapist)
• No age limit
• Not time-based — one unit per session per patient regardless of session length
• Cannot combine with individual therapy same-day (payer-varying)
• Documentation must show therapeutic interaction, not just information sharing

T1015 (Clinic Visit) Rules

• HCPCS code for FQHC/clinic setting
• Bundled with group therapy in some payers
• Medicaid-specific — commercial rarely accepts

Common Group Therapy Denials 2026

1. 90853 billed as time-based (should be per-session flat)
2. Attendance list missing from progress note
3. Concurrent 90837 individual therapy denied
4. Family therapy 90847 misapplied for <2 client group

Fix — Group Note Template

Standardize group therapy notes: attendance list, session objective, participation notes per client, homework assigned.

$1.04M case study · Free audit

– KD, Revenant Care