Medicare pays group therapy once a day, however long the group runs
Bill CPT 90853 once for each member present, and write a note for each member that tracks progress toward the member's goals.
Co-founder, JotPsych
Your therapy group ran past an hour. You'd like to bill the extra time.
WPS Government Services, “Medical Review Findings for Group Psychotherapy,” March 16, 2026, 41 minutes. https://www.youtube.com/watch?v=R-IjLhnhfnY
WPS Government Services processes Medicare claims for Iowa, Kansas, Missouri, Nebraska, Indiana, and Michigan. The analyst covers Medicare's coverage rules, the note for each member, and findings from claims WPS reviewed.
Medicare covers group therapy by telehealth, a WPS nurse analyst says at 17:00.
- Keep 90853 to one unit a day. CPT 90853 isn't a timed code, so you bill one unit even when your group runs past an hour, the analyst says at 9:30. Medicare's coding manual allows you one unit on a single date.
- Keep each group small enough to lead. WPS's coverage policy for Iowa, Kansas, Missouri, Nebraska, Indiana, and Michigan gives a maximum of 12 people as its example. Your note for each member should confirm the group had 12 or fewer, the analyst says at 20:30. Elsewhere, check your own contractor's policy.
- Write a note for each member who came. List the topics, what you did, and the member's progress toward goals (20:00). Sign and date each note with your credentials (21:00). In one claim the analyst shows, the note had every part, but its assessment said the member didn't attend (31:00). The date couldn't be billed.
- Bill 90853 and individual therapy on one day only for separate sessions. Medicare allows both sessions at separate times with distinct goals, when your notes show each one, the analyst says at 38:00. If Medicare's code-pair table pairs your codes and allows a modifier, add XE, which marks a separate encounter on the same date, per the coding manual.
Led by a clinician your state authorizes
12 people or fewer, in WPS's example
A covered diagnosis on the claim
Socialization or recreation
Music therapy or art classes
Outings, or eating together
Support groups with no clinician
WPS's policy for six Midwest states lists these activities as outside group therapy. Bill 90853 only for a group led by a clinician your state authorizes.
Our view
Each member's note is the claim's proof. Write each note the same day, while you remember what your members said, what you did, and what changed for each of them.
Give your group an appointment type in JotPsych that starts each visit with 90853 and your group template.
Book 15 minutes- WPS Government Services, "Medical Review Findings for Group Psychotherapy," YouTube, March 16, 2026, 41 minutes. A live WPS event held March 16, 2026, presented by a nurse analyst with provider outreach and education.
- Centers for Medicare & Medicaid Services, "NCCI Policy Manual for Medicare Services," chapter XI, revised January 1, 2026, page XI-34, item 5: one unit of 90853 on a single date of service.
- Centers for Medicare & Medicaid Services, "NCCI Policy Manual for Medicare Services," chapter I, general correct coding policies, revised January 1, 2026, page I-20: modifier XE, a separate encounter on the same date of service.
- Centers for Medicare & Medicaid Services, "Medicare NCCI Procedure to Procedure (PTP) Edits": the code-pair table Medicare posts each quarter. Read October 4, 2026.
- WPS, local coverage determination L34616, "Psychiatry and Psychology Services", for services on or after October 30, 2025: group therapy (e.g., maximum of 12 people) and the activities it excludes. Read October 4, 2026.