What your 90853 actually pays: Medicare's 2026 rate for group therapy

Group psychotherapy pays the least per patient of any code in this series, by a wide margin. It is also the code where the per-clinician-hour math looks completely different once you multiply by the size of the room.

The code, and the math that only works in aggregate

CPT code 90853 is group psychotherapy, billed once per patient in the group, for a session other than a multiple-family group. Each patient in the room generates a separate claim at the same rate. Looked at alone, per patient, it is the lowest-paying code in this entire series. Looked at per clinician-hour, it is a different story: a single clinician running one 60-minute group with eight patients bills 90853 eight times for that hour.

What Medicare pays in 2026

Medicare pays $30.39 nationally for 90853 in 2026, up from $28.14 in 2025, an increase of 8.0%. The number underneath that move is the Medicare conversion factor, a single dollar multiplier that CMS applies to every code on the physician fee schedule. It fell for five straight years, from a peak of $36.09 in 2020 to $32.35 in 2025, before this year's rule reversed course: $33.40 for 2026, a 3.26% increase. Behavioral health codes were explicitly exempted from a separate 2.5% efficiency cut applied elsewhere in the same rule.

An eight-patient group billed entirely to Medicare at the 2026 rate brings in $243.12 for one clinician-hour, more than either 99214 ($135.61) or 90837 ($167.00) pays for an hour with a single patient. The economics of group therapy depend entirely on filling the room; a group that runs at three patients instead of eight brings in $91.17 for the same hour, below what a single 90837 session pays.

What commercial payers pay

PayerPrice shows national average commercial rates for 90853 from $34.35 (BCBS/Anthem) to $43.66 (Aetna) as of August 2026, all above the Medicare rate. Every major commercial payer in the PayerPrice data pays more than Medicare for this code, unlike the mixed picture on several individual-therapy codes.

The so-what

• Track fill rate, not just whether a group runs. A group program's revenue lives or dies on how many patients are actually in the room each session, a number worth watching as closely as attendance in any other part of the practice.
• Do not assume group therapy is a low-value service line. Per patient it looks small. Per clinician-hour, a well-filled group often outperforms individual therapy, which changes how a practice should think about scheduling clinician time.