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Wiki CPT 90853 Group Requirement Psychotherapy

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pattisandlin

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Good Afternoon,

I am looking for the minimum requirements for "group" therapy. I have been unsuccessful at finding an answer searching the internet. I did find that some insurance plans determine what "group" means but if anyone can provide insight, it would be much appreciated.

Thank you!
 
I've been looking for a while and not found anything. I have found CMS says no more than 12, Medicaid I believe says 4 for a group. I find this especially difficult when we have "closed" groups which are basically contracted between the patient and Provider and then we only have two. Is two a group? I'd love an answer too. :)
 
I am looking for this information also, with no luck. Can you bill an E/M office visit along with a 90853? I'm leaning towards yes, and just adding a modifier 25 to the office visit. Also, we are an addiction clinic and have a lot of MD's but they are not psychologists...can they do these group therapy sessions?
Any information would be much appreciated!
 
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