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Group Psychotherapy (90853)

H

hthomson

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HELP- I am looking for the minimum participant requirements for group therapy. The only information I can find states group usually has 4-9 members. I am look for a more concrete answer for my providers. Thank You
 
The insurance may determine the upper and lower size limits of a group. In my state, the medicaid program is very specific about the size of a therapy group (4-10). I tried looking on various professional association groups but didn't have much luck.
 
Medicare has stated 2-12 participants. The participants are not required to be all Medicare beneficiaries, but the total number. When we were audited for our group notes, this wasn't something that they looked at. When asked that questions hypothetically, the response was and I quote "Hypothetically, don't let it happen". Unfortunately, it is up to each insurance company to decide this.
 
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