CPT 97150 is a key billing code used for group therapy sessions, particularly in physical therapy, occupational therapy, and behavioral health settings. If you’re a healthcare provider or billing specialist, understanding the correct use of the 97150 CPT code is essential for ensuring clean claims, timely reimbursements, and audit-proof documentation.
In 2025, with the continued updates in payer guidelines and billing regulations, applying the CPT code 97150 properly is more important than ever.
CPT code 97150 is used for therapeutic activities delivered in a group setting involving two or more participants. These sessions are led by licensed healthcare professionals, including physical therapists, occupational therapists, and others qualified to provide rehabilitative care. Such as
The 97150 CPT code description is:
“Therapeutic procedure(s), group (2 or more individuals), untimed.”
That means the service is not timed per patient, but rather, billed per group session, regardless of the individual’s time.
No, CPT 97150 is not a timed code. Unlike CPT 97110, which is billed in 15-minute increments per patient, 97150 is billed once per group session per patient, regardless of the time spent.
The code is widely applicable in:
It’s commonly used for services like:
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To bill this code correctly, you need:
Average Reimbursement Rate:
Billing Tips:
Code | Type | Time-Based? | Use Case |
97150 | Group Therapy | No | 2 patients, same or similar therapy |
97110 | Therapeutic Exercise | Yes (15 mins) | One-on-one physical therapy |
Pro tip: Don’t combine these two for the same patient on the same day unless supported by clear, separate documentation.
Medicare Billing Tips:
Private Insurance Tips:
Billing oversight: Many denials occur because group therapy was not covered under a specific plan or lacked prior approval.
Error | Correction |
Billing for only 1 patient | Use one-on-one codes like 97110 or 90837 |
Missing time logs | Always document session start/end times |
Incorrect group size | Ensure 2+ patients are documented per payer rule |
Omitting required modifiers | Add GP, GO, GN, CO, or CQ as applicable |
Correctly using the 97150 CPT code isn’t just about revenue; it’s about clinical clarity, compliance, and credibility. Whether you’re a provider or a billing team, mastering the nuances of this group therapy code helps you prevent denials, capture full reimbursement, and support optimal patient care.
By leveraging tools like real-time EHR prompts, structured documentation, and prior authorization workflows, you can take control of your CPT 97150 billing.
Need Help With CPT 97150 Billing?
Let Cures Medical Billing support your group therapy documentation, compliance, and payer-specific coding needs. Explore our:
CPT 97150 is used when two or more patients receive therapeutic treatment at the same time, in the same space, with similar goals like strength training, stretching, or group cognitive-behavioral therapy. It’s not one-on-one care, but everyone in the group is supervised by a licensed therapist throughout the session.
It’s billed per patient, not per group. So, if four patients participate in one group session, you’ll submit four separate 97150 charges one for each individual. But remember, this code is untimed, so you only bill it once per patient per session, no matter how long the group lasts.
Yes, but with caution. You can bill both codes for the same patient only if the services are completely separate. That means the patient must have participated in a documented group session and also had a distinct one-on-one therapy session with different goals, both clearly recorded.
Yes. You need at least two patients to bill CPT 97150. For mental health services under Medicare, the cap is usually four people in a group. If you only have one patient in a session, this code no longer applies you’ll need to use an individual therapy code instead.
Insurers look closely at group therapy claims. To stay safe, your notes should include: patient names, session start and end time, the techniques used (like stretching or cognitive exercises), and most importantly each person’s individual progress toward their treatment goals.
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