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Understand CPT 97150 A Guides to Group Therapy Billing

A man and two women discuss about the Group therapy and about CPT 97150?

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.

What Is the 97150 CPT Code?

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

  • Physical Therapists
  • Occupational Therapists
  • Speech-Language Pathologists
  • Therapy Assistants (under supervision)

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.

Is CPT 97150 a Timed Code?

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.

Who Can Use CPT 97150?

  • The code is widely applicable in:

    • Physical therapy (PT)
    • Occupational therapy (OT)
    • Speech therapy (SLP)
    • Behavioral or mental health group therapy

    It’s commonly used for services like:

    • Balance and gait training
    • Pain management exercises
    • Group CBT or mindfulness sessions
    • Stroke or post-op recovery conditioning

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CPT 97150 Documentation Requirements

To bill this code correctly, you need:

  • Group size: 2 or more individuals (Medicare allows up to 4 for mental health)
  • Participants listed by name
  • Interventions performed
  • Start and finish times of the meeting
  • Each patient’s functional progress toward goals

CPT 97150 Reimbursement Guidelines (2025 Update)

  • Average Reimbursement Rate:

    • Medicare pays around $16–$22 per unit (varies by location and specialty)
    • Commercial payers may reimburse higher, but require prior authorization

    Billing Tips:

    • Do not bill 97150 with one-on-one codes like 97110 for the same patient on the same day.
    • Always attach appropriate modifiers:
      • GP for Physical Therapy
      • GO for Occupational Therapy
      • GN for Speech-Language Pathology

CPT 97150 vs. 97110 - What’s the Difference?

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.

Private Insurance vs. Medicare: What to Know

Medicare Billing Tips:

  • Group size: Minimum 2, maximum 4 for behavioral therapy
  • Must be medically necessary
  • Document group dynamics, not just general therapy

Private Insurance Tips:

  • Always check plan-specific authorization requirements
  • Some plans limit session length or number of visits
  • Individual documentation is still required even in group settings

Billing oversight: Many denials occur because group therapy was not covered under a specific plan or lacked prior approval.

Common Billing Mistakes with CPT 97150

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

Tools to Make 97150 Billing Easier

  • EHR Templates: Auto-fill CPT 97150 notes with checkboxes for interventions and time
  • Modifier Checkers: Flag missing or incorrect therapy modifiers
  • Denial Analytics: Review rejected CPT 97150 claims by payer and fix patterns

Conclusion

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:

Frequently Asked Questions (FAQs)

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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