Virtual Group Therapy: How to Bill It Correctly and Get Paid
Blog Outline
- Introduction
- What Is Virtual Group Therapy and How Does It Differ Clinically?
- Key CPT Codes for Group Psychotherapy in 2025
- Group Therapy Billing Process — Step-by-Step Guide
- Documentation Standards and Compliance Requirements
- Reimbursement and Payer Readiness
- The Future of Online Group Therapy Reimbursement
- Conclusion
- FAQs
Introduction
Over the past few years, mental health providers have witnessed a remarkable evolution in how therapy is delivered — and billed. What started as a temporary solution during the pandemic has now become a core part of behavioral health care: virtual group therapy. Clinics, hospitals, and private practices alike are increasingly using online platforms to conduct group psychotherapy sessions, giving patients access to shared healing experiences. But as clinical adoption grows, so do the complexities behind billing for online group therapy sessions
Unlike individual teletherapy, group sessions involve multiple participants, varying session lengths, and multi-provider collaboration — all of which influence how claims are coded and reimbursed. Payers want detailed documentation of participation, supervision, and therapeutic intent before approving payment.
The challenge isn’t just getting paid — it’s getting paid accurately and compliantly. Each payer interprets group therapy coverage differently, especially when the sessions are virtual. Some follow CMS guidelines for group psychotherapy reimbursement, while others impose stricter requirements for documentation or patient eligibility.
What Is Virtual Group Therapy and How Does It Differ Clinically?
Virtual group therapy refers to structured psychotherapy sessions conducted online, where multiple patients participate together under the guidance of one or more licensed mental health professionals. These sessions typically focus on shared issues such as anxiety, trauma recovery, grief, or behavioral adjustment — creating a supportive therapeutic environment that emphasizes connection and group insight.
In recent years, virtual group therapy sessions have become a preferred model for both clinicians and patients. The combination of accessibility, cost-effectiveness, and the comfort of attending from home has made it an essential part of modern behavioral healthcare delivery. But while the clinical benefits are well-documented, billing for these services requires a deeper understanding of how group sessions are structured and documented compared to traditional, in-person formats.
Group sessions demand detailed tracking of attendance, session duration, participant engagement, and supervision. The therapist must ensure that each session meets the clinical definition of group psychotherapy. For billing purposes, this means the focus must remain on active therapeutic intervention rather than open discussion or peer sharing alone.
From a compliance perspective, online group counseling documentation must demonstrate that the session included structured therapeutic content, measurable goals, and clinician oversight. This documentation serves two purposes: it establishes clinical validity and supports accurate claim submission.
Clinically, group therapy delivered virtually must mirror the same standards as in-person care. Therapists are responsible for confirming participant identity, ensuring privacy through secure platforms, and maintaining confidentiality across multiple attendees — a critical compliance issue under HIPAA. Each session’s effectiveness, participation, and progress should be recorded individually, even though the session is conducted as a group.
While the group psychotherapy structure remains consistent with in-person care, the billing implications differ because virtual settings introduce new verification and compliance elements. Insurers increasingly require proof that sessions meet their definitions of real-time therapeutic interaction, with most demanding video participation instead of audio-only calls.
Key CPT Codes for Virtual Group Psychotherapy in 2025
For mental health providers offering virtual group therapy, accurate coding is the backbone of successful reimbursement. Understanding which billing codes for group psychotherapy apply — and how to document them properly — ensures each claim aligns with payer expectations and avoids compliance pitfalls.
The American Medical Association (AMA) continues to recognize two primary CPT codes for group-based psychotherapy services in 2025:
- 90853 – Group Psychotherapy (other than of a multiple-family group)
- 90849 – Multiple-Family Group Psychotherapy
Both codes describe structured psychotherapy sessions involving two or more patients, guided by a licensed clinician, where the therapeutic focus is behavioral or emotional improvement through group dynamics.
In virtual settings, these codes still apply, but how they are documented and reported differs from in-person care. For a session to qualify as billable, it must meet three key conditions:
- The provider delivers live, interactive psychotherapy to a defined group.
- Each participant’s attendance and engagement are recorded individually.
- The session is led by a clinician authorized under payer and state scope-of-practice regulations.
This distinction is critical — simply hosting an online group meeting or support circle does not meet the definition of billable psychotherapy. Each group session reimbursement claim must show that the therapy involved direct clinical intervention, not general wellness discussion or psychoeducation.
It’s also important to maintain accurate session timing. Group psychotherapy typically spans 45–60 minutes, and billing for shorter or longer sessions requires justification through progress notes. Payers may request logs of start and end times, confirming that sessions were live, interactive, and properly supervised.
Some clinicians attempt to combine 90853 with prolonged service codes or telehealth modifiers, but this should be done cautiously. Most payers still require that group therapy billing compliance in 2025 align with traditional psychotherapy parameters — meaning that each claim must represent a complete, self-contained session. When modifiers are used, they must be supported by documentation explaining the need for additional time or special circumstances (e.g., crisis interventions).
As coverage expands, insurers are expected to refine group session reimbursement guidelines further, particularly as parity laws strengthen in behavioral health. Providers who master coding accuracy today — and track payer updates closely — will find themselves ahead of the curve when broader virtual group therapy reimbursement becomes routine.
In short, while CPT codes for group psychotherapy haven’t changed much in 2025, how they are applied has. Virtual delivery adds documentation, compliance, and technology requirements that providers can’t overlook. A properly coded and well-documented session doesn’t just ensure payment — it protects the integrity of the therapeutic care being delivered
Group Therapy Billing for Virtual Visits — Step-by-Step Process
Step 1 — Verify coverage and patient eligibility
Confirm each participant’s insurance covers group psychotherapy and virtual delivery. Note payer-specific rules (prior auth, allowed platforms, or limits on group sessions) in your payer matrix.
Step 2 — Obtain informed consent and capture tele-platform details
Collect signed consent that notes the virtual format, privacy limits, and emergency procedures. Save platform name and version in the chart for compliance with virtual group therapy requirements.
Step 3 — Schedule with clear session metadata
Create a single group appointment linked to individual patient records. Record date, start/end times, facilitator(s), and session objective in the EHR to support later billing and audit requests.
Step 4 — Confirm attendance and identity at session start
Verify each participant’s identity and log the time they join/leave. Attendance logs are critical evidence for billing for online group therapy sessions and for resolving disputes.
Step 5 — Deliver structured clinical content and note interventions
Run the session as clinical group psychotherapy (not a support group). Document therapeutic interventions and measurable goals in the group note, and ensure facilitation reflects billed treatment intent.
Step 6 — Create individual progress notes after the group
For each participant, write a brief individualized progress note: participation level, response to interventions, clinical observations, and plan. These individual notes justify reimbursement for each billed attendee.
Step 7 — Assign the correct CPT code(s) and provider credentials
Use 90853 (group psychotherapy) or 90849 (multiple-family group) as appropriate. Ensure the billing clinician’s credentials match payer requirements and are documented in the claim.
Step 8 — Check for prior authorization or payer-specific modifiers
Before submitting, confirm if the insurer requires authorization, specific modifiers, or documentation uploads for virtual group claims. Update the payer matrix with any unique submission rules.
Step 9 — Batch and submit participant claims with matching notes
Only submit claims after all individual notes and attendance logs are completed. Include session duration, billing clinician NPI, and a clear place-of-service indicator appropriate to virtual care.
Step 10 — Monitor remittance and reconcile payments
Track EOBs and remittance advice to detect underpayments or coding denials. Reconcile payments against expected revenue to catch errors early.
Step 11 — Appeal and resubmit with clinical evidence if denied
If a claim denies for “insufficient documentation” or “non-covered service,” attach the relevant individual progress notes, attendance logs, and a cover letter explaining therapeutic intent, then resubmit.
Step 12 — Run periodic internal audits and update workflows
Monthly or quarterly, audit a sample of group sessions for documentation completeness, proper code use, and payer compliance. Use findings to update EHR templates and staff training.
Step 13 — Maintain patient transparency and clear financial policies
Provide participants with a Good Faith Estimate (if self-pay) and explain superbill options for out-of-network reimbursement. Clear communication reduces billing disputes and improves collections.
Quick Checklist for Group Therapy Billing
✓ eligibility
✓ consent
✓ schedule & metadata
✓ attendance log
✓ individual progress notes
✓ correct CPT & NPI
✓ prior auth check
✓ submit
✓ monitor
✓ appeal
✓ audit
✓ patient financial policy
Documentation and Compliance in Group Therapy Virtually
Accurate documentation for virtual group therapy begins with clinical intent. Each session must be recorded as structured psychotherapy, not a casual support meeting or educational group. Progress notes should demonstrate therapeutic objectives, measurable outcomes, and evidence of clinician oversight. For compliance, the documentation should capture who attended, what was covered, how long the session lasted, and what clinical methods were applied.
A well-documented group session typically includes five essential components:
- Session overview: Purpose, group theme, and target condition (e.g., anxiety management, trauma processing).
- Attendance record: Names of participants, arrival/departure times, and verification of identity.
- Therapeutic approach: Techniques used — cognitive-behavioral, dialectical, or mindfulness-based — and the therapist’s active interventions.
- Clinical observations: Individual participation summaries and behavioral notes for each patient.
- Outcomes and plan: Patient response, goal progression, and next steps
These elements create a defensible record that satisfies both clinical and payer documentation requirements. Most denials for group therapy occur not because of incorrect coding, but because of vague or incomplete records that fail to show measurable therapeutic progress.
HIPAA and confidentiality remain central to virtual group therapy compliance. Providers must use encrypted, HIPAA-compliant platforms and ensure that all participants are briefed on privacy expectations. Recording sessions should be avoided unless clinically required and explicitly consented to. If recorded, files must be stored securely, with restricted access and retention policies consistent with state and federal laws.
Reimbursement and Payer Readiness for Group therapy Billing
For mental health providers, navigating virtual group psychotherapy reimbursement is often a balancing act between payer policy, documentation accuracy, and evolving coverage standards.
Most commercial insurers and government programs — including Medicare and Medicaid — recognize group psychotherapy as a covered behavioral health service. However, the inclusion of virtual delivery varies widely. Some payers fully reimburse online sessions that meet parity standards, while others still restrict coverage to in-person encounters or specific diagnostic categories. Understanding where each payer stands is the first step toward group therapy coverage readiness.
At the federal level, the Centers for Medicare & Medicaid Services (CMS) continues to refine behavioral health reimbursement frameworks, signaling openness to permanent coverage for virtual group sessions that mirror in-person therapeutic intent and structure. But commercial insurers often require additional proof of compliance. In practice, reimbursement for group psychotherapy depends on four core elements:
While reimbursement for in-person group therapy has been stable for years, the reimbursement process for group counseling delivered virtually is still maturing. Many payers now include temporary tele-behavioral codes or rely on parity laws that require coverage equivalence for digital sessions. However, these laws vary by state and may not apply uniformly across commercial plans.
Despite these inconsistencies, trends are moving in a favorable direction. CMS’s push for integrated behavioral health reimbursement and the post-pandemic emphasis on tele-behavioral access are driving policy updates that will likely expand group session payment trends over the next few years. Providers who establish billing compliance workflows now — including payer readiness checklists, claim tracking dashboards, and documentation audits — will see smoother transitions when broader virtual group coverage becomes standard.
The Future of Online Group Therapy Reimbursement
The landscape of behavioral health billing is changing rapidly, and virtual group therapy stands at the center of this transformation. What was once a temporary telehealth adaptation is now becoming a permanent model of care — supported by digital infrastructure, payer innovation, and shifting federal policy.
In the near term, the future of group therapy reimbursement will be shaped by how quickly payers integrate parity principles into behavioral health billing. The Centers for Medicare & Medicaid Services (CMS) has already made strides toward permanent recognition of virtual behavioral care, and its next major step is likely to include structured coverage for online group psychotherapy.
Virtual Group Therapy
Commercial insurers are also moving in this direction, albeit cautiously. Several major payers are piloting programs that test reimbursement equivalency between in-person and virtual group therapy sessions. These pilot outcomes will determine how payer trends in group psychotherapy evolve — especially for providers using secure, HIPAA-compliant platforms and maintaining structured documentation.
Reimbursement parity
Technology will play a major role in this transition. Many EHR and billing platforms are incorporating automation tools that link attendance tracking, consent management, and documentation directly into billing workflows. This level of integration will make virtual group counseling billing more efficient, less error-prone, and fully audit-ready. Providers who invest in this infrastructure now will be the first to benefit from smoother reimbursement cycles as policies expand.
Digital infrastructure
Technology will play a major role in this transition. Many EHR and billing platforms are incorporating automation tools that link attendance tracking, consent management, and documentation directly into billing workflows. This level of integration will make virtual group counseling billing more efficient, less error-prone, and fully audit-ready. Providers who invest in this infrastructure now will be the first to benefit from smoother reimbursement cycles as policies expand.
Policy evolution
(CMS & state laws)
State-level parity laws are also gaining strength, requiring insurers to cover virtual behavioral health services at the same rate as in-person sessions. As these laws continue to expand, particularly in states that emphasize mental health equity, the virtual group counseling billing outlook will shift from uncertain to standardized. When paired with national mental health initiatives, this evolution could make online group therapy a fully reimbursable mainstream service by 2026 or 2027.
Ultimately, the future of group therapy reimbursement is not just about technology or policy — it’s about legitimacy.
Conclusion
Virtual group therapy has moved beyond being a post-pandemic adaptation — it’s now a vital part of how behavioral health care is delivered, accessed, and reimbursed. As patients continue to embrace the convenience and connection of online group sessions, providers face the equally important challenge of building billing systems that match this progress.
The shift toward virtual group therapy billing requires more than correct coding. It demands structured documentation, payer-specific compliance, and consistent adherence to clinical standards. When done right, billing becomes more than a back-office function — it becomes a reflection of clinical integrity and operational precision.
Providers who understand the nuances of group psychotherapy reimbursement — from proper use of CPT codes to individualized documentation and audit readiness — will have a clear advantage as payers expand their coverage frameworks. Those who wait for regulations to catch up may find themselves struggling to retrofit old workflows to new reimbursement models.
The online group counseling billing process is evolving quickly, and it’s doing so in providers’ favor. As CMS, commercial insurers, and state parity laws push for greater mental health access, reimbursement pathways will continue to open. Clinics that prepare now — by standardizing billing workflows, refining compliance practices, and integrating secure technology — will be best positioned to capture those opportunities when they arrive.
At MedStates, we believe that every provider deserves the tools, clarity, and confidence to bill ethically, accurately, and efficiently. As virtual care continues to grow, our mission remains simple: help practices get paid for the care they provide while staying fully compliant with payer and federal guidelines.
The future of group therapy is collaborative — both in care and in billing. By combining clinical excellence with administrative precision, providers can transform virtual group therapy into a sustainable, compliant, and fully reimbursable model of mental health care
