Fee Navigator®

    Health Service Code 08.44A

    Group psychotherapy, where all members of the group are receiving therapy in the session, full 15 minutes or major portion thereof for the first call when only one call is claimed

    NOTE:
    1. May be claimed by a physician other than a psychiatrist only when a physician assessment has established (during the same or a previous visit) that the patient is suffering from a psychiatric disorder.
    2. For treatment of non-psychiatric disorders, the appropriate office visit HSC should be claimed.
    3. Group therapy services for patients 18 years of age or younger may be claimed using HSC 08.44C or 08.44D.
    4. May be claimed by a general practitioner (GP) or a generalist in mental health (GNMH) when providing services in the capacity of the second or subsequent physician for psychotherapy of complex groups (HSC 08.44D).
    Category:V Visit
    Base rate:$44.10

    Fee modifiers:

    TypeCode# of callsExplicitActionAmount
    SKLLGNMHReplace Base$59.11
    SKLLGPReplace Base$44.10
    SKLLPSYCReplace Base$73.26
    SESUSESU1 - 32For Each Call Pay Base At100%
    NBPGNBPGYesReduce Base To
    CALLM151 - 32For Each Call Pay Base At100%
    TELETELESYesIncrease Base To120%

    Governing Rules:

    • 4.11.1

      A physician may submit claims for group psychotherapy, psychiatric management and/or indirect services for the same patient on the same day.