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Home / Services / Non Medicaid: Outpatient Group Therapy

Non Medicaid: Outpatient Group Therapy

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About

Coverage Information Icon

Non-Medicaid (State)

Diagnosis Group(s) Information Icon

Developmental Disability, Mental Health, Substance Use

Age Group(s) Information Icon

Adults 18+, Child

Reference Documents

Authorization

Submission Requirements Information Icon

  • Service Authorization Request (SAR)

Authorization Duration and Limits Information Icon

Adult Mental Health/Substance Use
No Prior Authorization required

  • Mental Health Billing limits: 52 sessions fiscal year limit (2 sessions per week, 9 per month when provided using a promising practice or evidenced based approach)
  • Substance Use Billing limits: 180 sessions fiscal year limit (3 sessions per week, 15 sessions per month)

Child Mental Health/Substance Use
No Prior Authorization required

  • Mental Health Billing limits: 52 sessions fiscal year limit (2 sessions per week, 9 per month when provided using a promising practice or evidenced based approach)
  • General group therapy: 16 sessions

ASAM Level of Care Information Icon

1

Request Prior Approval from Alliance Health

Service Codes & Descriptions

  • 90853 – Group Therapy

Full Service Definition

<a target="_blank" href="https://medicaid.ncdhhs.gov/media/10107/open">Download PDF</a>
Download PDF