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Coverage of Group Psychotherapy

Illinois Medicaid - HFS·IL · Psychiatry·Provider Notice
Effective date
Oct 1, 2009
We identified it
Jun 21, 2026
Days to comply

Summary

New rules for group psychotherapy billing effective October 1, 2009 limit patients to 2 sessions per 7-day period with specific documentation requirements. Starting January 1, 2010, only physicians with completed psychiatry residency can bill for these services and must have HFS 3882 certification on file.

Action Required

Action needed
By January 1, 2010: Physicians billing group psychotherapy must submit HFS 3882 Psychiatric Residency Certification and residency completion documentation to Healthcare and Family Services Provider Participation Unit. Update billing system to limit group psychotherapy to maximum 2 sessions per 7-day period per patient. Ensure sessions are minimum 45 minutes, group size maximum 12 patients, and physician documents session focus, participation level, and start/end times in medical record. Claims without proper certification will be rejected with code G98.