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Revisions and Enhancements to Mental and Behavioral Health CPT Codes in 2024
Updated: Apr 19
The American Medical Association (AMA) unveiled revisions to CPT codes for 2024 in November 2023, scheduled to go into effect on January 1, 2024. Noteworthy adjustments primarily focus on telehealth and Evaluation & Management (E/M) visits, impacting mental and behavioral health providers.
Key highlights of the 2024 CPT code revisions include:
Addition of Psychotherapy HCPCS codes G0017 and G0018
In-home telehealth services billed at non-facility rates
Updated physician fee rates for psychotherapy and HBAI services
MHCs and MFTs now eligible for direct Medicare billing
Removal of time ranges for E/M codes
Updates to 2024 CPT Codes Impacting Mental and Behavioral Health Practitioners
In the upcoming year, mental and behavioral health practitioners should anticipate several modifications to the CPT codes. While major adjustments are minimal, notable alterations primarily center around billing procedures that may influence practice billing methods.
Newly added HCPCS Codes for Crisis Psychotherapy Services
In 2024, CMS has introduced a duo of novel psychotherapy HCPCS codes:
G0017: Psychotherapy for crisis furnished in an applicable site of service (any place of service at which the non-facility rate for psychotherapy for crisis services applies, other than the office setting); first 60 minutes
G0018: Psychotherapy for crisis furnished in an applicable site of service (any place of service at which the non-facility rate for psychotherapy for crisis services applies, other than the office setting); each additional 30 minutes
(These codes are eligible for reimbursement when delivered as telehealth services and in other settings necessitating billing at the non-facility rate.)
Additional 2024 HCPCS codes, which could be pertinent to certain mental and behavioral health providers and their teams, consist of:
G0019: Community health integration services performed by certified or trained auxiliary personnel, including a community health worker, under the direction of a physician or other practitioner; 60 minutes per calendar month
G0022: Community health integration services, each additional 30 minutes per calendar month
G0136: Administration of a standardized, evidence-based social determinants of health risk assessment tool, 5-15 minutes
2. Telehealth services provided in patients' homes must now be billed at non-facility rates.
Telehealth services delivered to patients in their homes will now be compensated at non-facility rates according to a new policy outlined by the Centers for Medicare & Medicaid Services (CMS) for 2024. Billers are advised to append modifier 95 to telehealth claims when providers administer services from the hospital while the patient is at home, along with any required place of service (POS) modifiers:
02 (Telehealth provided other than in the patient’s home)
10 (Telehealth provided in the patient’s home)
3. Enhanced RVU for Certain Services
In 2024, mental and behavioral health providers will see a rise in relative value units (RVUs) for crisis care, psychotherapy, health behavior assessment and intervention (HBAI), and substance use disorder treatment. These services will experience a 19.1% increase over four years, starting with 2024. The adjustment applies to timed codes for behavioral health services under the Physician Fee Schedule (PFS).
4. Medicare billing is now available directly for mental health counselors and marriage and family therapists.
Starting this year, mental health counselors (MHCs) and marriage and family therapists (MFTs) can now bill Medicare directly for services covered under Part B. Moreover, addiction counselors eligible as MHCs under Medicare criteria can also bill Medicare for their services. It's important to note that MHCs and MFTs seeking Medicare billing privileges must enroll in the Medicare program.
5. Changes to Evaluation and Management (E/M) Billing Time Frames
Psychiatrists utilizing Evaluation and Management (E/M) codes should be aware of significant changes in the 2024 CPT code criteria for timed billing. Unlike previous codes that allowed for a range of time spent with a patient to determine the appropriate code, the 2024 codes now specify a minimum time requirement that providers must meet or exceed to utilize the code.
Review changes on our previous post: "What Changes Can You Expect for CPT Coding in 2024?"
TIP for MHCs and MFTs
Opt into Medicare Billing
Now, mental health counselors (MHCs) and marriage and family therapists (MFTs) are eligible to bill Medicare for their services, but enrolling in Medicare billing is a prerequisite. Refer to CMS's instructions for becoming a Medicare provider, detailing every essential step, including obtaining an NPI and collaborating with your designated Medicare Administrative Contractor (MAC).
Best,
Yadira Martinez | CEO
