As of Jan. 1, psychologists need to use new Current Procedural Terminology (CPT®) codes when billing all third-party payers for health behavior assessment and intervention (HBAI) services. The new codes have increased values that put them in line with the Medicare payments for psychotherapy services.
Psychologists use HBAI codes when billing for services that help patients cope with or manage physical health conditions. Such services include minimizing psychological and/or psychosocial barriers to recovery, improving patient adherence to medical treatment and helping patients manage their symptoms and adjust to a physical illness.
A single, untimed code will now be used to report health behavior assessment and reassessment (similar to CPT code 90791, psychiatric diagnostic evaluation). In addition, the new intervention service codes include a stand-alone 30minute base code that describes the primary service, as well as a 15-minute add-on code that describes additional work and time associated with the primary service.
Key points for using the new HBAI codes:
- HBAI codes are not used for mental health services. They require a physical health diagnosis from the International Classification of Diseases-10 to be the primary diagnosis, not a Diagnostic and Statistical Manual of Mental Disorders diagnosis code.
- HBAI codes and psychotherapy codes cannot be billed on the same date of service.
- Add-on codes should never be reported by themselves. They must be reported with the primary service base code.
- Claims for services provided in 2019 but submitted in 2020 should be filed using the old health and behavior codes (96150–96155).
- While all third-party payers require the use of the new codes for services provided on or after Jan. 1, reimbursement payments may be delayed while the new codes are added to the computerized claims processing systems.
