Behavioral health coding resource

This American Medical Association resource outlines key CPT® codes that physicians and their
care teams can use (as appropriate) when administering behavioral health screening, treatment,
and/or preventative services (telemedicine-related codes highlighted with a ). Codes are
mapped to the behavioral health integration (BHI) model continuum to help physicians quickly
determine which sets of codes might be most relevant to their practice.
Please consult the CPT code set to verify that the code selected best reflects the work
performed as noted in the code descriptors.

CPT® codes across the BHI continuum

Co-location Integrated care
Collaborative care

A B C D
Preventive Medicine Psychotherapy Adaptive Behavior General Behavioral
99401, 99402, 99403, 90832, 90833, 90834, Services Health Integration
99404, 99411, 99412 90836, 90837, 90838, 97151, 97152, 97153, Care Management
90853 97154, 97155, 97156, 99484
Behavior Change 97157, 97158
Interventions Developmental Psychiatric
99406, 99407, 99408, Behavioral Screening Health Behavior Collaborative Care
99409 96127, 96110, 96161 Assessment and Management
Intervention 99492, 99493, 99494,
96156, 96158, 96159, G2214
96160, 96161, 96164,
Cognitive
96165, 96167, 96168 Assessment and Care
96170, 96171 Plan Services
99483

Inter-professional
Digital Services
99446–9, 99451, 99452
G0546–G0551
CoCM General
Management
(Medicare)
G0511
Psychiatric
Collaborative Care
Model (Medicare)
G0512
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Under “co-location” (see chart, page 1) the behavioral health specialist is physically located in a primary care
clinic, or the primary care physician or other clinician is physically located in a mental health or substance use
disorder treatment setting. The distinguishing feature here is physical proximity. Codes under Column A and
Column B both fall under co-location.

Column A codes: These codes are intended to be preventive in nature/used prior to formal diagnosis in the hopes
of addressing issues before they become larger health issues. They do not require a large team to implement.
Preventive Medicine
• 99401, 99402, 99403, 99404 (Individual)
• 99411, 99412 (Group)

Behavior Change Interventions

• 9
 9406, 99407 Smoking and tobacco use cessation counseling visit
• 9
 9408, 99409 Alcohol and/or substance (other than tobacco) abuse structured screening,
brief intervention (SBI) services

Column B codes: These are behavioral health-focused codes that do not, depending on the capabilities of your
practice, require larger collaboration.
Psychotherapy
• 90832, 90834, 90837 Psychotherapy (30, 45, 60 min)
 eal-time audio-visual required, has a modifier 95 that can be recorded with codes
R
• 90833, 90836, 90838 Psychotherapy when performed with E/M service
 eal-time audio-visual required, has a modifier 95 that can be recorded with codes
R
See “Additional resources” (below) for more information on use of Modifier 25 when reporting
these codes
• 9
 0853 Group Psychotherapy

Developmental/Behavioral Screening
• 96127 Brief emotional/behavioral assessment (e.g., depression inventory, attention-deficit/
hyperactivity disorder [ADHD] scale), with scoring and documentation, per standardized instrument
• 9
 6110 Developmental screening (e.g., developmental milestone survey, speech and language
delay screen), with scoring and documentation, per standardized instrument
• 9
 6161 Administration of caregiver-focused health risk assessment instrument (e.g., depression
inventory) for the benefit of the patient, with scoring and documentation, per standardized
instrument

Under “integrated care” (see chart, page 1) the practice team includes primary care and behavioral health
physicians and other clinicians working together with patients and families, using a systematic, seamless
approach to provide patient-centered care for a defined population. The defining feature here is practice
change. Codes under Column C and Column D fall under integrated care, codes under Column C apply only to
collaborative care.

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Column C codes: This is where we begin to see a clear focus on behavioral health with a broader range of roles for
the care team that allow the physician or the qualified health care professional to bill the code.
Adaptive Behavior Services
• 9
 7151, 97152 (Assessment), 97153–97158 (Treatment)
• A
 ddress deficient adaptive behaviors, maladaptive behaviors, or other impaired functioning
secondary to deficient adaptive or maladaptive behaviors (e.g., instruction following, verbal and
nonverbal communication, imitation, play and leisure, social interactions, self-care, daily living,
personal safety)

Health Behavior Assessment and Intervention

NOTE: In the CY2025 PFS Final Rule, CMS finalized a set of six G-codes (G0546, G0547, G0548, G0549,
G0550 and G0551) for inter-professional consultations authorized by statute to treat behavioral
health conditions. A key driver appeared to be to ensure that these services could be reported by
those who cannot independently bill Medicare for E/M visits, such as clinical psychologists, clinical
social workers, marriage and family therapists, or mental health counselors. The new codes would
facilitate interprofessional consultations between treating/requesting practitioners and consultant
practitioners, whether one or both of the practitioners is in a specialty whose practice is limited to
the diagnosis and treatment of mental illness. More information can be found in the PDF Final Rule,
p. 601–607: https://public-inspection.federalregister.gov/2024-25382.pdf.

• 9
 6156–96171 (Individual, Group, Family)
• F ocus on psychological, behavioral, emotional, cognitive, and interpersonal factors complicating
medical conditions and treatments

Column D codes: These are some of the most comprehensive codes for an expansive coordination model with a
physician or a qualified health professional guiding the work of a defined team. Codes in this section are reported
over an extended period of time.
Care Management
• 9
 9484 General Behavioral Health Integration Care Management
• 9
 9492–99494, G2214 Psychiatric Collaborative Care Management

Inter-professional Digital Services

• G
 0546, Interprofessional telephone/Internet/electronic health record assessment and
management service provided by a practitioner in a specialty whose covered services are limited
by statute to services for the diagnosis and treatment of mental illness, including a verbal and
written report to the patient’s treating/requesting practitioner; 5-10 minutes of medical consultative
discussion and review
G0547, 11–20 minutes of medical consultative discussion and review
G0548, 21–30 minutes of medical consultative discussion and review
G0549, 31 or more minutes of medical consultative discussion and review

• G
 0550, Interprofessional telephone/Internet/electronic health record assessment and
management service provided by a practitioner in a specialty whose covered services are limited
by statute to services for the diagnosis and treatment of mental illness, including a written report
to the patient’s treating/requesting practitioner, five minutes or more of medical consultative time

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 • G
 0551, Interprofessional telephone/Internet/electronic health record referral service(s) provided
by a treating/requesting practitioner in a specialty whose covered services are limited by statute
to services for the diagnosis and treatment of mental illness, 30 minutes

• 9
 9446–9, 99451 Professional-to-professional digital consultation, billable by the consulting
psychiatrist
• 9
 9452 Professional-to-professional digital consultation, billable by the primary care professional
(telephone/Internet/EHR referral services)

Cognitive Assessment and Care Plan Services, 99483

• P
 rovided when a comprehensive evaluation of a new or existing patient who exhibits signs
and/or symptoms of cognitive impairment is required to establish or confirm a diagnosis, etiology
and severity for the condition
• T horough evaluation of medical and psychosocial factors, potentially contributing to
increased morbidity
CoCM General Care Management (Medicare), G0511

Psychiatric Collaborative Care Model (Medicare), G0512

Modifier 25 may be necessary to indicate that on the day a procedure or service identified by a CPT code
was performed, the patient’s condition required a significant, separately identifiable E/M service above and
beyond the other service provided or beyond the usual preoperative and postoperative care associated with
the procedure that was performed.

• A
 significant, separately identifiable E/M service is defined or substantiated by documentation
that satisfies the relevant criteria for the respective E/M service to be reported. (Please refer to the
guidelines in the CPT 2025 Professional Edition.)
• T he E/M service may be prompted by the symptom or condition for which the procedure and/
or service was provided. As such, different diagnoses are not required for reporting of the E/M
services on the same date. This circumstance may be reported by adding modifier 25 to the
appropriate level of E/M service.

NOTE: This modifier is not used to report an E/M service that resulted in a decision to perform
surgery (See modifier 57). For significant, separately identifiable non-E/M services, see modifier 59.

Modifier 93 (in effect as of Jan. 1, 2023) may be used for reporting audio-only services when appended with
Modifier 93. Procedures on this list involve electronic communication using interactive telecommunications
equipment that includes, at a minimum, audio. The codes eligible to be reported with this modifier are
indicated in Appendix T in CPT® 2025 Professional Edition, which include those marked with a above.

• A
 significant, separately identifiable E/M service is defined or substantiated by documentation
that satisfies the relevant criteria for the respective E/M service to be reported. (Please refer to the
guidelines in the CPT 2025 Professional Edition.)

NOTE: Modifier 93 (audio-only) and Modifier 95 (audio-visual) are not fully interchangeable.
Some codes are eligible for reporting with either modifier, but the list of CPT codes eligible to
report Modifier 93 is more focused than that for Modifier 95.

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For the latest on behavioral health exemptions, please review CMS’ Final Rule Fact Sheet or page 602 of the
Final Rule.

Additional resources (accessed March 3, 2025)

• B
 illing, Workflow and Administrative Tools for Successful implementation of the Collaborative Care Model
(American Psychiatric Association, webinar recording)
• I ntegrating Behavioral Health Care into Primary Care: Advancing Primary Care Innovation in Medicaid
Managed Care (Center for Health Care Strategy Inc., toolkit)
• G
 etting Paid for Screening and Assessment Services (American Academy of Family Physicians, short toolkit)
• S tandardized Screening/Testing Coding Fact Sheet for Primary Care Pediatricians: Developmental/
Emotional/Behavioral (American Academy of Pediatrics, toolkit)
• B
 ehavioral Health Integration Services (Centers for Medicare & Medicaid Services, Medicare Learning
Network Toolkit; August 2024)
• B
 HI Compendium (American Medical Association, toolkit; list of relevant codes, page. 23)

© 2025 American Medical Association. All rights reserved. 25-1262350

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