The new electronic version of the 2019 CPT manual is available from the Centers for Medicare and Medicaid Services (CMS). The Telebehavioral Health Institute has reviewed the manual to create this behavioral overview of revisions and additions that you’ll find relevant for telehealth reimbursement if you serve behavioral patients in 2019.
2019 CPT Codes for Telebehavioral Health
You’ll discover a new behavior assessment code intended to “address deficient adaptive behaviors (eg, impaired social, communication, or selfcare skills), maladaptive behaviors (eg, repetitive and stereotypic behaviors, behaviors that risk physical harm to the patient, others, and/or property), or other impaired functioning,” states the CPT book. The primary assessment code is:
- 97151 (Behavior identification assessment, administered by a physician or other qualified health care professional, each 15 minutes of the physician’s or other qualified health care professional’s time face-to-face with patient and/or guardian[s]/caregiver[s] administering assessments and discussing findings and recommendations, and non-face-to-face analyzing past data, scoring/interpreting the assessment, and preparing the report/treatment plan)
The code family also includes a supporting assessment code, 97152, which will be used to report the work of a provider working under the direction of a physician in a supporting capacity.
Also new are six codes in the range of 97153-97158, which “describe services that address specific treatment targets and goals based on results of previous assessments,” according to CPT.
The medicine section also contains multiple new psychological testing codes in the range of 96130-96146, which are in the broader subsection of “central nervous system assessments/tests.”
Want to Maximize Telehealth Reimbursement?
For more information about other telebehavioral health and telemental health reimbursement, see the Telebehavioral Health Institute’s “Telemental Health and Telebehavioral Health Reimbursement Strategies: Increasing Authorization & Payment.” This professional online training with 3 CME/CE Hours will review relevant telehealth, telemedicine, telemental health, and telebehavioral health reimbursement law and proper procedures for practitioners and consultants.
Recommended Reimbursement Articles
- 99091: New Telehealth CPT Code for Remote Patient Monitoring
- CMS Congressional Report: 85.4% of all Telehealth Users Had Mental Health Diagnosis
- Medicare Next Generation ACO Model Telehealth Expansion Waiver
- Epstein Becker & Green 2018 Telehealth Report
- MACRA & Telehealth Reimbursement
- Telehealth Reimbursement: Legally and Ethically Practicing Over State Lines Using a Consultative Model
- Interstate Licensing Compact and Telehealth Reimbursement: Recommendations of the U.S. Departments of Health and Human Services, Treasury, and Labor to the U.S. President
- Remote Patient Monitoring & Telehealth Reimbursement
- Telehealth Reimbursement for Home-Based Care
- Telehealth Place of Service & Telehealth Reimbursement
- Facility Fees & Telehealth Reimbursement