G0560, Safety planning interventions, each 20 minutes personally performed by the
HCPCS/CPT
Prior Authorization
No Prior Auth Required
Code is covered without prior authorization (high confidence)
Medicare Pricing
Work RVU
1.09
Facility
$39.41
Non-Facility
$42.42
Documentation Required
- Claims must meet the reasonable and necessary requirements described in the related LCD (L35101); providers must retain medical record documentation supporting medical necessity per the LCD.
- When billing for services that are not covered, the claim must include the appropriate modifier to indicate non-coverage status.
- When a second provider bills a diagnostic interview for a beneficiary they are seeing for the first time, documentation should support that it is the provider's first encounter with the beneficiary.
- All services must be documented in the patient's medical record with legible patient identification (e.g., full name, dates of service) and the legible signature of the responsible physician or NPP.
Key Coverage Criteria
- Diagnostic interview codes (e.g., CPT 90791/90792) are indicated for the initial evaluation of a beneficiary, and a second provider seeing the beneficiary for the first time may report diagnostic interview codes for that initial encounter.
- CPT code 96105 is indicated for formal evaluation of aphasia using a standardized instrument (for example, the Boston Diagnostic Aphasia Examination).
- HCPCS codes G0017 and G0018 are appropriate for services provided in non-facility places of service other than Office.
- Psychotherapy for crisis (CPT 90839, 90840, HCPCS G0017, G0018) is covered when reporting the total face-to-face duration of crisis psychotherapy provided to the patient and/or family, with the patient present for all or some of the service and the clinician devoting full attention to that patient.
- When a psychiatric diagnostic evaluation with medical assessment is performed, bill CPT 90792 or an appropriate Evaluation & Management (E/M) code (e.g., 99202-99255, 99304-99310, 99341-99350) to reflect the medical assessment.
- If a patient referred with an organic diagnosis is found to have a mental health diagnosis, bill the established mental health diagnosis rather than the referring organic diagnosis.
4 Active Policies
A57520, Billing and Coding: Psychiatric Diagnostic Evaluation and Psychotherapy Services
J9
FIRST_COAST-L33252, Psychiatric Diagnostic Evaluation and Psychotherapy Services
J9
NOVITAS-L35101, Psychiatric Codes
JH
A57130, Billing and Coding: Psychiatric Codes
JL
Related Codes
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