Does H0023 require prior authorization?

No, H0023 does not require prior authorization (high confidence). Code is covered without prior authorization.

What is the Medicare reimbursement rate for H0023?

Medicare facility rate: N/A. Non-facility rate: N/A. Work RVU: 0.00.

HCPCS/CPT

No Prior Auth Required

Code is covered without prior authorization (high confidence)

Work RVU

0.00

Facility

N/A

Non-Facility

N/A

Baseline behavioral measurements of function;and
Intensive in-home behavioral health services may be consideredmedically necessarywhenALLof the following selection criteria are met (A, B and C):
There is documentation thatallof the followingSeverity of Illnesscriteria are met (1 through 7):Specific psychiatric symptoms or disturbances of mood or behavior, consistent with the American Psychiatric Association's Diagnostic and Statistical Manual of Mental Disorders/International Classification of Diseases diagnosis listed, are linked to functional impairment and risk of serious harm;andThere are specific deficits directly related to the intensive in-home behavioral health services;andThe m [...]
Specific psychiatric symptoms or disturbances of mood or behavior, consistent with the American Psychiatric Association's Diagnostic and Statistical Manual of Mental Disorders/International Classification of Diseases diagnosis listed, are linked to functional impairment and risk of serious harm;and
There are specific deficits directly related to the intensive in-home behavioral health services;and
The member and significant others demonstrate motivation for treatment, are capable of benefiting from the treatment approach planned, and participate in treatment;and

ANTHEM-CG-BEH-14, CG-BEH-14 Intensive In-home Behavioral Health Services

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