Health and Behavior Assessment/Intervention

Health and Behavior Assessment/Intervention is covered when a patient with an underlying physical illness or injury has documented biopsychosocial factors significantly affecting medical treatment, is alert and has capacity for face-to-face psychological evaluation/intervention, and there is a documented need to address barriers to managing the illness and ADLs. Reassessments require documented change in mental or medical status; family-involved interventions are allowed when a family representative directly participates. Services that are non-medical, maintenance-oriented, or for patients lacking capacity (e.g., severe dementia, delirium, persistent vegetative state) are not covered.

"Patient has an underlying physical illness or injury."

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