Medicare Payment Codes Related to Care Management

Starting in 2017, the Centers for Medicare & Medicaid Services (CMS) provided new Healthcare Common Procedure Coding System (HCPCS) codes for care management payment.

Here are the codes and descriptions:

• G0502: Initial psych care management, 70 minutes.
• G0503: Subsequent psych care management, 60 minutes.
• G0504: Initial/subsequent psych care management, additional 30 minutes.
• G0507: Care management services, minimum 20 minutes.

The G0507 must include:

• Initial assessment or follow-up monitoring, including use of applicable validated rating scales.
• Behavioral healthcare planning in relation to behavioral/psychiatric health problems, including revision for patients who are not progressing or whose status changes.
• Facilitating and coordinating treatment, such as psychotherapy, pharmacotherapy, counseling, and/or psychiatric consultation.
• Continuity of care with a designated member of the care team.

Source: AIMS Center, University of Washington; aims.uw.edu.