HCPCS code G0507
Care management services for behavioral health conditions, at least 20 minutes of clinical staff time, directed by a physician or other qualified health care professional, per calendar month, with the following required elements: initial assessment or follow-up monitoring, including the use of applicable validated rating scales; behavioral health care 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; and continuity of care with a designated member of the care team
What G0507 means
G0507 (Care manage serv minimum 20) belongs to the HCPCS Level II G series (Procedures / Professional Services (Temporary)). Its Medicare coverage status is Carrier judgment. Medicare coverage is left to the judgment of the local Medicare Administrative Contractor (MAC), so check your MAC's local coverage determinations.
Part B pricing: Price established by carriers (e.g., not otherwise classified, individual determination, carrier discretion).
CMS cross-references this code to 99484. Check that code if G0507isn't payable for your claim.
Code details
- Short description
- Care manage serv minimum 20
- Coverage code
- C = Carrier judgment
- Pricing indicator
- 13 = Price established by carriers (e.g., not otherwise classified, individual determination, carrier discretion)
- Multiple pricing indicator
- A = Not applicable as HCPCS priced under one methodology
- Type of service
- 1 = Medical care
- Action code
- N = No maintenance for this code
- Action effective date
- January 01, 2018
- Code added date
- January 01, 2017
- Data year
- 2026
Questions about G0507
What is HCPCS code G0507?
HCPCS code G0507 is a Level II code in the G series (Procedures / Professional Services (Temporary)). Its full description is: "Care management services for behavioral health conditions, at least 20 minutes of clinical staff time, directed by a physician or other qualified health care professional, per calendar month, with the following required elements: initial assessment or follow-up monitoring, including the use of applicable validated rating scales; behavioral health care 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; and continuity of care with a designated member of the care team"
Is G0507 a CPT code?
No. G0507 is a HCPCS Level II code maintained by CMS, not a CPT (Level I) code from the American Medical Association. People often search for it as a CPT code because both code sets are reported on the same claims.
Does Medicare cover HCPCS code G0507?
The Medicare coverage code for G0507 is "Carrier judgment". Medicare coverage is left to the judgment of the local Medicare Administrative Contractor (MAC), so check your MAC's local coverage determinations.
When was HCPCS code G0507 added?
G0507 was added to the HCPCS code set on January 01, 2017. The most recent action on it (No maintenance for this code) took effect on January 01, 2018.
Nearby G codes
All G codes- G0502Initial psychiatric collaborative care management, first 70 minutes in the first calendar month of behavioral health care manager activities, in consultation with a psychiatric consultant, and directed by the treating physician or other qualified health care professional, with the following required elements: outreach to and engagement in treatment of a patient directed by the treating physician or other qualified health care professional; initial assessment of the patient, including administration of validated rating scales, with the development of an individualized treatment plan; review by the psychiatric consultant with modifications of the plan if recommended; entering patient in a registry and tracking patient follow-up and progress using the registry, with appropriate documentation, and participation in weekly caseload consultation with the psychiatric consultant; and provision of brief interventions using evidence-based techniques such as behavioral activation, motivational interviewing, and other focused treatment strategies
- G0503Subsequent psychiatric collaborative care management, first 60 minutes in a subsequent month of behavioral health care manager activities, in consultation with a psychiatric consultant, and directed by the treating physician or other qualified health care professional, with the following required elements: tracking patient follow-up and progress using the registry, with appropriate documentation; participation in weekly caseload consultation with the psychiatric consultant; ongoing collaboration with and coordination of the patient's mental health care with the treating physician or other qualified health care professional and any other treating mental health providers; additional review of progress and recommendations for changes in treatment, as indicated, including medications, based on recommendations provided by the psychiatric consultant; provision of brief interventions using evidence-based techniques such as behavioral activation, motivational interviewing, and other focused treatment strategies; monitoring of patient outcomes using validated rating scales; and relapse prevention planning with patients as they achieve remission of symptoms and/or other treatment goals and are prepared for discharge from active treatment
- G0504Initial or subsequent psychiatric collaborative care management, each additional 30 minutes in a calendar month of behavioral health care manager activities, in consultation with a psychiatric consultant, and directed by the treating physician or other qualified health care professional (list separately in addition to code for primary procedure); (use g0504 in conjunction with g0502, g0503)
- G0505Cognition and functional assessment using standardized instruments with development of recorded care plan for the patient with cognitive impairment, history obtained from patient and/or caregiver, in office or other outpatient setting or home or domiciliary or rest home
- G0506Comprehensive assessment of and care planning for patients requiring chronic care management services (list separately in addition to primary monthly care management service)
- G0508Telehealth consultation, critical care, initial , physicians typically spend 60 minutes communicating with the patient and providers via telehealth
- G0509Telehealth consultation, critical care, subsequent, physicians typically spend 50 minutes communicating with the patient and providers via telehealth
- G0511Rural health clinic or federally qualified health center (rhc or fqhc) only, general care management, 20 minutes or more of clinical staff time for chronic care management services or behavioral health integration services directed by an rhc or fqhc practitioner (physician, np, pa, or cnm), per calendar month
- G0512Rural health clinic or federally qualified health center (rhc/fqhc) only, psychiatric collaborative care model (psychiatric cocm), 60 minutes or more of clinical staff time for psychiatric cocm services directed by an rhc or fqhc practitioner (physician, np, pa, or cnm) and including services furnished by a behavioral health care manager and consultation with a psychiatric consultant, per calendar month
- G0513Prolonged preventive service(s) (beyond the typical service time of the primary procedure), in the office or other outpatient setting requiring direct patient contact beyond the usual service; first 30 minutes (list separately in addition to code for preventive service)