2024 Updates and Changes for Mental and Behavioral Health CPT Codes

The American Medical Association (AMA) announced CPT code changes for 2024 in November of 2023, with the new changes slated to take effect on January 1, 2024. Most updates for 2024 target revisions to telehealth and Evaluation & Management (E/M) visits, both of which may affect mental and behavioral health providers.

Here’s a highlight of the 2024 CPT code changes to be aware of:

Psychotherapy HCPCS codes G0017 and G0018 added
In-home telehealth services are billed at non-facility rates
New physician fee rates for psychotherapy and HBAI services
MHCs and MFTs can now bill Medicare directly
E/M codes no longer have time ranges

2024 CPT Code Changes Mental and Behavioral Health Providers Should Know About

In 2024, mental and behavioral health providers won’t see massive changes to the CPT codeset. Aside from a few coding changes we note below, most updates focus on billing changes that could affect how a practice bills.

1. New HCPCS Codes for Crisis Psychotherapy Services

CMS has added two new psychotherapy HCPCS codes in 2024:

G0017: Psychotherapy for crisis furnished in an applicable site of service (any place of service at which the non-facility rate for psychotherapy for crisis services applies, other than the office setting); first 60 minutes
G0018: Psychotherapy for crisis furnished in an applicable site of service (any place of service at which the non-facility rate for psychotherapy for crisis services applies, other than the office setting); each additional 30 minutes

These codes are reimbursable when provided as telehealth services and other settings that require billing at the non-facility rate.

Other new 2024 HCPCS codes that may be relevant to some mental and behavioral health providers and their teams include:

G0019: Community health integration services performed by certified or trained auxiliary personnel, including a community health worker, under the direction of a physician or other practitioner; 60 minutes per calendar month
G0022: Community health integration services, each additional 30 minutes per calendar month
G0136: Administration of a standardized, evidence-based social determinants of health risk assessment tool, 5-15 minutes

2. In-Home Telehealth Services Must Be Billed at Non-Facility Rates

Although Medicare continues to pay for telehealth services in the new year, the Centers for Medicare & Medicaid Services (CMS) outlined a new policy for 2024 stating that providers will be reimbursed at the non-facility rate when telehealth services are provided to a patient in their home. Billers should append modifier 95 to any telehealth claims in which the provider offers services from the hospital and the patient is in their home in addition to any place of service (POS) modifiers needed, like 02 (Telehealth provided other than in patient’s home) or 10 (Telehealth provided in patient’s home).

3. Increased RVU for Some Services

In 2024, mental and behavioral health providers can expect increased relative value units (RVUs) for crisis care, psychotherapy, health behavior assessment and intervention (HBAI), and substance use disorder treatment. The value for these services is set to increase by 19.1% over a four-year period, with 2024 marking the first year for the increase. This change will apply to timed behavioral health services codes under the Physician Fee Schedule (PFS).

4. Direct Medicare Billing for Mental Health Counselors and Marriage and Family Therapists

Beginning this year, mental health counselors (MHCs) and marriage and family therapists (MFTs) can bill Medicare under Part B coverage for their services allowed by the PFS. Additionally, addiction counselors who qualify as MHCs under Medicare guidelines can also bill Medicare for their services. Note that MHCs and MFTs who would like the ability to bill Medicare must enroll in the Medicare program to do so.

5. E/M Billing Time Range Changes

Psychiatrists who bill E/M codes should take note of important 2024 CPT code changes to E/M timed billing. While previous E/M codes for office visits included time ranges for total time spent with a patient to determine the correct code, 2024 codes have a set time that the provider must reach or exceed to use that code.

For example, 99214 codes for an established patient office or outpatient visit with a moderate level of medical decision making. In 2023, providers using total time for code selection could only bill this code if they spent 30-39 minutes on the encounter. In 2024, the code requires providers to meet or exceed 30 minutes of total time on the encounter.

Best Practices for Mental and Behavioral Health Professionals to Navigate CPT Code Changes for 2024

Because the 2024 updates can affect your billing procedures and reimbursement rates, it’s important to keep your practice and procedures up to speed so that you can continue to bill and get reimbursed properly. There are several steps you can take as a provider to prepare yourself and your practice for the 2024 CPT code changes and billing updates.

Update Billing Software to Include New Codes and E/M Changes

Your first step should be to update your billing software to include the new psychotherapy, social determinants of health risk assessment tool, and community health integration services codes outlined above.

Also, make it clear to your billers that MHCs and MFTs who can’t bill E/M codes can use the new psychotherapy codes G0017 and G0018 instead.

Enroll in Medicare Billing

MHCs and MFTs can now bill Medicare for their services, but enrolling in Medicare billing is necessary to do so. Follow CMS’s guide to becoming a Medicare provider, which outlines each required step, from getting an NPI to working with your assigned Medicare Administrative Contractor (MAC).

Prepare Patients for Potential Billing Changes

As noted previously, some services you provide in 2024 may have higher reimbursement rates than previous years, meaning that you can bill higher for these procedures. Patients who regularly receive these services might see slight increases in out-of-pocket amounts depending on their insurance company. Keeping them informed of these potential changes is always a good idea.

Ensure Billers Correctly Bill Telehealth Services

The 2024 update to telehealth services requires billers to consider the POS of the visit. Remember that when a patient receives these services at home, the provider gets billed at the non-facility rate. POS modifiers and modifier 95 are essential in these cases to receive the correct reimbursement, so a brush-up training on these concepts could be helpful for billers.

The CPT code changes for 2024 can enhance your practice and improve your billing procedures when you take the time to understand them and adjust your billing accordingly. This guide gives you essential information about these changes to successfully implement them into your practices and ensure your billers are prepared to navigate them smoothly.

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