Health and Behavior Assessment and Intervention Services

The Health and Behavior (H&B) CPT® codes were first established in 2002 to reimburse psychologists for providing psychological services that help patients manage physical health problems. This family of codes was revised for 2020 and a new set of codes to describe these Health Behavior Assessment and Intervention (HBAI) services went into effect on Jan. 1.

Health behavior assessment is conducted through health-focused clinical interviews, behavioral observation and clinical decision-making, includes evaluation of the patient’s responses to disease, illness or injury, outlook, coping strategies, motivation and adherence to medical treatment. Health behavior interventions are provided individually, to a group (two or more patients), and/or to the family, with or without the patient present, and include promotion of functional improvement, minimization of psychological and/or psychosocial barriers to recovery, and management of and improved coping with medical conditions.

As of Jan. 1, 2020, practitioners need to use the new CPT codes to report HBAI services when billing all federal and private insurance carriers. Provided below is a list of the new codes and descriptors. The list is intended to familiarize you with the 2020 HBAI code family and will be helpful for updating your billing and claims processing systems.

• Descriptors for 2020 Health Behavior Assessment and Intervention Services CPT® Codes for Psychologists (PDF, 66KB).

In addition to the new code numbers, the relative value units for HBAI services were increased. Below you will find a descriptors list, similar to the above document, that also contains the 2020 Relative Value Units (RVUs).

• Descriptors and Relative Value Units (RVUs) 2020 Health Behavior Assessment and Intervention Services CPT® Codes for Psychologists (PDF, 74KB).

APA has developed a crosswalk between H&B codes 96150-96155 (2002-2019) and the corresponding new codes (effective Jan. 1, 2020). This PDF is intended to assist psychologists as they make the transition.

• Crosswalk for 2020 Health Behavior Assessment and Intervention Services CPT® Codes (PDF, 106KB).

Please continue to visit this webpage and monitor APA Services publications for additional information on HBAI and other billing, coding, and reimbursement topics.

Key Facts for Utilizing Health Behavior Assessment and Intervention CPT^® Codes

• HBAI codes are not used for mental health services. They apply to services that address psychological, behavioral, emotional, cognitive, and interpersonal factors in the treatment/management of patients diagnosed with physical health problems.
• Use of HBAI codes requires a physical health diagnosis (ICD-10) to be the primary diagnosis, not a DSM diagnosis code.
• The codes capture services related to physical health, such as: patient adherence to medical treatment; symptom management; health-promoting behaviors; health-related risky behaviors; and adjustment to physical illness.
• HBAI codes and Psychotherapy codes cannot be billed at the same time.
• There are HBAI services that can be provided via Telehealth. See additional information.
• HBAI services provided prior to January 1, 2020, should be filed using CPT codes 96150-96155

• Responses to commonly asked questions regarding the new HBAI codes (PDF, 147KB)
• Updated guidance on billing and coding: Testing services on the same date of HBAI services (January 2020)
• 2020 Health Behavior Assessment and Intervention Billing and Coding Guide (PDF, 201KB)

○ Addendum B: Glossary/Reliable Sources for Technical Terms for the HBAI Billing and Coding Guide (PDF, 61KB)

○ Addendum C: Non-Covered Primary ICD-10-CM Diagnosis Codes for the HBAI Billing and Coding Guide (PDF, 165KB)

• Webinar series on HBAI codes: A series of pre-recorded mini-webinars from Nov. 2019 on how to use the new codes
• Psychologists will see payment increases for health behavior services in 2020
• Psychologists’ Health and Behavior Codes Are Changing
• Proposed Rule Offers Better Medicare Reimbursement for Psychologists
• A letter from APA Services Inc. sent Sept. 18, 2019, (PDF, 163KB), to Seema Verma, administrator of the Centers for Medicare and Medicaid Services, commented on the proposed rule on the 2020 Medicare physician fee schedule released on July 29, 2019.

Note: H&B services provided prior to Jan, 1, 2020, should be filed using CPT codes 96150-96155.

The CPT codes below should also be used to file claims for services provided in 2019, but submitted in 2020.

• March 21, 2018 Webinar: "Getting Reimbursed: How to Effectively Use H&B codes"
• Integrated Health Care: How to Use Health & Behavior CPT® Codes (Flash)
• Health and Behavior CPT® Codes
• Health and Behavior (H&B) Services Frequently Asked Questions

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