skip to main content

Health 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 January 1, 2020.

Download the Health Behavior Assessment and Intervention CPT Codes for Psychologists factsheet (PDF, 277KB)opens in new window, which includes 2022 CPT codes, descriptors, relative value units (RVUs) and Medicare reimbursement rates.

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.

2020 Family of Health Behavior Assessment and Intervention Services

As of January 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.

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 RVUs.

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

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

ADVERTISEMENT

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

News and related resources for 2020

○ Addendum B: Glossary/reliable sources for technical terms for the HBAI billing and coding guide (PDF, 61KB)opens in new window

○ Addendum C: Non-covered primary ICD-10-CM diagnosis codes for the HBAI billing and coding guide (PDF, 165KB)opens in new window

2002–2019 Health and Behavior Assessment and Intervention Codes

Note: H&B services provided prior to January 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.


CPT® Code Descriptor

96150

Health and behavior assessment (e.g., health-focused clinical interview, behavioral observations, psychophysiological monitoring, health-oriented questionnaires), each 15 minutes face-to-face with the patient; initial assessment

*Initial assessment of the patient to determine biopsychosocial factors affecting the patient’s physical health and any treatment problems

96151

Health and behavior assessment (e.g., health-focused clinical interview, behavioral observations, psychophysiological monitoring, health-oriented questionnaires), each 15 minutes face-to-face with the patient; reassessment

*Reassessment of the patient to evaluate a patient’s condition and determine the need for further treatment. A reassessment may be performed by a clinician other than the one who conducted the patient’s initial assessment

96152

Health and behavior intervention, each 15 minutes, face-to-face; individual

*Intervention service provided to an individual to modify the behavioral, cognitive and biopsychosocial factors affecting the patient’s physical health. Examples include increasing the patient’s awareness about his or her disease by using cognitive and behavioral approaches to initiate physician-prescribed diet and exercise regimens.

96153

Health and behavior intervention, each 15 minutes, face-to-face; group (2 or more patients)

*Intervention services provided to a group. Example: A smoking-cessation program that includes educational information, cognitive-behavioral treatment and social support.

*Payment amount is per person, the total group fee equals the amount for 1 unit (15 minutes), multiplied by the number of persons in the group

96154

Health and behavior intervention, each 15 minutes, face-to-face; family (with the patient present)

*Intervention service provided to a family with the patient present. Example: Psychologist could use relaxation techniques with both a diabetic child and his/her parents to reduce the child’s fear of receiving injections and the parents’ tension when administering the injections.

96155

Health and behavior intervention, each 15 minutes, face-to-face; family (without the patient present)

*Intervention service provided to a family without the patient present. Example: Working with parents and siblings to shape a diabetic child’s behavior.

*Note: Medicare and many private insurers exclude coverage for this code since the patient is not present.

Related resources

CPT Copyright 2019 American Medical Association. All rights reserved.
CPT® is a registered trademark of the American Medical Association.

Last updated: November 2022Date created: 2018

Contact APA Services