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G0323 Care management services for behavioral health conditions, at least 20 minutes of clinical psychologist...
HCPCS Procedure & Supply Codes
Code Changed 2024-01-01: Long Description changed.
G0323 - Care management services for behavioral health conditions, at least 20 minutes of clinical psychologist, clinical social worker, mental health counselor, or marriage and family therapist time, per calendar month. (these services include 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, coordination with and/or referral to physicians and practitioners who are authorized by medicare to prescribe medications and furnish e/m services, counseling and/or psychiatric consultation; and continuity of care with a designated member of the care team)
The above description is abbreviated. This code description may also have Includes, Excludes, Notes, Guidelines, Examples and other information.
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The above description is abbreviated. This code description may also have Includes, Excludes, Notes, Guidelines, Examples and other information.
Additional Code Information includes:
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HCPCS Index Entries (Reverse Index Lookup) 
reverse_index/reverse_index_content.php?set=HCPCS&c=G0323
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DMEPOS Products (Durable Medical Equipment, Prosthetics, Orthotics, Supplies)
dmepos/dmepos_content.php?set=HCPCS&c=G0323
Calculated for National Unadjusted (00000)
* Note: Medicare may or may NOT reimburse you for this code. The fees provided below are based on values established by CMS/Medicare. Please check with your local Medicare contact on whether this code is eligible for reimbursement.
Medicare vs. My Fee Evaluation
| Modifier | Medicare Allowed | 150% | 200% | My Fee |
|---|---|---|---|---|
| (none) | $43.27 | $64.91 | $86.55 | (your fee) |
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Medicare Participating - Assignment Accepted (Mandatory)
| Modifier | Allowed | Medicare 80% | Patient Pays |
|---|---|---|---|
| (none) | $43.27 | $##.## | $##.## |
Medicare Non-Participating - Assignment Accepted (Check To Doctor)
| Modifier | Allowed | Medicare 80% | Patient Pays | Limiting Charge (Amount Billed) |
|---|---|---|---|---|
| (none) | $##.## | $##.## | $##.## | $##.## |
Medicare Non-Participating - Assignment NOT Accepted (Check To Patient)
| Modifier | Allowed | Medicare 80% | Patient Pays | Limiting Charge (Amount Billed) |
|---|---|---|---|---|
| (none) | $##.## | $##.## | $##.## | $##.## |
Medicare vs. My Fee Evaluation
| Modifier | Medicare Allowed | 150% | 200% | My Fee |
|---|---|---|---|---|
| (none) | $54.92 | $82.39 | $109.85 | (your fee) |
Access to calculated fee values is available. Access to this feature is available in the following products:
Note: Subscribers will see the calculated values below. |
Medicare Participating - Assignment Accepted (Mandatory)
| Modifier | Allowed | Medicare 80% | Patient Pays |
|---|---|---|---|
| (none) | $54.92 | $##.## | $##.## |
Medicare Non-Participating - Assignment Accepted (Check To Doctor)
| Modifier | Allowed | Medicare 80% | Patient Pays | Limiting Charge (Amount Billed) |
|---|---|---|---|---|
| (none) | $##.## | $##.## | $##.## | $##.## |
Medicare Non-Participating - Assignment NOT Accepted (Check To Patient)
| Modifier | Allowed | Medicare 80% | Patient Pays | Limiting Charge (Amount Billed) |
|---|---|---|---|---|
| (none) | $##.## | $##.## | $##.## | $##.## |
This section shows APC information including: Status Indicator, Relative Weight, Payment Rate, Crosswalks, and more. Access to this feature is available in the following products:
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Calculated for National Unadjusted (00000)
* Note: Medicare may or may NOT reimburse you for this code. The fees provided below are based on values established by CMS/Medicare. Please check with your local Medicare contact on whether this code is eligible for reimbursement.
RVU Components (by modifier)
| Modifier | Work | Practice Expense | Malpractice Expense | Total |
|---|---|---|---|---|
| (none) | 0.93 | 0.31 | 0.06 | 1.300 |
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Practitioner Labor
| Pre-Service | Intra-Service | Post-Service | Total Time* |
|---|---|---|---|
| ## | ## | ## | ## min |
* Total Time may be greater than the displayed components.
Work RVU Components (by modifier)
| Modifier | National Unadjusted Work RVU | Work GPCI | Adjusted Work RVU |
|---|---|---|---|
| (none) | ##.## | ##.## | 0.93 |
Clinical Labor - Direct Expense
| Staff | Staff Rate | Pre Time | Intra Time | Post Time | Total Time |
|---|---|---|---|---|---|
| RN/LPN/MTA | $0.50 / min | ## min | ## min | ## min | ## min |
Equipment - Direct Expense
| Item | Purchase Price | Expected Life | Total Time |
|---|---|---|---|
| $##.## | ## years | ## min |
Supplies - Direct Expense
| Item | Unit Price | Quantity | Unit | Amount |
|---|---|---|---|---|
| assessment monitoring instruments | $##.## | ## | item | $##.## |
Indirect Expenses (clerical,overhead, and other) are also included in the practice expense.
PE RVU Components (by modifier)
| Modifier | National Unadjusted PE RVU | PE GPCI | Adjusted PE RVU |
|---|---|---|---|
| (none) | ##.## | ##.## | 0.310 |
RVU Components (by modifier)
| Modifier | Work | Practice Expense | Malpractice Expense | Total |
|---|---|---|---|---|
| (none) | 0.93 | 0.66 | 0.06 | 1.650 |
Access to calculated fee values is available. Access to this feature is available in the following products:
Note: Subscribers will see the calculated values below. |
Practitioner Labor
| Pre-Service | Intra-Service | Post-Service | Total Time* |
|---|---|---|---|
| ## | ## | ## | ## min |
* Total Time may be greater than the displayed components.
Work RVU Components (by modifier)
| Modifier | National Unadjusted Work RVU | Work GPCI | Adjusted Work RVU |
|---|---|---|---|
| (none) | ##.## | ##.## | 0.93 |
Clinical Labor (Non-Facility)- Direct Expense
| Staff | Staff Rate | Pre Time | Intra Time | Post Time | Total Time |
|---|---|---|---|---|---|
| RN/LPN/MTA | $0.50 / min | ## min | ## min | ## min | ## min |
Equipment (Non-Facility)- Direct Expense
| Item | Purchase Price | Expected Life | Total Time |
|---|---|---|---|
| $##.## | ## years | ## min |
Supplies (Non-Facility)- Direct Expense
| Item | Unit Price | Quantity | Unit | Amount |
|---|---|---|---|---|
| assessment monitoring instruments | $##.## | ## | item | $##.## |
Indirect Expenses (clerical,overhead, and other) are also included in the practice expense.
PE RVU Components (by modifier)
| Modifier | National Unadjusted PE RVU | PE GPCI | Adjusted PE RVU |
|---|---|---|---|
| (none) | ##.## | ##.## | 0.660 |
View relationships (or crosswalks) between code sets. Access to this feature is available in the following products:
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Medicare Policies & Guidelines (Articles, LCDs, NCDs)
coverage/coverage_content.php?set=HCPCS&c=G0323
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