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Intensive behavioral counseling for cardiovascular disease, HCPCS code G0446

Medicare pays a primary care physician or other primary care practitioner in a primary care setting to annually provide one face-to-face behavioral counseling session.

The code is defined as 15 minutes. In order to bill these, the record must show that the service took over half of the threshold time, or 7 ½ minutes. All Medicare patients are eligible for the service.  The Medicare national payment amount is about $26.

G0446  Annual, face-to-face intensive behavioral therapy for cardiovascular disease, individual, 15 minutes.

The service has three components:

  1. The first is to encourage aspirin use for primary prevention a cardiovascular disease when the benefits outweigh the risks for men age 45-79 and women 55-79. (When the patient is in that age range.)
  2. The second is to screen for high blood pressure and all adults aged 18 and older.
  3. And the third is intensive behavioral counseling to promote a healthy diet for adults who already have hyperlipidemia, hypertension, advancing age, and other known risk factors for cardiovascular and diet related chronic diseases.

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Accurate at time of posting: August 2, 2018
by Betsy Nicoletti
Tagged With: HCPCS codes, Medicare rules, preventive medicine services

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Our mission is to provide accurate, comprehensive, up-to-date coding information, allowing medical practices to increase revenue, decrease coding denials and reduce compliance risk. That's what coding knowledge can do.

In 1988, CodingIntel.com founder Betsy Nicoletti started a Medical Services Organization for a rural hospital, supporting physician practice. She has been a self-employed consultant since 1998. She estimates that in the last 20 years her audience members number over 28,400 at in person events and webinars. She has had 2,500 meetings with clinical providers and reviewed over 43,000 medical notes. She knows what questions need answers and developed this resource to answer those questions. For more about Betsy visit www.betsynicoletti.com.

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