The trend toward breaking down health care silos to free physicians to practice in new and different ways is illustrated by the different classifications mental and behavioral health services fall under in the 2023 Current Procedural Terminology (CPT®) code set.
The CPT codes used to characterize mental and behavioral health services this year include brand new codes plus revisions that fall into categories such as digital health and evaluation and management (E/M).
Modifications to the mental and behavioral health E/M codes include revisions to guidelines and parenthetical notes to align with similar changes to 2023 E/M guidelines in other categories.
Codes 99354–99357 were deleted.
CPT codes for remote physiological monitoring (RPM) CPT codes were created in 2019 and cover device setup, educating patients in the use of the devices, device supply, and the management of patient treatment.
RPM codes are intended for use in capturing patient data such as weight, blood pressure, pulse oximetry or respiratory flow rate.
Last year, codes for remote therapeutic monitoring (RTM) were released that measured therapy adherence. Using the same structure as the RPM codes, RTM codes are used for measuring therapy adherence and therapy response.
They represent the review and monitoring of data related to, but not limited to, a therapeutic response and allow physicians to assess the impact of a particular treatment regimen.
The original RTM codes focused on the status of the patient’s musculoskeletal and respiratory systems and were organized in the Appendix R digital medicine-services taxonomy. New this year are codes for cognitive behavioral therapy (CBT), and they were added to the appendix.
The codes “present review and monitoring of data related to signs, symptoms and functions of a therapeutic response,” said Stephen Gillaspy, PhD, the American Psychological Association representative to the AMA CPT Editorial Panel. He discussed the changes at a session of the AMA Outpatient CDI Workshop and CPT and RBRVS 2023 Annual Symposium.
“These data may represent objective device-generated integrated data or subjective inputs reported by a patient,” Gillaspy added. “These data are reflective of therapeutic responses that provide a functionally integrated representation of the patient.”
Codes used for RTM of CBT include:
- 98975: To report the set-up and patient education on operating any device used for therapeutic data collection.
- 98978: 30-day device supply with scheduled recording and/or programmed alert transmission to monitor CBT.
- 98980: First 20 minutes of RTM management services during a calendar month.
- 98981: Each additional 20-minute period spent on RTM management.
There must be at least one interactive communication with the patient or caregiver for 98980 and 98981.
Another revision is the deletion of Category III codes 0702T and 0703T, which had previously been used to report RTM of CBT.
A new Category III code to the mental and behavioral health family is 0783T for transcutaneous auricular neurostimulation—a procedure used to help relieve opioid-withdrawal symptoms.
New this year are codes for conducting group caregiver behavior-management training sessions by a physician or other qualified health professional. Caregivers are trained to respond to a disease or illness expressed by objectionable, problematic or disagreeable behavior with evidence-based methods that encourage desirable behavior.
The new codes for this service are:
- 96202: For the initial 60 minutes of a multifamily group training session.
- 96203: Each additional 15 minutes.
“The service is intended to be provided to the caregivers in a multifamily group setting without the identified patient present,” said Gillaspy, an associate professor and research director in the Section of General and Community Pediatrics at The University of Oklahoma College of Medicine.
“It's important to know that, even though it's provided to the caregivers, it’s for the direct benefit of the patient,” he added, noting that “it's common for the identified patient to attend concurrent group sessions of their own.”