Psychiatry Coding & Reimbursement Alert

Question: One of our psychologists was checking with us whether he is allowed to bill for face-to-face behavioral counseling for obesity? One of our coders is of the opinion that since it involves counseling, it can be billed. However, another person is saying that he is not allowed to bill for this service. Who is correct?

Answer: Even though face-to-face behavioral counseling for obesity involves counseling the patient, psychiatrists and psychologists are not among the list of provider types that Medicare recognizes in its coverage and payment of behavioral counseling for obesity (G0447, Face-to-face behavioral counseling for obesity, 15 minutes). Although there has been some amount of pressure to allow psychiatrists and clinical psychologists to be paid for this service under Medicare, there have been no changes in this regard.

Currently, Medicare only covers counseling for obesity when provided by the following provider specialty types:

• General Practice 
• Internal Medicine 
• Family Practice 
• OB/GYN 
• Geriatric Medicine 
• Pediatric Medicine 
• Nurse Practitioner 
• Physician Assistant 
• Certified Clinical Nurse Specialist

Resources: For more information regarding counseling services for obesity under Medicare, you can check this link at http://www.cms.gov/Outreach-and-Education/Medicare-Learning-Network-MLN/MLNMattersArticles/downloads/MM7641.pdf.