CPT 0362T: Behavior Identification Supporting Assessment, On-site
Commercial payers pay $83 on average nationally for this procedure.
CPT code 0362T describes an on-site behavior identification supporting assessment in which a physician or other qualified healthcare professional directs technicians to perform follow-up assessment of a patient’s maladaptive destructive behavior; the service is reported in 15-minute units of face-to-face technician time and includes the provider’s direction, interpretation, and report. This service is a procedural assessment typically delivered in an appropriate on-site clinical or therapeutic environment such as an outpatient behavioral health clinic, specialty therapy center, or other supervised treatment setting and is classified as a time-based, face-to-face assessment service for behavioral health.
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National Reimbursement Benchmarks
National commercial reimbursement for CPT 0362T centers on BUCA’s average commercial benchmark of $83, which serves as a mid-market reference point among the payers. Blue Cross Blue Shield’s distribution is relatively broad (P75–P25 = $93.2 - $40.6 = $52.6), while UnitedHealth Group exhibits the widest dispersion (P75–P25 = $242.6 - $109.3 = $133.3), indicating substantial variability in contracted rates. Aetna and Cigna have tighter spreads by comparison (Aetna: $68.7 - $13.0 = $55.7; Cigna: $88.2 - $40.5 = $47.7), though Aetna’s low median pulls its center lower than BUCA.
Median positioning also differs: Blue Cross Blue Shield and UnitedHealth Group sit well above BUCA’s $83 average (BCBS median $57.3; UnitedHealth Group median $155.5), with UnitedHealth Group’s high mean ($174.1) reflecting high-end outliers. Cigna (median $51) and Aetna (median $18) are below BUCA on central tendency, highlighting payer-by-payer variation in customary commercial payments for this code.