Summary & Overview
HCPCS C7900: Remote Hospital Staff Mental Health/Substance Use Service, 15–29 min
HCPCS Level II code C7900 identifies a hospital staff–delivered, remote service for the diagnosis, evaluation, or treatment of mental health or substance use disorders lasting 15–29 minutes when the patient is located in their home and there is no associated professional service. This code matters nationally as health systems expand hospital-based telebehavioral services and payers refine remote service billing policies.
Key payers discussed include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find a concise overview of the code’s clinical intent and operational context, a summary of which major payers recognize or reimburse the service, and discussion of implications for hospital outpatient coding and telebehavioral program design. Practical items covered include common modifiers used with remote hospital staff services (provided in separate sections), considerations for billing when no professional service is present, and where to look for payer-specific policy updates.
The publication offers national-level benchmarking insights, notes on relevant policy direction for remote behavioral health delivered by hospital staff, and clinical context for implementation in home-based telehealth programs. Data not available in the input is noted where payer-specific coverage details, associated taxonomies, ICD-10 pairings, related codes, and service line classifications are not provided.
Billing Code Overview
HCPCS Level II code C7900 describes a remote hospital staff service for diagnosis, evaluation, or treatment of a mental health or substance use disorder, lasting 15–29 minutes, provided when the patient is in their home. The service is delivered remotely by hospital-employed staff who are licensed to provide mental health services under applicable state law(s). There is no associated professional service linked to this hospital staff encounter.
Service Type: Remote hospital staff mental health/substance use disorder service
Typical Site of Service: Patient's home (telehealth/remote delivery by hospital staff)
Clinical & Coding Specifications
Clinical Context
A 42-year-old woman with a history of generalized anxiety disorder and alcohol use disorder schedules a remote follow-up behavioral health visit with hospital-employed licensed clinical social worker (LCSW) after discharge from an inpatient detoxification unit. The patient is located at home and signs in to the hospital’s secure telehealth portal. The hospital staff clinician provides a 20-minute therapeutic check-in focused on symptom review, brief cognitive behavioral techniques, safety assessment, and coordination of community substance-use resources. No physician or other professional service is billed in association with this encounter. Documentation includes start and stop times, informed consent for telehealth, location of the patient (home), clinician license and taxonomy, mental status findings, interventions provided, clinical assessment, and any referrals or follow-up plans. The encounter is captured as a hospital outpatient remote behavioral health service billed with C7900 reflecting a 15–29 minute hospital staff remote visit for mental health or substance use disorder when the patient is at home and no associated professional service is billed.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
95 | Synchronous telemedicine service rendered via real-time interactive audio and video |