Summary & Overview
HCPCS C7901: Remote Hospital Staff Mental Health or Substance Use Service, 30–60 Min
HCPCS Level II code C7901 designates a hospital-staff–delivered remote service for the diagnosis, evaluation, or treatment of a mental health or substance use disorder that lasts 30–60 minutes and is provided while the patient is in their home, with no associated professional service. Nationally, this code clarifies billing for non-physician hospital personnel delivering behavioral health care remotely and affects how hospitals document and claim these services under telehealth and remote care arrangements.
Key payers addressed include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find a concise overview of the code's clinical scope and administrative purpose, comparisons of payer coverage approaches where available, and practical context for coding and billing workflows. The publication also highlights common modifiers and related administrative considerations that influence claim adjudication.
This summary equips hospital billing staff, health system compliance teams, and revenue cycle personnel with the information needed to recognize where C7901 fits within remote behavioral health service billing, what payers typically consider when evaluating such claims, and which operational areas (documentation, service timing, and provider qualifications) are most relevant. Data not available in the input: associated taxonomies, ICD-10 diagnoses, specific payer policy details, and related codes.
Billing Code Overview
HCPCS Level II code C7901 describes a remote hospital staff service for diagnosis, evaluation, or treatment of a mental health or substance use disorder lasting 30–60 minutes, delivered when the patient is located in their home. The service is provided by hospital-employed staff who are licensed to provide mental health services under applicable state law(s). This code applies when there is no associated professional service reported.
Service type: Remote behavioral health services provided by hospital staff
Typical site of service: Patient's home (telehealth/telephonic or other remote modalities when the patient is at home)
Clinical & Coding Specifications
Clinical Context
A 32-year-old patient with a history of major depressive disorder and recent increase in suicidal ideation contacts their hospital-affiliated behavioral health service for urgent follow-up. A licensed clinical social worker employed by the hospital conducts a scheduled remote session while the patient remains at home. The encounter lasts 45 minutes and involves assessment of mood, safety screening, medication adherence, brief psychotherapy techniques, and coordination with the patient’s outpatient psychiatrist for possible medication adjustment. No physician or other professional service is billed with this encounter; the hospital bills for the remote behavioral health service provided by its licensed staff under the hospital’s outpatient or observation account.
Clinical workflow:
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Referral or patient-initiated contact routed to hospital behavioral health triage.
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Verification of patient identity, location (home), and consent for a remote visit documented in the medical record.
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Licensed hospital staff member performs remote assessment and intervention for 30–60 minutes, documents findings, safety plan, and care coordination actions.
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Charge entry using
C7901for a 30–60 minute remote hospital staff mental health/substance use disorder service with no associated professional service; appropriate modifier appended as applicable and documentation retained to support time, content, and non-physician hospital staffing model. -
Post-encounter coordination: message to treating psychiatrist, scheduling follow-up, or referral to emergency services if required.