Summary & Overview
HCPCS C7902: Remote Hospital Behavioral Health Service in Home
HCPCS Level II code C7902 represents a hospital-employed, remote behavioral health service provided to patients in their homes for diagnosis, evaluation, or treatment of mental health or substance use disorders, billed per additional 15-minute increment. Nationally, this code reflects the growing role of hospital-based remote care teams in extending behavioral health services into patients’ home environments, supporting access and continuity of care when no separate professional service is billed. Key payers addressed in this analysis include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will learn what the code covers clinically, typical billing scenarios, and which payers recognize the service. The publication outlines benchmarks and common payer practices where available, summarizes relevant policy considerations affecting remote hospital behavioral health services, and provides clinical context about use cases for home-based telebehavioral interventions. Data not available in the input for some fields is noted where applicable. This resource is intended as a concise reference for coding, billing, and program planning related to hospital-provided remote behavioral health services delivered in the home setting.
Billing Code Overview
HCPCS Level II code C7902 describes a remote hospital staff behavioral health contact: service for diagnosis, evaluation, or treatment of a mental health or substance use disorder, billed in 15-minute increments for each additional interval. The service type is remote hospital-employed behavioral health service delivered by hospital staff who are licensed to provide mental health services under applicable state law(s). The typical site of service is the patient’s home, and the code is used when there is no associated professional service (it is listed separately in addition to a primary service).
Clinical & Coding Specifications
Clinical Context
A 42-year-old patient with a diagnosis of major depressive disorder is enrolled in a hospital-based remote behavioral health program. The patient is at home and requires an additional 15-minute remote counseling session delivered by hospital-employed licensed clinical social worker under state law. The hospital documents a primary telehealth behavioral health service earlier in the encounter billed by an attending psychiatrist; because the additional time is delivered by hospital staff with no associated professional service, the hospital bills the incremental remote time using C7902 for each additional 15-minute block. The clinical workflow includes: intake and triage by nursing or behavioral health access staff, scheduling of the remote session, delivery of the 15-minute focused therapeutic intervention by hospital-licensed mental health staff (documenting start/stop times, clinical content, patient location as home, and that no separate professional service occurred), and submission of the C7902 line item in the hospital outpatient or facility claim with appropriate modifiers and linkage to the primary service line as required by payer rules.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
95 | Synchronous telemedicine service rendered via real-time interactive audio and video telecommunications system |