Summary & Overview
HCPCS G0546: Interprofessional Mental Health e-Consult, 5–10 Minutes
HCPCS Level II code G0546 denotes a short interprofessional consultative service — 5–10 minutes of telephone, internet, or electronic health record assessment and management — performed by a specialty practitioner whose services are statutorily limited to diagnosing and treating mental illness, with a verbal and written report provided to the treating/requesting clinician. Nationally, this code supports care coordination and specialist input without a face-to-face visit, helping to streamline access to psychiatric expertise and reduce unnecessary referrals.
Key payers covered in this analysis include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find a concise explanation of what G0546 represents, the clinical and administrative contexts in which it applies, and the typical settings for its use. The publication outlines payer adoption patterns and reimbursement benchmarking where available, summarizes relevant policy updates affecting interprofessional electronic consultations, and clarifies billing and documentation considerations tied to the service description. The content is intended to help clinicians, practice managers, and policy professionals understand the role of G0546 in remote specialty consultation workflows and payer-covered scenarios at a national level.
Billing Code Overview
HCPCS Level II code G0546 describes an interprofessional telephone/internet/electronic health record assessment and management service provided by a practitioner in a specialty whose covered services are limited by statute to services for the diagnosis and treatment of mental illness. The service includes a verbal and written report to the patient's treating or requesting practitioner and involves 5–10 minutes of medical consultative discussion and review.
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Service type: Interprofessional consultative assessment and management conducted via telephone, internet, or electronic health record communication
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Typical site of service: Remote/virtual clinical consultation between practitioners, with reports delivered to the treating/requesting clinician
Clinical & Coding Specifications
Clinical Context
A primary care physician requests a brief specialist consultation from a child and adolescent psychiatrist regarding medication management for a 14-year-old patient with worsening major depressive disorder and emerging suicidal ideation. The psychiatrist, whose statutory services are limited to mental illness diagnosis and treatment, reviews the primary care chart and recent symptom scores in the electronic health record, conducts a 7-minute interprofessional telephone discussion with the requesting clinician, and provides both a verbal recommendation and a concise written report in the chart. The workflow: the requesting clinician documents the consult request and relevant history; the specialist reviews records, discusses assessment and recommendations with the treating clinician by phone/electronic message for 5–10 minutes, documents the consultative opinion and any medication or monitoring suggestions, and the requesting clinician integrates the recommendations into the patient plan of care. Typical sites of service include outpatient clinics, behavioral health integration settings, and physician offices where interprofessional electronic or telephone consultation occurs.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
22 | Increased procedural services | Use when the specialist's consult required substantially more work than typical (e.g., unusually complex review or extended discussion beyond 10 minutes); documentation must justify increased effort. |