Summary & Overview
HCPCS G0550: Interprofessional Mental Health Consult, 5+ Minutes
HCPCS Level II code G0550 denotes an interprofessional consultative assessment delivered via telephone, internet, or electronic health record by a practitioner in a specialty statutorily limited to diagnosing and treating mental illness. The service requires five minutes or more of consultative time and a written report to the treating or requesting clinician. Nationally, this code matters as telehealth and interprofessional communication grow as modalities for timely specialty input in behavioral health care pathways.
Key payers addressed include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find a concise explanation of the code's clinical intent and operational context, payer coverage scope, common modifiers used with the service, and typical billing considerations. The publication outlines benchmark elements and policy updates relevant to interprofessional remote consults, plus clinical context for how this service fits into multidisciplinary behavioral health management. Data not available in the input for specific reimbursement amounts, associated taxonomies, and ICD-10 pairings.
Billing Code Overview
HCPCS Level II code G0550 represents 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 the diagnosis and treatment of mental illness. The service requires 5 minutes or more of medical consultative time and includes a written report to the patient's treating or requesting practitioner.
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Service type: Interprofessional consultative assessment and management
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Typical site of service: This service is typically delivered remotely via telephone, internet, or through the electronic health record and is provided by a consulting practitioner in a statutorily limited mental health specialty.
Clinical & Coding Specifications
Clinical Context
A primary care clinician requests a consult from a psychiatric specialist to clarify diagnosis and management for a patient with worsening depressive symptoms and new suicidal ideation. The patient is a 34-year-old with a history of major depressive disorder experiencing increased insomnia, decreased appetite, and passive suicidal thoughts after a recent medication change. The primary care clinician sends a succinct clinical summary and relevant EHR records via secure electronic health record messaging and requests guidance on medication adjustment and safety planning. A board-certified psychiatrist reviews the chart, spends five minutes or more in interprofessional electronic assessment (telephone/EHR/internet), documents the psychiatric assessment, formulates recommendations (medication change, safety plan, and suggestion for expedited outpatient psychiatric follow-up), and prepares a written report sent back to the requesting clinician. The workflow includes: receipt of request, chart review, focused remote consultation by the psychiatric specialist, preparation of a written consult note, transmission of recommendations to the treating/requesting practitioner, and documentation of the consult time to meet the G0550 five-minute minimum requirement.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
22 | Increased procedural services | When the consultation required substantially greater work than usual (rare for brief interprofessional consults). |