Summary & Overview
HCPCS G0570: Behavioral Health Care Management, Monthly
HCPCS Level II code G0570 represents monthly care management services for patients with behavioral health conditions directed by a physician or other qualified health care professional. The code formalizes a structured, longitudinal approach to assessment, monitoring, care planning, treatment coordination and continuity of care for behavioral and psychiatric conditions. Nationally, G0570 matters because payers and care teams increasingly rely on structured care management to improve outcomes, streamline behavioral health integration, and support value-based payment models.
Key payers addressed include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare and Medicare. Readers will find an overview of the code’s clinical intent and service setting, payer coverage considerations and typical billing context. The publication also summarizes practical benchmarks and policy updates that affect use of the code and explains clinical context around monthly behavioral health care management services, including common components such as validated symptom rating scales, care plan development and treatment coordination.
This summary is intended for clinicians, practice managers, billing professionals and policy analysts seeking a concise national-level briefing on G0570, what it covers, and where it fits in behavioral health and primary care workflows. Data not available in the input is noted where applicable in the detailed sections.
Billing Code Overview
HCPCS Level II code G0570 describes care management services for behavioral health conditions, billed per calendar month and directed by a physician or other qualified health care professional. Required elements include an initial assessment or follow-up monitoring using applicable validated rating scales, behavioral health care planning and revisions for patients who are not progressing or whose status changes, facilitation and coordination of treatment such as psychotherapy, pharmacotherapy, counseling and/or psychiatric consultation, and continuity of care with a designated member of the care team. This code is reported in addition to advanced primary care management codes when applicable.
Service type: Behavioral health care management, monthly
Typical site of service: Outpatient clinics, behavioral health programs, primary care clinics coordinating behavioral health treatment, and other ambulatory care settings
Clinical & Coding Specifications
Clinical Context
A 38-year-old patient with recurrent major depressive disorder and generalized anxiety is enrolled in monthly behavioral health care management led by a psychiatrist in collaboration with a primary care physician and a licensed clinical social worker. At the initial month, the psychiatrist performs an assessment including standardized scales (e.g., PHQ-9, GAD-7), documents a behavioral health care plan with pharmacotherapy initiation and psychotherapy referral, and designates a care team member for continuity. Each subsequent calendar month, the clinician or care manager conducts follow-up monitoring using validated rating scales, updates the care plan for nonresponse or symptom change, facilitates medication adjustments with the prescriber, coordinates psychotherapy and psychiatric consultation, and documents outreach and coordination activities. Services are billed once per calendar month under G0570 when directed by a physician or other qualified health care professional and when all required elements (assessment/follow-up, validated scales, care planning and revision, facilitation/coordinating treatment, and continuity of care) are met.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
25 | Significant, separately identifiable evaluation and management service by the same physician on the same day | Use when a distinct E/M visit is provided the same day as and documentation supports a separate service |