G2122 HCPCS Reimbursement & Policy Benchmarks | OpenPayer

Summary & Overview

HCPCS G2122: Depression, Anxiety, Apathy, and Psychosis Not Assessed

HCPCS Level II code G2122 denotes that depression, anxiety, apathy, and psychosis were not assessed during a clinical encounter. As a documentation-status code, it signals the absence of evaluation for these common mental health domains and can affect quality measurement and billing workflows. Nationally, consistent capture of mental health assessments is a priority for payers and regulators, making codes like G2122 relevant for quality reporting, care management, and administrative review.

This publication covers payer handling and coverage context for major national payers: Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find a concise overview of typical use cases for G2122, implications for documentation and quality programs, and what is available from public policy and reimbursement guidance. The report summarizes benchmarks where available and notes gaps in publicly available coding policy. It provides clinical context on the domains referenced by the code and outlines where additional assessment or coding would normally be expected in ambulatory behavioral health and primary care settings.

Data not available in the input for specific modifiers, associated taxonomies, ICD-10 pairings, and related codes.

AetnaBlue Cross Blue ShieldCigna HealthUnitedHealthcareMedicareG2122HCPCS Level IImental health screeningdocumentation statusbehavioral healthquality reportingambulatory care

Billing Code Overview

HCPCS Level II code G2122 indicates that depression, anxiety, apathy, and psychosis were not assessed. The code describes a documentation or billing status where these key mental health domains were not evaluated during the encounter.

Service type: Mental health assessment/documentation status
Typical site of service: Behavioral health outpatient or any ambulatory clinical setting where mental status and symptom screening would normally be performed

Data not available in the input for associated taxonomies, ICD-10 diagnoses, or related codes.

Clinical & Coding Specifications

Clinical Context

A typical patient is an older adult resident in a skilled nursing or long-term care facility who exhibits mood and behavior changes such as withdrawal, low motivation, agitation, suspiciousness, or sleep disturbance. During a routine nursing assessment or following staff concern, the primary care clinician or attending physician documents that depression, anxiety, apathy, and psychosis were not assessed during the visit due to limited time, resident refusal, acute medical instability, or lack of available collateral information. The clinical workflow begins with nursing triage and brief behavioral screening, followed by a focused visit by a physician, nurse practitioner, or physician assistant. If a full mental health evaluation is deferred, the clinician documents rationale and plans (for example, schedule a separate psychiatric consult, obtain caregiver history, or perform cognitive testing later). Typical sites of service include skilled nursing facilities (SNF), long-term care facilities, assisted living, or inpatient hospital units when the team documents that these psychiatric domains were not assessed during the encounter.

Coding Specifications

Modifier	Description	When to Use
`22`	Increased procedural services	When substantially greater effort or complexity is documented for the visit beyond typical expectations.

HCPCS G9518: Documentation of Active Injection Drug Use

HCPCS-G0568-INITIAL-PSYCHIATRIC-COLLABORATIVE-CARE-MANAGEMENT

HCPCS G0568: Initial Psychiatric Collaborative Care Management

HCPCS-G9743-PSYCHIATRIC-SYMPTOMS-NOT-ASSESSED

HCPCS G9743: Psychiatric Symptoms Not Assessed

HCPCS-LEVEL-II-G9810-ASTHMA-CONTROLLER-MEDICATION-ADHERENCE-PDC-75

HCPCS Level II G9810: Asthma Controller Medication Adherence (PDC ≥75%)

HCPCS-G0565-IMPLANTABLE-GLUCOSE-SENSOR-REPLACEMENT-365-DAY

HCPCS G0565: Removal and Replacement of 365-Day Implantable Glucose Sensor

HCPCS-G0080-EXTENSIVE-CARE-MANAGEMENT-HOME-VISIT-NEW-PATIENT

HCPCS G0080: Extensive 75-Minute Care Management Home Visit for New Patient

HCPCS-G9646-90-DAY-MRS-0-2-FUNCTIONAL-OUTCOME

HCPCS G9646: 90-Day mRS 0–2 Functional Outcome

HCPCS-G2139-POSTOPERATIVE-BACK-PAIN-VAS-NUMERIC-SCALE

HCPCS G2139: Postoperative Back Pain by VAS/Numeric Scale

HCPCS-G9673-CARDIOVASCULAR-PREVENTION-MEASURES-REPORTING

HCPCS G9673: Cardiovascular Prevention Measures Reporting

HCPCS-G0329-ELECTROMAGNETIC-THERAPY-CHRONIC-WOUNDS

HCPCS G0329: Electromagnetic Therapy for Chronic Ulcers

Showing 1–10 of 1996

Taxonomy Code	Specialty	Notes
`207P00000X`	Family Medicine	Primary care clinicians who commonly perform brief behavioral assessments in long-term care.
`207Q00000X`	Internal Medicine	Hospitalists and primary care internists providing acute or facility-based care.
`363L00000X`	Nurse Practitioner	Advanced practice clinicians who perform assessments and document deferrals.
`208D00000X`	Psychiatry	Psychiatric consultants who receive referrals when assessment is deferred or incomplete.
`207R00000X`	Geriatric Medicine	Specialists focused on older adults in whom mood, apathy, and psychosis screening is frequent.

Related Diagnoses

ICD-10 Code	Description	Clinical Relevance
`F32.9`	Major depressive disorder, single episode, unspecified	Depression is a primary condition warranting assessment when mood symptoms are present.
`F41.9`	Anxiety disorder, unspecified	Anxiety commonly co-occurs with depressive symptoms and is part of the deferred assessment domains.
`R41.0`	Disorientation, unspecified	Cognitive changes may accompany apathy and prompt further assessment after deferral.
`F06.0`	Psychotic disorder due to known physiological condition	Psychosis may be secondary to medical illness and requires targeted evaluation if initially not assessed.
`F05`	Delirium, not elsewhere classified	Acute confusion or behavioral change can preclude formal psychiatric assessment and may be the reason for deferral.

Related CPT Codes

CPT Code	Description	Relationship to This Procedure
`90791`	Psychiatric diagnostic evaluation (no medical services)	Performed when a full psychiatric assessment follows the deferred evaluation documented as not assessed.
`99213`	Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity	Common E/M code for facility or clinic visits where a brief assessment occurs and psychiatric domains may be deferred.
`99304`	Nursing facility initial care, per day, for the evaluation and management of a resident	Used for initial SNF assessments; documentation may note that psychiatric domains were not assessed.
`99483`	Cognitive assessment and care planning for patients with cognitive impairment	Often performed subsequently when apathy or cognitive symptoms prompt a comprehensive evaluation after initial deferral.
`96127`	Brief emotional/behavioral assessment (e.g., depression inventory)	Short screening tool used when clinicians later perform targeted assessments after initial deferral.

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