Summary & Overview

HCPCS M1352: Suicidal Ideation and Behavior Assessment

HCPCS Level II code M1352 represents documentation of suicidal ideation and/or behaviors identified via the Columbia-Suicide Severity Rating Scale (C-SSRS) or an equivalent standardized assessment. The code captures a critical clinical finding used across care settings to identify patients at risk for self-harm, trigger safety planning, and guide treatment and referral decisions. Nationally, consistent capture of suicidal ideation is important for quality measurement, care coordination, and population-level monitoring of mental health needs.

Key payers in the analysis include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find an overview of the clinical context of M1352, where and how it is typically used, and what elements are commonly included in claims for behavioral health risk assessments. The publication outlines benchmarks and policy-relevant considerations for billing and documentation, summarizes payer coverage patterns where available, and highlights implications for outpatient, primary care, and emergency settings. The content is intended to support billing staff, compliance officers, and clinical leaders seeking a concise reference on the purpose and operational use of HCPCS Level II code M1352. Data not available in the input is noted where applicable.

AetnaBlue Cross Blue ShieldCigna HealthUnitedHealthcareMedicareM1352HCPCS Level IIsuicidal ideationc-ssrsbehavioral health assessmentmental health screeningrisk assessmentemergency behavioral healthoutpatient psychiatry

Billing Code Overview

HCPCS Level II code M1352 documents suicidal ideation and/or behavior symptoms identified using the Columbia-Suicide Severity Rating Scale (C-SSRS) or an equivalent standardized assessment. This code is used to record the presence and severity of suicidal thoughts or behaviors as observed or reported during a clinical assessment.

Service type: Behavioral health risk assessment / mental health screening and evaluation

Typical site of service: Outpatient behavioral health clinics, primary care settings, emergency departments, and community mental health programs

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

Clinical & Coding Specifications

Clinical Context

A 32-year-old patient presents to an outpatient behavioral health clinic expressing passive and active suicidal thoughts during a scheduled psychiatric follow-up. The clinician administers a Columbia-Suicide Severity Rating Scale (C-SSRS) to quantify ideation severity and recent suicidal behavior. The assessment is documented in the electronic health record, including endorsed ideation items, any preparatory behaviors, lethality intent, and immediate risk factors (e.g., plan, intent, access to means). Based on the results, the clinician develops a safety plan, arranges urgent follow-up or higher level of care if indicated, and communicates findings to the primary care provider and, when required, the patient’s insurer.

Typical workflow steps:

Triage identifies suicide risk during intake or encounter.
Licensed clinician (psychiatrist, psychiatric nurse practitioner, psychologist, or licensed clinical social worker) performs the C-SSRS or equivalent standardized instrument.
Findings are documented and time-stamped in the chart; risk level is recorded and a safety plan or disposition is created.
Billing staff links the HCPCS code M1352 to the encounter for payor submission, applying applicable modifiers for unusual circumstances or multiple services.

Typical site of service: outpatient behavioral health clinic, psychiatric clinic, emergency department behavioral health area, or community mental health center.

Typical patient scenario: adult with worsening depressive symptoms and new passive and active suicidal ideation, no immediate medical instability, receives a structured C-SSRS interview (including lethality and behavior items), brief crisis intervention, and arranged follow-up within 24–72 hours.

Coding Specifications

Modifier	Description	When to Use
`22`	Increased procedural services	When documentation supports substantially greater complexity or time than usual for administering and documenting a suicide risk assessment.
`23`	Unusual anesthesia	Not typically applicable to this service; rarely used for behavioral assessments.
`52`	Reduced services	When the assessment was partially performed or curtailed and full service was not provided.
`53`	Discontinued procedure	When the assessment was started but stopped due to patient medical emergency or safety concerns.
`54`	Surgical care only	Not applicable; included for completeness but generally not used for behavioral assessments.
`55`	Post-op care only	Not applicable to this service; not typically used.
`56`	Pre-op care only	Not applicable to this service.
`62`	Two surgeons	Not applicable; behavioral health assessments are single-provider services.
`AS`	Non‑participating anesthesiologist	Not applicable to standard behavioral assessments.
`CO`	Payment adjustment for workers' compensation	Use when the claim is related to workers’ compensation and required by the payer.
`CQ`	Service furnished under a contract to the Department of Veterans Affairs	Use for eligible VA-contracted services when applicable.
`FX`	Designated by third-party payer for special payment consideration	Use when a payer requires this modifier for specific payment rules.
`FY`	Item/service paid under a fee schedule	Use when payer requires signaling of fee-schedule payment; rare for this code.
`QK`	Medical direction of two, three, or four qualified health-care professionals	Use when the clinician medically directs multiple qualified individuals providing components of the assessment.
`QX`	Monitored anesthesia care service by CRNA with medical direction by physician	Not applicable to this service.

Taxonomy Code	Specialty	Notes
`103T00000X`	Psychiatrist	Most commonly performs diagnostic evaluation and risk assessment.
`363L00000X`	Nurse Practitioner — Psychiatric/Mental Health	Performs standardized suicide risk assessments and safety planning.
`1041A0400X`	Psychologist	Conducts structured assessments like the `C-SSRS` and documents findings.
`1041C0700X`	Licensed Clinical Social Worker	Provides crisis assessment, safety planning, and coordination of care.
`367500000X`	Behavioral Health Counselor	Performs standardized screening and brief interventions in outpatient settings.

ICD-10 Code	Description	Clinical Relevance
`F32.9`	Major depressive disorder, single episode, unspecified	Depression commonly coexists with suicidal ideation; C-SSRS helps quantify risk.
`F33.1`	Major depressive disorder, recurrent, moderate	Recurrent depression increases risk for suicidal ideation and behavior.
`F41.1`	Generalized anxiety disorder	Anxiety disorders can accompany suicidal ideation; assessment clarifies risk contributors.
`F43.10`	Post-traumatic stress disorder, unspecified	PTSD is associated with increased suicidal ideation and behavior.
`F20.9`	Schizophrenia, unspecified	Psychotic disorders carry suicide risk; structured assessment documents ideation and behavior.
`R45.851`	Suicidal ideations	Directly documents the presenting symptom that `M1352` captures clinically.
`T14.91`	Suicide attempt, initial encounter	Used when an assessment identifies or follows a recent suicide attempt or self-harm.

CPT Code	Description	Relationship to This Procedure
`90791`	Psychiatric diagnostic evaluation (no medical services)	Commonly performed alongside `M1352` for a comprehensive psychiatric assessment when a new or unstable presentation is evaluated.
`99214`	Office or other outpatient visit, established patient, moderate complexity	Used for extended evaluation and management visits that include administration of a standardized suicide risk assessment and management planning.
`99285`	Emergency department visit for the evaluation and management of a patient, high severity	Used in the emergency department when a patient presents with acute suicidal ideation requiring high-complexity ED evaluation in addition to `M1352`.
`90839`	Psychotherapy for crisis, first 60 minutes	May be billed when the assessment leads directly into a crisis psychotherapy session on the same date.
`99406`	Smoking and tobacco use cessation counseling (3–10 minutes)	Data not directly related; included for completeness only — Data not available in the input.

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