HCPCS Level II M1357: Reduction in Suicidal Ideation or Behavior - OpenPayer

Summary & Overview

HCPCS Level II M1357: Reduction in Suicidal Ideation or Behavior

HCPCS Level II code M1357 represents a documented reduction in suicidal ideation and/or behavior at follow-up assessment within 120 days of an index assessment. This measure is clinically important as it tracks short-term improvement in suicidality, a key quality and safety indicator in behavioral health care and integrated primary care. Nationally, monitoring reductions in suicidal ideation supports population health efforts, care coordination, and quality reporting across payers.

Key payers addressed include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find a concise overview of the code's clinical meaning and the settings where it is typically applied, plus benchmark and coverage considerations relevant to major national payers. The publication outlines expected service lines, typical sites of service, and what measure capture implies for clinical workflows. It also summarizes where data is available and notes fields that were not provided in the source input.

This piece is intended to inform billing, quality, and clinical teams about the role of M1357 in documenting short-term reductions in suicidality, helping organizations align documentation and reporting practices with payer requirements and quality measurement efforts.

AetnaBlue Cross Blue ShieldCigna HealthUnitedHealthcareMedicareM1357HCPCS Level IImental healthsuicidal ideationfollow-up assessmentbehavioral healthquality measureoutpatient care

Billing Code Overview

HCPCS Level II code M1357 denotes patients who had a reduction in suicidal ideation and/or behavior upon follow-up assessment within 120 days of the index assessment. This measure captures clinical improvement in suicidality documented at a follow-up evaluation within a 120-day timeframe after the initial assessment.

Service type: Follow-up mental health assessment focused on suicidal ideation and behavior
Typical site of service: Outpatient behavioral health settings, mental health clinics, primary care clinics with behavioral health integration, and other ambulatory settings where follow-up risk assessments are performed

Data not available in the input.

Clinical & Coding Specifications

Clinical Context

A 34-year-old patient presented to outpatient behavioral health following an index assessment documenting active suicidal ideation with intent and plans. The clinician completed a comprehensive risk assessment, safety planning, and initiated or adjusted evidence-based treatment (psychotherapy and/or medication). A follow-up assessment occurred within 120 days and demonstrated a clinically meaningful reduction in suicidal ideation and/or behavior compared with the index assessment. Typical workflow includes: initial intake and risk assessment, documentation of baseline ideation severity and behaviors, implementation of safety plan and care coordination (including crisis resources and family notification as appropriate), treatment initiation or modification, and a structured follow-up visit within 120 days to reassess ideation and behaviors, document change, and close or revise the safety plan.

Coding Specifications

Modifier	Description	When to Use
`22`	Increased procedural services	Use when work required to document assessment and follow-up is substantially greater than typical due to complexity (e.g., extensive multidisciplinary coordination, prolonged counseling related to acute suicidality).
`23`

HCPCS M1150: Left Ventricular Ejection Fraction ≤40% or Moderately/Severely Depressed LV Function

HCPCS-M1487-HOSPICE-PATIENT-STATUS-YEAR-BEFORE-OR-DURING-EVALUATION

HCPCS M1487: Hospice Patient in Year Before or During Evaluation

HCPCS-M1469-HEPATITIS-B-HISTORY-OR-POSITIVE-HEPATITIS-B-TEST

HCPCS Level II M1469: Hepatitis B History or Positive Hepatitis B Test

HCPCS-M1474-PATIENTS-WITH-DIAGNOSIS-OF-DEMENTIA

HCPCS M1474: Patients with Diagnosis of Dementia

HCPCS-M1410-NO-BRCA-GERMLINE-TESTING-OR-GENETIC-COUNSELING-6-MONTHS

HCPCS M1410: No BRCA1/BRCA2 Germline Testing or Genetic Counseling

HCPCS-M1445-POSTPARTUM-CARE-VISIT-12-WEEKS

HCPCS M1445: Postpartum Care Visit, Up to 12 Weeks

HCPCS-M1363-NO-FOLLOW-UP-ASSESSMENT-120-DAYS

HCPCS Level II M1363: Missed Follow-Up Assessment Within 120 Days

HCPCS-M1229-HCV-VIREMIA-REFERRAL-TO-HCV-CLINICIAN

HCPCS Level II M1229: Referral for HCV Viremia to HCV Clinician

HCPCS-M1472-HEPATITIS-B-VACCINATION-INCOMPLETE-DOSES

HCPCS Level II M1472: Incomplete Hepatitis B Vaccination by Age

HCPCS-M1305-PNEUMOCOCCAL-VACCINE-ADULT-IMMUNIZATION

HCPCS Level II M1305: Adult Pneumococcal Vaccination

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Taxonomy Code	Specialty	Notes
`101Y00000X`	Psychiatry	Psychiatrists commonly perform initial risk assessments, medication management, and follow-up safety evaluations.
`2084P0800X`	Clinical Social Work	Licensed clinical social workers frequently provide psychotherapy, safety planning, and follow-up assessments.
`103T00000X`	Psychological Services	Psychologists conduct standardized assessments, psychotherapy, and follow-up evaluations for suicidal ideation.
`261QM0800X`	Behavioral Health & Mental Health Service Provider	Nurse practitioners in behavioral health deliver medication management and follow-up risk assessments.
`3084N0400X`	Family Medicine	Primary care physicians may perform initial screening, coordination of care, and follow-up assessment when integrated behavioral health services are provided.

ICD-10 Code	Description	Clinical Relevance
Data not available in the input.

Related CPT Codes

CPT Code	Description	Relationship to This Procedure
`90791`	Psychiatric diagnostic evaluation (no medical services)	Used for the initial comprehensive psychiatric diagnostic interview and risk assessment at index visit preceding the follow-up that documents reduction in suicidal ideation.
`90792`	Psychiatric diagnostic evaluation with medical services (e.g., medication management)	Used when the initial assessment includes medical evaluation or initiation/adjustment of psychotropic medications prior to the 120-day follow-up.
`90832`	Psychotherapy, 30 minutes with patient	Brief psychotherapy sessions provided between index and follow-up to address suicidal ideation and monitor response.
`90834`	Psychotherapy, 45 minutes with patient	Standard psychotherapy session commonly used for ongoing treatment between index and follow-up assessments.
`99406`	Smoking and tobacco use cessation counseling, intermediate; 3-10 minutes	Example of a brief behavioral counseling code sometimes performed concurrently in comprehensive behavioral health care (use only if applicable).
`99354`	Prolonged physician service in the office or outpatient setting, requiring direct patient contact beyond the usual service; first hour	Use when extended time is required for complex safety planning or coordination beyond typical psychotherapy or evaluation timeframes.

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