M1360 C-SSRS Assessment Reimbursement & Policy | OpenPayer

Summary & Overview

HCPCS M1360: C-SSRS Suicidal Ideation and Behavior Assessment

HCPCS Level II code M1360 denotes a behavioral health risk assessment for suicidal ideation and/or behavior symptoms based on the C-SSRS. This code captures the use of a validated screening and rating tool widely used across clinical settings to identify suicide risk and document severity. As suicide prevention remains a major public health priority, accurate coding for C-SSRS assessments supports clinical documentation, care coordination, and tracking of safety interventions at a national level.

Key payers covered in this analysis include Aetna, Blue Cross Blue Shield, Cigna, UnitedHealthcare, and Medicare. The publication provides readers with a concise overview of how M1360 is used in practice, typical sites of service, and what stakeholders monitor when this assessment is billed. Readers will find benchmarks and policy-relevant context about clinical documentation expectations and site-of-service considerations, plus notes on common modifiers and billing practices where available.

The piece is intended for practice managers, behavioral health clinicians, billing professionals, and policy analysts seeking a national-level reference for coding and documentation of suicide risk assessments using the C-SSRS. Data not provided in the input, such as specific payer edits and ICD-10 pairings, are noted as unavailable.

AetnaBlue Cross Blue ShieldCignaUnitedHealthcareMedicareM1360HCPCS Level IIsuicidal ideationC-SSRSbehavioral healthrisk assessmentmental health codingemergency departmentoutpatient psychiatry

Billing Code Overview

HCPCS Level II code M1360 represents assessment of suicidal ideation and/or behavior symptoms based on the C-SSRS (Columbia-Suicide Severity Rating Scale). The service is an behavioral health risk assessment focused on identifying, documenting, and quantifying suicidal thoughts or behaviors using the standardized C-SSRS instrument.

Service Type: Behavioral health risk assessment using C-SSRS

Typical Site of Service: Outpatient behavioral health clinics, psychiatric practices, emergency departments, primary care settings with behavioral health integration, and telehealth behavioral assessments

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

Clinical & Coding Specifications

Clinical Context

A 28-year-old patient presents to the emergency department after expressing active thoughts of suicide to a family member. Triage nursing documents recent passive and active suicidal ideation. A behavioral health clinician performs the Columbia-Suicide Severity Rating Scale (C-SSRS) interview, documents presence and severity of suicidal ideation and any recent suicidal behavior, and communicates findings to the emergency physician and the psychiatric crisis team. The clinician records risk level, immediate safety planning needs, and disposition (admit to inpatient psychiatry, transfer to crisis stabilization unit, or discharge with outpatient follow-up and safety plan). The service typically occurs in the emergency department, psychiatric urgent care, inpatient psychiatric unit, or behavioral health clinic, and is provided by psychiatrists, psychiatric nurse practitioners, licensed clinical social workers, or crisis clinicians. Billing uses HCPCS Level II code M1360 to capture suicidal ideation and/or behavior symptoms based on the C-SSRS during the encounter, and documentation includes the C-SSRS instrument, risk assessment, time spent, interventions, and disposition decision.

Coding Specifications

Modifier	Description	When to Use
`22`	Increased procedural services	Use when the C-SSRS assessment requires substantially greater work or documentation than typical (extensive risk history or multi-hour crisis management).

HCPCS M1420: Complete Ophthalmologic Care MIPS Value Pathway

HCPCS-M1458-PATIENT-DIED-PERFORMANCE-PERIOD

HCPCS M1458: Patient Died Prior to End of Performance Period

HCPCS-M1241-PATIENT-DID-NOT-RESPOND-TO-FEELING-SEEN-AS-A-PERSON

HCPCS Level II M1241: Patient Did Not Respond to 'Seen as a Person' Question

HCPCS-M1494-PATIENT-REPORTED-FALL-SINCE-LAST-VISIT

HCPCS Level II M1494: Patient Reported Fall Since Last Visit

HCPCS-M1180-IMMUNE-CHECKPOINT-INHIBITOR-THERAPY-MONITORING

HCPCS M1180: Patients on Immune Checkpoint Inhibitor Therapy

HCPCS-M1408-GERMLINE-BRCA-TESTING-BEFORE-OVARIAN-CANCER-DIAGNOSIS

HCPCS M1408: Germline BRCA Testing Before Ovarian Cancer Diagnosis

HCPCS-M1429-RETINAL-EXAM-RETINOPATHY-WITH-SEVERITY-DOCUMENTED

HCPCS Level II M1429: Retinal Exam Finding with Retinopathy

HCPCS-M1437-TELEHEALTH-ENCOUNTER

HCPCS M1437: Encounters Conducted via Telehealth

HCPCS-M1393-NONRECURRENT-MELANOMA-STATUS

HCPCS M1393: Nonrecurrent Melanoma Status

HCPCS-M1471-MEDICARE-PART-B-HEP-B-VACCINE-COVERAGE-STATUS

HCPCS M1471: Medicare Part B Hepatitis B Vaccine Coverage Status

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Taxonomy Code	Specialty	Notes
`2084P0900X`	Psychiatrist	Commonly performs or oversees C-SSRS administration and risk stratification.
`363L00000X`	Nurse Practitioner - Psychiatric/Mental Health	Frequently conducts assessments in ED, inpatient, and outpatient behavioral settings.
`1041C0700X`	Clinical Social Worker	Performs C-SSRS interviews, safety planning, and coordination of care.
`103T00000X`	Psychologist	Conducts structured assessments and documents suicidal ideation and behavior.
`101YP2500X`	Behavioral Health Crisis Counselor	Performs crisis assessments using C-SSRS in urgent settings.

Related Diagnoses

ICD-10 Code	Description	Clinical Relevance
`F32.9`	Major depressive disorder, single episode, unspecified	Depressive disorders frequently present with suicidal ideation assessed by the C-SSRS.
`F33.1`	Major depressive disorder, recurrent, moderate	Recurrent depression is a common driver of suicidal thoughts and behaviors.
`R45.851`	Suicidal ideation	Directly documents presence of suicidal thoughts and correlates with use of the C-SSRS.
`T14.91`	Suicide attempt, initial encounter	Captures documented self-harm attempt; C-SSRS helps characterize behavior and intent.
`F41.9`	Anxiety disorder, unspecified	Anxiety disorders can co-occur with suicidal ideation and are evaluated during risk assessment.
`F43.21`	Adjustment disorder with depressed mood	Acute stressors and adjustment disorders can include suicidal ideation assessed by C-SSRS.
`F20.9`	Schizophrenia, unspecified	Psychotic disorders carry suicide risk and warrant structured ideation/behavior assessment.

Related CPT Codes

CPT Code	Description	Relationship to This Procedure
`90791`	Psychiatric diagnostic evaluation (no medical services)	Often performed alongside `M1360` when a full psychiatric diagnostic interview is needed after C-SSRS identifies significant risk.
`99283`	Emergency department visit, established patient, moderate complexity	Common ED E/M code used when a patient with suicidal ideation presents and a focused C-SSRS is part of evaluation.
`99407`	Smoking and tobacco use cessation counseling, intensive (greater than 10 minutes)	Example behavioral intervention code; analogous intensive counseling codes may be used when extensive safety counseling is provided (note: use only when clinically appropriate).
`90832`	Psychotherapy, 30 minutes with patient	Short psychotherapy sessions that may follow C-SSRS assessment for safety planning or crisis intervention.
`90834`	Psychotherapy, 45 minutes with patient	Common duration for psychotherapy or crisis counseling sessions following a suicidal ideation assessment.
`G0389`	Prolonged services in the emergency department requiring direct patient contact beyond the usual service (per Medicare)	Use when the C-SSRS assessment and resulting management require prolonged time in the ED beyond typical E/M visit.

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