Screening Code G0447 for Intensive Behavioral Therapy (IBT) for Obesity
Medicare beneficiaries with obesity, defined as Body Mass Index (BMI) equal to or greater than 30 kg/m2, who are competent and alert at the time that counseling is provided and whose counseling is furnished by a qualified primary care physician or other primary care practitioner in a primary care setting.
Official description of G0447 is: “Face-to-face behavioral counseling for obesity, 15 minutes.”
G0447 Billing Guidelines
One face-to-face visit every week for the first month;
One face-to-face visit every other week for months 2-6; and
One face-to-face visit every month for months 7-12 if the beneficiary meets the 3kg (6.6 lbs) weight loss requirement during the first six months.
Reassessment
At the 6-month visit, a reassessment of obesity and determining the amount of weight loss should be performed.
To be eligible for additional face-to-face visits occurring once a month for months 7-12, beneficiaries must have achieved a reduction in weight of at least 3kg (6.6 lbs.), over the first 6 months of Intensive Behavioral Therapy.
This determination must be documented in the physician’s office records for applicable beneficiaries consistent with usual practice.
For beneficiaries who do not achieve a weight loss of at least 3kg (6.6 lbs.) during the first six months of intensive therapy, a reassessment of their readiness to change and BMI is appropriate after an additional 6-month period.
IBT for obesity consists of the following:
1. Screening for obesity in adults using measurement of BMI calculated by dividing weight in kilograms by the square of height in meters (expressed kg/m2);
2. Dietary (nutritional) assessment; and,
3. Intensive behavioral counseling and behavioral therapy to promote sustained weight loss through high intensity interventions on diet and exercise
Specialty Types For G0447
Medicare will pay claims for G0447 only when services are submitted by the following provider specialty types found on the provider’s Medicare enrollment record:
01 – General Practice
08 – Family Practice
11 – Internal Medicine
16 – Obstetrics/Gynecology
37 – Pediatric Medicine
38 – Geriatric Medicine
50 – Nurse Practitioner
89 – Certified Clinical Nurse Specialist
97 – Physician Assistant
Place reassessment Service Codes
Medicare will pay for obesity counseling claims containing HCPCS G0447 only when services are provided with the following POS codes:
POS 11 – Physician’s Office
POS 22 – Outpatient Hospital
POS 49 – Independent Clinic
POS 71 – State or local public health clinic.