How To Use HCPCS Code G0018

HCPCS code G0018 describes the provision of psychotherapy for crisis in an applicable site of service. This code is used to identify additional 30-minute increments of crisis psychotherapy services provided in a non-office setting where the non-facility rate for these services applies. In this article, we will explore the details of HCPCS code G0018, including its official description, procedure, when to use it, billing guidelines, historical information, Medicare and insurance coverage, and provide examples of when this code should be billed.

1. What is HCPCS G0018?

HCPCS code G0018 is used to identify additional 30-minute increments of psychotherapy for crisis services provided in an applicable site of service. It is important to note that this code is not used to identify the primary service, but rather the additional time spent on crisis psychotherapy beyond the primary service. The primary service code should be reported separately.

2. Official Description

The official description of HCPCS code G0018 is “Psychotherapy for crisis furnished in an applicable site of service (any place of service at which the non-facility rate for psychotherapy for crisis services applies, other than the office setting); each additional 30 minutes (list separately in addition to code for primary service).” The short description for this code is “Crisis psychotherapy add 30m.”

3. Procedure

1. The provider should first identify the primary service code that represents the initial crisis psychotherapy session.
2. If additional time beyond the primary service is required, the provider should report HCPCS code G0018 for each additional 30-minute increment.
3. The provider should ensure that the service is furnished in an applicable site of service where the non-facility rate for psychotherapy for crisis services applies, other than the office setting.
4. The additional time spent on crisis psychotherapy should be documented in the patient’s medical record.

4. When to use HCPCS code G0018

HCPCS code G0018 should be used when providing additional 30-minute increments of crisis psychotherapy services in an applicable site of service. It is important to ensure that the service is furnished in a setting where the non-facility rate for psychotherapy for crisis services applies, other than the office setting. Providers should also follow any specific eligibility criteria or guidelines set forth by payers when using this code.

5. Billing Guidelines and Documentation Requirements

When billing for HCPCS code G0018, healthcare providers should ensure that the following guidelines and documentation requirements are met:

• The primary service code representing the initial crisis psychotherapy session should be reported separately.
• HCPCS code G0018 should be listed separately in addition to the code for the primary service.
• The service should be documented in the patient’s medical record, including the additional time spent on crisis psychotherapy.

6. Historical Information and Code Maintenance

HCPCS code G0018 was added to the Healthcare Common Procedure Coding System on January 01, 2024. As of its addition, there have been no maintenance actions taken for this code. The pricing for this code is established by carriers, indicating that it is not otherwise classified and is subject to individual determination and carrier discretion.

7. Medicare and Insurance Coverage

Medicare and insurance coverage for HCPCS code G0018 may vary. Providers should consult with the respective payers to determine coverage and reimbursement policies. The pricing indicator code for this code is 13, indicating that the price is established by carriers. The multiple pricing indicator code is A, indicating that it is not applicable as HCPCS priced under one methodology.

8. Examples

Here are five examples of when HCPCS code G0018 should be billed:

1. A patient receives an initial crisis psychotherapy session in an applicable site of service, and an additional 30 minutes of crisis psychotherapy is provided beyond the primary service.
2. A patient requires an extended crisis psychotherapy session in a non-office setting, and an additional 60 minutes of crisis psychotherapy is provided beyond the primary service.
3. A patient receives an initial crisis psychotherapy session in an applicable site of service, and an additional 30 minutes of crisis psychotherapy is provided during a follow-up visit.
4. A patient requires ongoing crisis psychotherapy services in a non-office setting, and an additional 30 minutes of crisis psychotherapy is provided during each session.
5. A patient receives an initial crisis psychotherapy session in an applicable site of service, and an additional 30 minutes of crisis psychotherapy is provided during a group therapy session.