As we step into 2025, exciting changes are taking place in the realm of clinical social work and mental health care. The Center for Medicare and Medicaid Services (CMS) has released updated reimbursement opportunities for Safety Planning Interventions (SPI) and follow-up services, paving the way for providers to better serve their clients while ensuring they are compensated for their critical work.

What Does This Mean for Providers?

Mental health providers play a vital role in supporting individuals facing crises, whether related to mental health, substance use, or other urgent safety concerns. Safety planning and follow-up interventions are essential tools, offering clients a structured approach to navigating challenges and maintaining stability. The recognition of these services for reimbursement underscores their importance in delivering comprehensive care.

Key Updates:

  • HCPCS Code G0560:
    • Reimburses Safety Planning Intervention (SPI) services.
    • These services can now be billed in 20-minute increments by licensed professionals.
    • Medicare reimburses G0560 at $41.41 per 20-minute increment, effective January 1, 2025.
  • HCPCS Code G0544:
    • Covers post-discharge telephonic follow-up contact provided after an emergency department discharge for behavioral health or crisis encounters.
    • These services can be performed by auxiliary personnel under the billing practitioner.
    • Medicare reimburses G0544 at $16.98 per 15-minute phone call.

💡 Important Note: Not all insurance providers have adopted these codes. It is recommended to verify coverage with each payer to ensure reimbursement eligibility.

What is Safety Planning Intervention (SPI)?

A Safety Planning Intervention involves collaborating with a client to develop a personalized list of coping and response strategies, along with sources of support, to use during crises. While it is not a suicide risk assessment, SPI is a proactive intervention for individuals at elevated risk of suicide or overdose. Components of a safety plan include:

  • Recognizing warning signs of a crisis.
  • Developing internal coping and response strategies.
  • Utilizing social contacts and settings to reduce risky thoughts or behaviors.
  • Involving family members or significant others to help resolve the crisis.
  • Making referrals to appropriate crisis services and community organizations.
  • Creating a safe environment, including restricting access to lethal means.

What This Means for You

  • Streamlined Billing: Simplify the process of documenting and claiming reimbursement for SPI and follow-up services.
  • Increased Accessibility: Ensure more clients benefit from proactive, supportive care while maximizing your practice’s revenue potential.
  • Support for Providers: At Healthcare Partners Consulting & Billing, LLC, we’re here to help you navigate these updates and ensure you receive the reimbursements you’re entitled to. From claims submission to denial management, we’re with you every step of the way.

Additional Resources

For more details, visit the Federal Register.

Let Us Help

Ready to take advantage of these new opportunities? Contact us at info@hpcbilling.com or visit hpcbilling.com. Together, we can simplify your administrative tasks so you can focus on what matters most: providing excellent care.

Stay informed, stay empowered, and step confidently into 2025 with these new reimbursement options.

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