Medicare pays a primary care physician or other primary care practitioner in a primary care setting to annually provide one face-to-face behavioral counseling session for cardiovascular disease. Although CMS has developed a HCPCS code specifically for this service, many primary care clinicians perform this service as part of an E/M service or a wellness visit.
The code is defined as 15 minutes. In order to bill these, the record must show that the service took over half of the threshold time, or 7.5 minutes. All Medicare patients are eligible for the service.
- G0446 Annual, face-to-face intensive behavioral counseling for cardiovascular disease, individual, 15 minutes.
The service has three components:
- The first is to encourage aspirin use for primary prevention a cardiovascular disease when the benefits outweigh the risks for men age 45-79 and women 55-79. (When the patient is in that age range.)
- The second is to screen for high blood pressure in all adults aged 18 and older.
- And the third is intensive behavioral counseling to promote a healthy diet for adults who already have hyperlipidemia, hypertension, advancing age, and other known risk factors for cardiovascular and diet related chronic diseases.
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