Question 1

What is HCPCS code G0554?

Accepted Answer

HCPCS code G0554 is "Add 20 m of monthly tx". Each additional 20 minutes of monthly treatment management services directly related to the patient's therapeutic use of the digital mental health treatment (dmht) device that augments a behavioral therapy plan, physician/other qualified health care professional time reviewing data generated from the dmht device from patient observations and patient specific inputs in a calendar month and requiring at least one interactive communication with the patient/caregiver during the calendar month

Question 2

What category is G0554 in?

Accepted Answer

G0554 belongs to HCPCS Category G (Procedures/Professional Services).

Question 3

When should I use HCPCS code G0554?

Accepted Answer

Use G0554 when billing for add 20 m of monthly tx. HCPCS Level II codes like this are used for items and services not covered by CPT codes, including medical supplies, equipment, drugs administered in clinical settings, and certain healthcare services.

Question 4

Is G0554 covered by Medicare?

Accepted Answer

Coverage for G0554 (Add 20 m of monthly tx) depends on medical necessity and specific Medicare guidelines. Check the applicable Local Coverage Determination (LCD) or National Coverage Determination (NCD) for detailed coverage criteria. Private insurers may have different coverage policies.

Question 5

What documentation is required for G0554?

Accepted Answer

Documentation for G0554 should include: the medical necessity for the item or service, supporting diagnosis codes (ICD-10), prescription or order from the treating physician, and proof that the item meets quality standards. Some items may require additional documentation like a Certificate of Medical Necessity (CMN).