Medicare Claims Processing Manual (Pub. 100-04), Ch. 9 § 70.8
General Care Management Services – Chronic Care or Psychiatric
70.8- General Care Management Services – Chronic Care or Psychiatric
Collaborative Care Model (CoCM) Services
(Rev. 10357, Issued: 09-18-2020, Effective: 10-19-2020, Implementation: 10-19-2020)
Effective for services furnished on or after January 1, 2018, RHCs and FQHCs are paid
for General Care Management or Psychiatric CoCM services when G0511 or G0512 is
billed alone or with other payable services on an RHC or FQHC claim. HCPCS code
G0511 or G0512 can only be billed once per month per beneficiary, and cannot be billed
if other care management services are billed for the same time period.
HCPCS codes G0511 and G0512 are subject to coinsurance and deductibles on RHC
claims. Only coinsurance applies on FQHC claims. Coinsurance is 20 percent of the
lesser of the RHC or FQHC’s charge for HCPCS codes G0511 and G0512, or the
corresponding rate.
The allowable revenue code is 052X. These HCPCS codes of G0511 or G0512 should not be
billed with modifier CG for payment on RHC claims.