Payment of Health Behavior Assessment and Intervention Services Approved for Clinical Social Workers

Mirean Coleman, LICSW, CT Director of Clinical Practice

On November 2, 2023, the Centers for Medicare and Medicaid Services (CMS) released the final rule for the 2024 Medicare Physician Payment Schedule. NASW is happy to inform its members that the final rule reported that clinical social workers, beginning January 1, 2024, will be reimbursed for Health Behavior Assessment and Intervention Services (HBAI) performed. These services are used to identify the psychological, behavioral, emotional, cognitive, and social factors included in the treatment of physical health problems. The services are reported by using procedural billing codes 96156, 96158, 96159, 96164, 96165, 96167, and 96168. Allowing clinical social workers to receive reimbursement for these services will permit better integration of physical and behavioral health care. Since the inception of these codes in 2003, NASW has been advocating for clinical social work reimbursement of these services to CMS and through federal legislation.

NASW will analyze the 2709-page final rule and make available to its members a detailed summary of other updates in the coming weeks. The text of the final rule can be accessed at: https://public-inspection.federalregister.gov/2023-24184.pdf. Page 547 of the text provides information about the HBAI rule. Members who have questions about coding for HBAI services may contact mcoleman.nasw@socialworkers.org