G0323 HCPCS code: Care management services for behavioral health conditions, at least 20 minutes of clinical psychologist, clinical social worker, mental health counselor, or marriage and family therapist time, per calendar month. (these services include the following required elements: initial assessment or follow-up monitoring, including the use of applicable validated rating scales; behavioral health care planning in relation to behavioral/psychiatric health problems, including revision for patients who are not progressing or whose status changes; facilitating and coordinating treatment such as psychotherapy, coordination with and/or referral to physicians and practitioners who are authorized by medicare to prescribe medications and furnish e/m services, counseling and/or psychiatric consultation; and continuity of care with a designated member of the care team)

G0323 is the HCPCS Level II code for care management services for behavioral health conditions, at least 20 minutes of clinical psychologist, clinical social worker, mental health counselor, or marriage and family therapist time, per calendar month. (these services include the following required elements: initial assessment or follow-up monitoring, including the use of applicable validated rating scales; behavioral health care planning in relation to behavioral/psychiatric health problems, including revision for patients who are not progressing or whose status changes; facilitating and coordinating treatment such as psychotherapy, coordination with and/or referral to physicians and practitioners who are authorized by medicare to prescribe medications and furnish e/m services, counseling and/or psychiatric consultation; and continuity of care with a designated member of the care team). In 2024 Medicare paid an average of $33.95 per service for G0323 across 7,189 services. Its Medicare coverage code is C (Carrier judgment): Coverage is decided by the Medicare contractor (MAC) case by case. The NCCI unit limit is 1 per day on outpatient hospital claims. Medicare volume rose 132% from 2023 to 2024 (3,101 to 7,189 services). In 2024, about 177 clinicians billed Medicare for G0323 for 3,121 beneficiaries; Texas, Nevada, Georgia accounted for 57% of services.

Code details

Who bills G0323 (2024)

Counts only. Supplier and clinician names, contact lists and state-by-state detail are in Caduvo.

Medicare utilization for G0323, 2023–2024

States with the most G0323 services (2024)

NCCI unit limits (MUE)

Medicare policy articles for this code

• A59723: Billing and Coding: Outpatient Psychotherapy (Palmetto GBA (MAC - Part A, MAC - Part B))
• A59723: Billing and Coding: Outpatient Psychotherapy (Palmetto GBA (MAC - Part A, MAC - Part B))

Covered diagnoses (428 ICD-10-CM codes)

The diagnoses most often listed as covered in the policy articles above:

Showing 10 of 428. The full list, non-covered diagnoses and CSV export are in Caduvo.

What changed for G0323

• 2023-01-01: G0323 added to HCPCS Level II
• Next scheduled CMS quarterly update (HCPCS and DMEPOS fee schedule): 2027-01-01

Frequently asked questions

What is HCPCS code G0323?

G0323 is the HCPCS Level II code for care management services for behavioral health conditions, at least 20 minutes of clinical psychologist, clinical social worker, mental health counselor, or marriage and family therapist time, per calendar month. (these services include the following required elements: initial assessment or follow-up monitoring, including the use of applicable validated rating scales; behavioral health care planning in relation to behavioral/psychiatric health problems, including revision for patients who are not progressing or whose status changes; facilitating and coordinating treatment such as psychotherapy, coordination with and/or referral to physicians and practitioners who are authorized by medicare to prescribe medications and furnish e/m services, counseling and/or psychiatric consultation; and continuity of care with a designated member of the care team). Short descriptor: "Care manage beh svs 20mins".

How much does Medicare pay for G0323?

In 2024, the average Medicare payment was $33.95 per service (average allowed $43.71).

Does Medicare cover G0323?

Coverage code C — Carrier judgment. Coverage is decided by the Medicare contractor (MAC) case by case.

Which diagnoses support coverage for G0323?

Medicare policy articles that cite G0323 list 428 covered ICD-10-CM diagnosis codes across 2 articles. The most cited include F01.A0 (Vascular dementia, mild, without behavioral disturbance, psychotic disturbance, mood disturbance, and anxiety), F01.A11 (Vascular dementia, mild, with agitation), F01.A18 (Vascular dementia, mild, with other behavioral disturbance). A listed diagnosis is necessary but not sufficient; the policy's other criteria still apply.

How many units of G0323 can be billed per day?

1 on outpatient hospital claims; 1 on practitioner claims (NCCI medically unlikely edits).

Related G03 codes

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• G0302 — Pre-operative pulmonary surgery services for preparation for lvrs, complete course of services, to include a minimum of 16 days of services
• G0303 — Pre-operative pulmonary surgery services for preparation for lvrs, 10 to 15 days of services
• G0304 — Pre-operative pulmonary surgery services for preparation for lvrs, 1 to 9 days of services
• G0305 — Post-discharge pulmonary surgery services after lvrs, minimum of 6 days of services
• G0306 — Complete cbc, automated (hgb, hct, rbc, wbc, without platelet count) and automated wbc differential count
• G0307 — Complete (cbc), automated (hgb, hct, rbc, wbc; without platelet count)
• G0308 — Creation of subcutaneous pocket with insertion of 180 day implantable interstitial glucose sensor, including system activation and patient training
• G0309 — Removal of implantable interstitial glucose sensor with creation of subcutaneous pocket at different anatomic site and insertion of new 180 day implantable sensor, including system activation
• G0310 — Immunization counseling by a physician or other qualified health care professional when the vaccine(s) is not administered on the same date of service, 5 to 15 mins time (this code is used for medicaid billing purposes)
• G0311 — Immunization counseling by a physician or other qualified health care professional when the vaccine(s) is not administered on the same date of service, 16-30 mins time (this code is used for medicaid billing purposes)
• G0312 — Immunization counseling by a physician or other qualified health care professional when the vaccine(s) is not administered on the same date of service for ages under 21, 5 to 15 mins time (this code is used for medicaid billing purposes)

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Next steps

• Run a reimbursement report for a device billed under G0323
• Watch G0323 for fee, coverage and descriptor changes
• Build a full Medicare revenue model for G0323

Sources: CMS HCPCS Level II release October 2026; CMS DMEPOS fee schedule; CMS NCCI MUE tables; CMS Medicare utilization (physician and DME supplier files); CMS Medicare Coverage Database articles. Fees are Medicare allowables, not commercial rates. Not billing or legal advice.

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