Aug 11, 2026
Behavioral health integration is becoming increasingly embedded in primary care reimbursement, and the 2026 Medicare Physician Fee Schedule introduces an important structural development for practices participating in Advanced Primary Care Management (APCM).
Beginning January 1, 2026, CMS introduced three optional HCPCS add-on codes specifically for behavioral health services furnished alongside APCM: G0568, G0569, and G0570. These codes allow practices to report additional behavioral health care management when a patient is already receiving an APCM service during the same calendar month.
The change is significant because APCM was designed around a monthly, bundled approach to care management rather than the minute-by-minute billing structure traditionally associated with many individual care-management services. CMS describes APCM as a monthly service that incorporates elements of chronic care management, principal care management, transitional care management, and communication-based services. Unlike traditional time-based care-management codes, APCM itself is not billed according to accumulated minutes.
The behavioral health add-ons extend that framework into psychiatric collaborative care and general behavioral health integration.
For practices, the key issue is not simply learning three new code numbers. It is understanding when these codes can be reported, what clinical model each represents, how they interact with APCM, and how documentation and workflow need to change.
What Changed in 2026?
The 2026 APCM framework uses three base HCPCS codes:
G0556
G0557
G0558
These codes represent different levels of Advanced Primary Care Management based on patient complexity and eligibility.
CMS then established three behavioral health add-on codes:
Code | Behavioral health service | APCM relationship |
|---|---|---|
G0568 | Initial psychiatric Collaborative Care Management | Add-on to APCM |
G0569 | Subsequent psychiatric Collaborative Care Management | Add-on to APCM |
G0570 | General Behavioral Health Integration | Add-on to APCM |
CMS specifically describes G0568, G0569, and G0570 as optional add-on codes that can be used when general BHI or psychiatric CoCM services are provided in conjunction with APCM.
This creates a layered reimbursement structure:
APCM base service → behavioral health add-on → additional behavioral health care management
The behavioral health service does not exist independently of the APCM relationship for purposes of these new add-on codes. The practice must satisfy the applicable APCM requirements and the requirements of the behavioral health service being reported.
G0568: Initial Psychiatric Collaborative Care Management
G0568 is used for the initial calendar month of psychiatric Collaborative Care Management (CoCM) for a patient who is also receiving APCM.
The service incorporates the core elements of the Collaborative Care Model, including behavioral health care management, psychiatric consultation, measurement-based assessment, treatment planning, patient engagement, and ongoing tracking.
The code descriptor includes activities such as:
outreach and engagement;
an initial behavioral health assessment;
validated rating scales;
development of an individualized treatment plan;
psychiatric consultant review;
registry enrollment and tracking;
weekly caseload consultation;
coordination with the treating primary care professional; and
brief evidence-based behavioral interventions.
This is important clinically because G0568 is not simply a code for documenting that a patient has depression, anxiety, or another behavioral health condition.
It reflects participation in a structured collaborative-care system.
A practice therefore needs to have an operational workflow capable of supporting the model. That typically means clearly defined responsibilities among the treating primary care clinician, behavioral health care manager, and psychiatric consultant.
Measurement-based care remains central
One of the defining characteristics of CoCM is the systematic use of validated measures rather than relying exclusively on narrative clinical impressions.
For example, a patient entering a collaborative-care program might have a baseline PHQ-9, followed by repeated assessments during treatment. The results can be incorporated into registry tracking and discussed during psychiatric consultation.
The clinical value is also important from a documentation perspective: the record should demonstrate that measurements are being used to guide treatment rather than simply administered as isolated screening instruments.
G0569: Subsequent Psychiatric Collaborative Care Management
G0569 applies to subsequent calendar months of psychiatric CoCM for patients who continue to receive collaborative behavioral health management alongside APCM.
The emphasis shifts from initial assessment and treatment-plan development toward ongoing monitoring, coordination, and treatment adjustment.
CMS's descriptor includes:
tracking patient progress;
continued registry management;
weekly caseload consultation;
collaboration with the treating clinician and other mental health providers;
review of treatment progress;
recommendations for treatment changes when indicated;
medication-related recommendations through the appropriate clinical team;
brief behavioral interventions;
repeated validated outcome measures; and
relapse-prevention planning when patients approach remission or treatment completion.
That distinction matters when building documentation templates.
A subsequent-month note should not simply copy the initial assessment. It should demonstrate what happened during the current month and how the patient's clinical status affected the care plan.
For example, documentation might address:
PHQ-9 increased from 9 to 15 over the current monitoring period. Patient reports worsening sleep and reduced occupational functioning following loss of employment. Case reviewed during psychiatric consultation. Recommendation was to reassess medication adherence and consider medication adjustment with the treating clinician. Behavioral health care manager initiated behavioral activation focused on daily structure and activity scheduling.
The important element is the clinical chain:
measurement → interpretation → consultation → intervention → follow-up
That is much more informative than a generic statement such as “patient continues to receive behavioral health services.”
G0570: General Behavioral Health Integration
G0570 is different from G0568 and G0569.
It is designed for general Behavioral Health Integration (BHI) rather than the full psychiatric Collaborative Care Model.
The code covers monthly behavioral health care-management activities including:
initial assessment or follow-up monitoring;
validated rating scales when applicable;
behavioral health care planning;
modification of the care plan when the patient is not progressing;
coordination of psychotherapy, pharmacotherapy, counseling, or psychiatric consultation;
and continuity of care with designated members of the care team.
The distinction between General BHI and CoCM is clinically meaningful.
A practice may be coordinating behavioral health treatment without operating the full CoCM infrastructure. General BHI provides a mechanism for incorporating behavioral health management into the broader primary-care management framework.
In practical terms, G0570 is not simply a less expensive version of G0568 or G0569. The underlying service model is different.
The Most Important Rule: These Are APCM Add-On Codes
The central billing concept is straightforward:
G0568, G0569, and G0570 are add-on codes associated with APCM.
CMS's 2026 guidance states that an APCM base code — G0556, G0557, or G0558 — must be reported in the same month when these optional behavioral health add-ons are used.
This means practices should not think about G0568–G0570 as a completely independent behavioral health code family.
Instead, the workflow should be viewed as:
1. Patient qualifies for APCM
↓
2. Practice furnishes the required APCM services
↓
3. Patient also receives qualifying behavioral health integration or CoCM services
↓
4. Appropriate behavioral health add-on is reported
The same-month relationship is therefore a critical operational consideration.
How G0568, G0569, and G0570 Differ
A useful way to think about the codes is by clinical pathway.
G0568
Use when the patient is entering the initial month of psychiatric CoCM.
The emphasis is on establishing the collaborative-care infrastructure:
assessment;
validated measurement;
treatment planning;
registry enrollment;
psychiatric consultation;
patient engagement;
and initiation of evidence-based behavioral interventions.
G0569
Use for subsequent months of psychiatric CoCM.
The emphasis is on:
monitoring;
measurement-based follow-up;
psychiatric consultation;
treatment adjustment;
care coordination;
behavioral interventions;
and relapse prevention.
G0570
Use for General BHI.
The emphasis is on:
behavioral health assessment and monitoring;
care planning;
coordination;
treatment facilitation;
and continuity across the care team.
The CMS descriptors make the distinction particularly important: G0568 and G0569 are tied to the structured psychiatric Collaborative Care Model, whereas G0570 represents general behavioral health care management.
Why the APCM Connection Matters
APCM represents a broader shift in how CMS approaches primary-care management.
Traditional care-management billing often requires practices to document accumulated time and meet specific monthly thresholds. APCM was designed differently.
CMS describes APCM as a monthly bundled service that is not time-based. Instead of documenting every minute spent on individual care-management activities, practices report the appropriate APCM level when the required service elements are furnished.
The behavioral health add-ons allow behavioral health work to sit on top of that primary-care management structure.
This is particularly relevant for patients with multiple interacting conditions.
Consider a patient with:
type 2 diabetes;
hypertension;
major depressive disorder;
worsening medication adherence;
and declining occupational functioning.
The primary-care team may already be providing APCM. Behavioral health professionals can then participate in structured care coordination and monitoring through the applicable behavioral health pathway.
The result is closer to a genuinely integrated care model rather than parallel medical and mental-health services operating independently.
Documentation: What Practices Should Capture
One of the biggest implementation mistakes would be treating the new codes as a simple billing-code update.
The codes reflect clinical workflows, and documentation should demonstrate that those workflows actually occurred.
For CoCM, the medical record should make it possible to reconstruct the patient's progression through the collaborative-care model.
Useful documentation elements include:
Initial assessment
Document the patient's behavioral health presentation, relevant symptoms, functional impairment, validated measures, clinical formulation, and initial treatment plan.
Registry or systematic tracking
Where the CoCM model requires registry tracking, documentation should demonstrate that patients are actively monitored rather than placed into a registry without subsequent clinical follow-up.
Psychiatric consultation
The record should capture relevant consultation activity and recommendations, including how recommendations were communicated to the treating team.
Treatment-plan changes
When symptoms worsen or fail to improve, documentation should show how that information affected the treatment strategy.
Measurement-based follow-up
Repeated outcome measures should have a clinical purpose. A PHQ-9 score is much more useful when the record explains what changed because of the result.
Care coordination
Document meaningful coordination among primary care, behavioral health staff, psychiatric consultants, therapists, and other relevant providers.
Transition and relapse prevention
When a patient improves, documentation should show how the team determines whether active collaborative management should continue, change, or transition toward maintenance.
Does the New APCM Structure Eliminate the Need for Careful Documentation?
No.
The fact that APCM is not time-based does not mean that practices can reduce behavioral health documentation to a checkbox.
This distinction is especially important.
Not time-based does not mean not documented.
A practice still needs to demonstrate that the required service elements were actually furnished.
For example, simply recording “BHI provided this month” does not establish that an appropriate behavioral health assessment, care planning, monitoring, coordination, or other required activity occurred.
The documentation should tell a clinically coherent story.
For CoCM, that story is particularly important because the model depends on longitudinal tracking and team-based decision-making.
What About the Existing CoCM and BHI Codes?
The 2026 changes should not be interpreted as meaning that every existing behavioral health integration code has disappeared.
CMS's own 2026 materials continue to list 99484 among General BHI services and 99492, 99493, and 99494 among Psychiatric CoCM services. CMS also separately identifies the new G0568–G0570 codes as APCM add-ons.
This distinction is critical.
The appropriate question for a practice is not:
“Which old code do I replace with the new G-code?”
The better question is:
“Is this patient receiving APCM, and if so, does the behavioral health service meet the requirements for one of the new APCM add-ons?”
That framing prevents practices from treating the 2026 codes as a universal behavioral-health coding conversion.
G0568/G0569 vs. Traditional CoCM Workflow
For practices already operating CoCM, the new APCM pathway introduces an additional billing configuration rather than eliminating the underlying clinical model.
The Collaborative Care Model still depends on several core elements:
Primary care clinician
Responsible for the patient's overall medical care and treatment decisions.
Behavioral health care manager
Provides patient outreach, monitoring, brief interventions, care coordination, and registry management.
Psychiatric consultant
Provides psychiatric expertise and participates in systematic caseload consultation.
Measurement-based care
Uses standardized measures to assess treatment response.
Registry-based tracking
Allows the team to identify patients who are not improving and need additional intervention.
The billing architecture may change depending on the patient's APCM status, but these clinical components remain central to the CoCM model represented by G0568 and G0569.
Practical Workflow for 2026
A practice implementing these codes can build a workflow around several checkpoints.
Step 1: Identify APCM eligibility
Determine whether the patient meets the requirements for one of the APCM base codes.
Step 2: Establish the behavioral health pathway
Determine whether the patient is receiving General BHI or psychiatric CoCM.
Step 3: Select the appropriate add-on
For psychiatric CoCM:
initial month → G0568
subsequent month → G0569
For General BHI:
applicable monthly service → G0570
Step 4: Verify same-month APCM billing
Confirm that the appropriate APCM base code is also being reported for the patient during the applicable calendar month.
Step 5: Complete clinical documentation
Document the actual behavioral health activities, measurements, coordination, treatment planning, and follow-up.
Step 6: Audit the workflow
Review claims against the underlying clinical record.
The purpose of an internal audit should not simply be to check whether the code is present. It should verify that the documentation supports the service represented by the code.
What This Means for Behavioral Health Teams
The 2026 APCM changes are particularly relevant for behavioral health professionals working inside primary-care organizations.
Historically, mental health services and medical care have often been reimbursed through separate workflows. Integrated care models challenge that separation.
The new APCM behavioral health add-ons create another mechanism for recognizing behavioral health work as part of longitudinal primary-care management.
For behavioral health teams, this can create an opportunity to formalize activities that are clinically valuable but difficult to fit into traditional visit-based reimbursement:
systematic symptom monitoring;
communication with primary care;
psychiatric consultation;
care-plan coordination;
follow-up between visits;
treatment-response tracking;
relapse prevention;
and coordination with other providers.
However, practices should avoid interpreting the codes simply as additional revenue opportunities.
The underlying requirement is integrated clinical care, not merely additional billing.
Common Implementation Mistakes
Treating G0568–G0570 as standalone behavioral health codes
The most important conceptual mistake is ignoring their APCM relationship.
These are specifically structured as add-ons to APCM.
Confusing CoCM with General BHI
G0568 and G0569 describe psychiatric Collaborative Care Management, while G0570 describes General BHI.
The staffing structure and clinical workflow are therefore not interchangeable.
Assuming “not time-based” means “documentation-light”
APCM's non-time-based structure does not remove the obligation to document the required service elements.
Failing to distinguish initial and subsequent CoCM months
G0568 and G0569 are not interchangeable. The first calendar month and subsequent months have different service descriptions.
Using measurement tools without integrating the results
A PHQ-9, GAD-7, or other validated measure should contribute to clinical decision-making. Measurement without action weakens the logic of measurement-based care.
Copying forward behavioral health notes
Longitudinal care management requires documentation of change. If every month's record looks identical, it may be difficult to demonstrate meaningful ongoing management.
A More Useful Way to Think About the 2026 Changes
The introduction of G0568, G0569, and G0570 is best understood as part of a broader transition toward integrated, longitudinal, population-oriented primary care.
The codes connect three previously distinct concepts:
Primary-care management
The APCM framework provides the foundation.
Behavioral health integration
G0570 allows general behavioral health management to be layered into that framework.
Collaborative psychiatric care
G0568 and G0569 provide an APCM-associated pathway for structured psychiatric CoCM.
This is clinically important because behavioral health conditions frequently affect treatment adherence, chronic disease management, functional status, and utilization of medical services.
A patient with depression who is not taking diabetes medication consistently, for example, may require more than an isolated psychotherapy appointment. The clinically appropriate intervention may involve measurement, primary-care communication, medication coordination, behavioral activation, psychiatric consultation, and longitudinal follow-up.
That is precisely the kind of care architecture that integrated behavioral health models are designed to support.
What Practices Should Do Now
For organizations affected by the 2026 changes, implementation should begin with workflow rather than billing software.
A useful internal checklist is:
Identify which APCM services the organization provides.
Determine whether behavioral health services are delivered through General BHI or CoCM.
Map each behavioral health workflow to the applicable G-code.
Verify that APCM and the behavioral health add-on are being reported in the required monthly relationship.
Update EHR templates to capture the required clinical elements.
Ensure validated measurement tools are incorporated into follow-up workflows.
Define responsibilities among primary care, behavioral health care managers, and psychiatric consultants.
Train billing staff not to treat the new codes as universal replacements for existing behavioral health billing.
Review payer-specific implementation instructions and MAC guidance before submitting claims.
Audit a sample of claims against the clinical record.
This approach is much safer than simply adding three new codes to a charge master.
Conclusion
The 2026 introduction of G0568, G0569, and G0570 represents an important development in Medicare's approach to integrating behavioral health into primary care.
The codes function as APCM behavioral health add-ons:
G0568 supports the initial month of psychiatric Collaborative Care Management;
G0569 supports subsequent months of psychiatric Collaborative Care Management;
G0570 supports General Behavioral Health Integration.
The practical significance is broader than the code numbers themselves. Practices need to understand the relationship between APCM and behavioral health services, distinguish CoCM from General BHI, and build documentation and clinical workflows that reflect genuine longitudinal care.
For behavioral health organizations, the most useful response is therefore not simply updating billing references. The 2026 framework is an opportunity to examine whether the practice has the infrastructure necessary for measurement-based, team-based, coordinated behavioral health care and whether its documentation accurately captures that work.
This article is intended for educational purposes and should not be treated as billing or legal advice. Practices should verify current CMS guidance, Medicare Administrative Contractor instructions, payer policies, and applicable professional requirements before submitting claims.
FAQ
Are G0568, G0569, and G0570 APCM codes?
They are APCM behavioral health add-on HCPCS codes. The APCM base service is reported using G0556, G0557, or G0558, while G0568–G0570 provide additional behavioral health services when applicable.
What is the difference between G0568 and G0569?
G0568 describes the initial calendar month of psychiatric Collaborative Care Management. G0569 describes subsequent calendar months of psychiatric Collaborative Care Management.
What does G0570 represent?
G0570 represents General Behavioral Health Integration care management furnished in conjunction with APCM.
Does G0570 represent psychiatric Collaborative Care Management?
No. G0570 is for General BHI. Psychiatric CoCM is represented by G0568 for the initial month and G0569 for subsequent months.
Does APCM use minute-based billing?
APCM itself is designed as a monthly, non-time-based service rather than requiring minute-by-minute billing. However, practices still need to document that the required service elements were furnished.
Can a practice report these codes without an APCM base code?
The new codes are structured as add-ons to APCM. CMS guidance specifies that an APCM base code must be reported in the same month when the optional behavioral health add-on is used.
References
If you’re ready to spend less time on documentation and more on therapy, get started with a free trial today
Not medical advice. For informational use only.
Outline
More articles
