Intensive Behavioral Therapy (IBT) for Obesity
HCPCS/CPT Codes
G0447 – Face-to-face behavioral counseling for obesity, 15 minutes
G0473 – Face-to-face behavioral counseling for obesity, group (2–10), 30 minutes
ICD-10-CM Codes
Z68.30, Z68.31, Z68.32, Z68.33, Z68.34,
Z68.35, Z68.36, Z68.37, Z68.38, Z68.39,
Z68.41, Z68.42, Z68.43, Z68.44, or Z68.45
Who Is Covered
Medicare beneficiaries:
• With obesity (Body Mass Index [BMI] ≥ 30 kilograms [kg] per meter squared);
• Who are competent and alert at the time counseling is provided; and
• Whose counseling is furnished by a qualified primary care physician or other primary care practitioner in a primary care setting
Frequency
• First month: one visit every week;
• Months 2 – 6: one visit every other week; and
• Months 7 – 12: one visit every month if certain requirements are met
At the 6-month visit, a reassessment of obesity and a determination of the amount of weight loss must be performed.
To be eligible for additional face-to-face visits occurring once a month for an additional 6 months, beneficiaries must have lost at least 3kg.
For beneficiaries who do not achieve a weight loss of at least 3 kg during the first 6 months, a reassessment of their readiness to change and BMI is appropriate after an additional 6-month period.
Beneficiary Pays
• Copayment/coinsurance waived
• Deductible waived
