Reimbursement
$149.30
Threshold
70m
2026 Status
Active
What is CPT Code G0568?
CPT G0568 is defined as: Behavioral Health Integration services furnished in conjunction with Advanced Primary Care Management (APCM) services, sharing a common care plan; 1st 70 minutes in the 1st calendar month. This code mirrors CPT 99492 (Initial CoCM) for patients enrolled in the APCM program.
This code is primarily used for BHI services. It falls under the category of Behavioral Health Integration (BHI) / CoCM and is valid for the 2026 calendar year according to the CMS Physician Fee Schedule.
2026 RVU Components
Relative Value Units (Non-Facility)
Work RVU
1.88
Physician Effort
PE (Non-Fac)
2.48
Practice Expense
Malpractice
0.11
Risk Factor
Total RVU
4.47
Note: [(Work RVU * Work GPCI) + (PE RVU * PE GPCI) + (MP RVU * MP GPCI)] * Conversion Factor
2026 CMS Policy Intelligence
apcm integration
Specific 'mirror' code created to allow BHI/CoCM billing alongside the new bundled APCM model.
mirror valuation
CMS ensures payment neutrality by matching G0568 valuation exactly to CPT 99492.
efficiency shield
Exempt from the -2.5% efficiency adjustment applied to procedural services in 2026.
Administrative Framework
Place of Service
Key Modifiers
Operational Requirements
minimum time
70 minutes in the first calendar month
staff type
Clinical staff supported by a Psychiatric Consultant and a Care Manager
frequency
Once per patient per first month of BHI service in APCM
add on codes
care plan requirement
Must share a common, integrated care plan with the base APCM service (G0556-G0558).
Compliance Checklist
Audit Defense
No specific audit defense elements defined.
2026 Update
Practices adopting APCM must switch from 99492 to G0568 for their integrated behavioral health claims.
Common Clinical Scenarios
CMS Eligibility: 1 or more behavioral health conditions requiring integrated management. Initial engagement phase of CoCM within an APCM practice
Target Specialties & Utilization
Typical Clinical Indications (ICD-10)
Billing Differentiation
VS 99492
99492 is for standard FFS; G0568 is for use only when billing APCM (G0556-G0558).
VS G0569
G0568 is for the FIRST month; G0569 is for subsequent months.
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