Question 1

What are the primary APCM codes for behavioral health in 2026?

Accepted Answer

CMS introduced G0568, G0569, and G0570 to reflect the complexity of managing chronic conditions. For behavioral health, these allow for enhanced reimbursement when managing patients with two or more chronic conditions, such as MDD and generalized anxiety disorder, providing a stable monthly revenue stream beyond traditional E/M codes.

Question 2

Can we bill BHI add-on codes alongside APCM?

Accepted Answer

Yes, Behavioral Health Integration (BHI) codes can often be stacked with APCM codes when the specific requirements for both are met. This 'stacking' strategy is essential for psychiatric practices to maximize per-patient revenue while ensuring comprehensive medication management and care coordination are documented properly.

Question 3

How does Tile's AI automate the tracking of billable minutes?

Accepted Answer

Tile’s AI monitors every patient interaction, including outbound follow-ups, medication reminders, and screening calls. The system automatically logs time spent on these non-face-to-face activities, ensuring that the 20-minute minimums for APCM and BHI are accurately captured and pushed to your billing software.

Question 4

What documentation is required for G0568-G0570?

Accepted Answer

Documentation must show continuous care management, including a systematic assessment, a care plan, and 24/7 access to care. Tile’s AI ensures these touchpoints are recorded, providing a robust audit trail that proves the practice met the required service levels for chronic mental health management.

Question 5

Which behavioral health conditions qualify for APCM enrollment?

Accepted Answer

Any condition expected to last at least 12 months qualifies. In psychiatry, this includes Major Depressive Disorder, Bipolar Disorder, Schizophrenia, and Substance Use Disorders. Tile’s AI can scan your EHR to identify eligible patients and initiate the automated enrollment process through structured phone outreach.

Question 6

How does the AI handle PHQ-9 and GAD-7 screenings?

Accepted Answer

Tile’s AI can conduct automated outreach to administer standardized screenings like the PHQ-9 or GAD-7. The results are instantly transcribed and integrated into the patient record, allowing providers to adjust treatment plans and meeting the 'systematic assessment' requirement for APCM billing.

Question 7

Can the AI assist with psychiatric medication adherence?

Accepted Answer

Absolutely. The AI performs scheduled check-ins to monitor for side effects and adherence to psychiatric medications. For patients on high-risk medications or those in OUD treatment, these automated touchpoints ensure safety and provide the continuous monitoring required for high-level APCM reimbursement.

Question 8

How do we handle no-shows for psychiatric follow-ups?

Accepted Answer

Behavioral health has notoriously high no-show rates. Tile’s AI uses predictive modeling to identify high-risk patients and sends personalized, conversational reminders. If a patient misses a visit, the AI immediately initiates a re-engagement flow to reschedule, protecting your revenue and patient stability.

Question 9

How is 42 CFR Part 2 handled for SUD patients?

Accepted Answer

Tile is designed with specialized consent workflows for Substance Use Disorder patients. The AI can capture and store the specific, granular consents required under 42 CFR Part 2, ensuring that data sharing between the AI platform and your EHR remains fully compliant with federal privacy laws.

Question 10

Does the AI support crisis intervention standards?

Accepted Answer

While Tile is not a crisis line, it is programmed with keyword detection for self-harm or crisis language. If a patient expresses a crisis during an APCM follow-up call, the AI immediately triggers an emergency escalation protocol, alerting your clinical staff or diverting the call to a crisis professional.

Question 11

Is the platform HIPAA compliant for psychiatric notes?

Accepted Answer

Yes, Tile is fully HIPAA compliant. All voice interactions are encrypted, and data is stored in secure environments. We provide Business Associate Agreements (BAAs) to all behavioral health practices, ensuring that sensitive mental health data is protected at the highest industry standards.

Question 12

How does Tile manage DEA requirements for tele-psychiatry?

Accepted Answer

Tile helps maintain the 'regularly scheduled visit' cadence required for controlled substance prescribing under DEA guidelines. By automating the scheduling and follow-up between in-person or synchronous video visits, the AI ensures your practice remains compliant with Ryan Haight Act nuances.

APCM Billing FAQ for Behavioral Health & Psychiatry

Coding & Reimbursement

Clinical Enrollment & Workflow

Compliance & Special Regulations

Ready to transform your behavioral health & psychiatry practice?