Question 1

What are the specific 2026 BHI add-on codes for depression?

Accepted Answer

The 2026 CMS updates introduce G0568, G0569, and G0570 as add-on codes to APCM. These codes account for the additional time and resources required to manage behavioral health conditions like major depressive disorder and generalized anxiety disorder within a primary care or psychiatric setting.

Question 2

How does AI call handling facilitate APCM enrollment?

Accepted Answer

AI-driven phone systems can proactively reach out to patients diagnosed with chronic anxiety or depression to explain the benefits of the APCM program. They can capture the necessary verbal consent and document the interaction directly in the EHR, significantly reducing the administrative burden.

Question 3

Which patients qualify for the BHI add-on under APCM?

Accepted Answer

Patients with two or more chronic conditions, where at least one is a behavioral health condition like depression or anxiety, are eligible. The BHI add-on specifically targets the coordination of psychotherapy, medication management, and regular symptom monitoring using standardized tools.

Question 4

Is a new consent form required for the BHI add-on?

Accepted Answer

Yes, patients must provide informed consent to participate in the APCM program and its behavioral health components. This includes explaining cost-sharing responsibilities. AI automation ensures this conversation happens consistently and is recorded for audit purposes.

Question 5

How do I identify eligible patients for BHI enrollment?

Accepted Answer

Our AI solution scans your EHR for patients with relevant ICD-10 codes and historically high PHQ-9 or GAD-7 scores. It then flags these individuals for enrollment calls, ensuring no eligible patient—and no potential revenue—is overlooked by your clinical staff.

Question 6

How can AI help with PHQ-9 and GAD-7 screening?

Accepted Answer

AI call agents can conduct structured PHQ-9 and GAD-7 screenings over the phone at regular intervals. The scores are automatically calculated and pushed to the provider dashboard, allowing for real-time monitoring of treatment efficacy for depression and anxiety without manual data entry.

Question 7

What happens if an AI screening detects a high suicide risk?

Accepted Answer

Safety is paramount. If an AI call agent detects a high score on PHQ-9 Question 9 or specific crisis keywords, the system is programmed to immediately escalate the call to a live clinical staff member or provide the patient with emergency resources according to your practice's protocols.

Question 8

Can AI assist in antidepressant medication management?

Accepted Answer

Yes. AI can perform follow-up calls after a medication change to check for side effects or early signs of improvement. This structured data helps providers make informed decisions during the next visit and satisfies the documentation requirements for BHI management.

Question 9

How does automated follow-up improve outcomes for anxiety?

Accepted Answer

Patients with generalized anxiety disorder often benefit from consistent touchpoints. AI-driven follow-ups provide a sense of continuous care, ensuring patients adhere to their treatment plans and allowing for early intervention if symptoms escalate between scheduled visits.

Question 10

Does the AI integrate with my existing EHR for BHI billing?

Accepted Answer

Tile Healthcare’s AI solutions are designed to integrate with major EHR systems. Screening scores, call durations, and patient responses are logged automatically, providing the digital documentation needed to bill G0568-G0570 codes with confidence.

Question 11

Can I bill BHI add-ons alongside standard APCM codes?

Accepted Answer

Yes, the G0568-G0570 codes are designed to be billed in conjunction with the base APCM codes. This reflects the increased complexity of managing co-occurring physical and mental health conditions, such as depression alongside heart disease or diabetes.

Question 12

What is the revenue potential of adding BHI to APCM?

Accepted Answer

By utilizing BHI add-ons, practices can see a significant increase in per-member per-month (PMPM) revenue. AI automation makes this profitable by handling the time-consuming tasks of outreach and monitoring that would otherwise require expensive clinical staff time.

Question 13

How do AI call centers help meet MIPS quality measures?

Accepted Answer

AI ensures that PHQ-9 and GAD-7 screenings are performed with 100% consistency across your patient panel. This directly improves performance on MIPS measures related to depression remission and anxiety monitoring, leading to higher reimbursement adjustments.

Question 14

What documentation is required to defend a BHI claim?

Accepted Answer

Claims for G0568-G0570 require proof of systematic assessment, monitoring using validated tools, and medication management. AI provides a time-stamped, digital trail of every patient interaction, making it easy to satisfy payer audits and compliance reviews.

Question 15

How does AI reduce the cost of BHI program delivery?

Accepted Answer

Traditional BHI programs often fail due to the high cost of staff time spent on the phone. AI reduces these costs by over 70% by automating routine screenings and enrollment, allowing your clinicians to focus on high-acuity patient care and psychotherapy coordination.

APCM Billing FAQ: Depression & Anxiety BHI Codes

Enrollment & Consent

Clinical Monitoring & Automation

Billing & Revenue Optimization

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