BHI Enrollment & APCM Add-on Checklist for 2026

Select patients with two or more chronic conditions who are already enrolled in or eligible for base APCM services.

Administer the PHQ-9 tool via AI-automated phone calls to establish a clinical baseline for depression symptoms.

Use standardized GAD-7 screenings to identify anxiety levels, ensuring the patient meets the criteria for integrated behavioral support.

Confirm the patient is actively billed under a base APCM code, as BHI add-ons G0568-G0570 cannot be billed in isolation.

Ensure a formal mental health diagnosis is recorded in the EHR to support the medical necessity of the BHI add-on services.

Secure and document verbal or written consent specifically for the BHI component, explaining potential cost-sharing and benefits.

Screen for social factors that may impact behavioral health, such as housing or food insecurity, to enhance the care plan.

Apply G0568 for the first 20 minutes of BHI-specific clinical staff time spent on care coordination and monitoring.

Set up your billing system to track incremental 20-minute blocks using G0569 and G0570 for extended care coordination time.

Revise the patient's existing care plan to include specific behavioral health goals, interventions, and expected outcomes.

Document all interactions with psychiatric consultants or external mental health providers involved in the patient's care.

Maintain a precise log of minutes spent on BHI services to prevent billing errors and ensure compliance with CMS rules.

Verify that the BHI add-on codes are linked correctly to the primary APCM claim in the clearinghouse software.

Ensure that BHI billing practices align with federal mental health parity requirements for integrated care models.

Deploy AI voice agents to call patients monthly and collect PHQ-9/GAD-7 scores automatically.

Integrate your AI call handling system with the EHR to push screening results and call logs directly into patient charts.

Configure automated alerts to notify clinical staff immediately if a patient's PHQ-9 score increases significantly.

Utilize AI transcription and summarization to create concise BHI care coordination notes for provider review.

Schedule automated outbound calls to check medication adherence for prescribed behavioral health treatments.

Program the AI system to identify crisis keywords and instantly route those patients to a licensed clinical professional.

Use AI analytics to identify patients who are not responding to screenings, allowing for targeted human intervention.