CMS Pub. 100-04, ch. 9, § 70.8

Collaborative Care Model (CoCM) Services

(Rev. 10357, Issued: 09-18-2020, Effective: 10-19-2020, Implementation: 10-19-2020)

Effective for services furnished on or after January 1, 2018, RHCs and FQHCs are paid

for General Care Management or Psychiatric CoCM services when G0511 or G0512 is

billed alone or with other payable services on an RHC or FQHC claim. HCPCS code

G0511 or G0512 can only be billed once per month per beneficiary, and cannot be billed

if other care management services are billed for the same time period.

HCPCS codes G0511 and G0512 are subject to coinsurance and deductibles on RHC

claims. Only coinsurance applies on FQHC claims. Coinsurance is 20 percent of the

lesser of the RHC or FQHC’s charge for HCPCS codes G0511 and G0512, or the

corresponding rate.

The allowable revenue code is 052X. These HCPCS codes of G0511 or G0512 should not be

billed with modifier CG for payment on RHC claims.