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CPT®
97157

CPT® Code 97157

Official Description

Multiple-family group adaptive behavior treatment guidance, administered by physician or other qualified health care professional (without the patient present), face-to-face with multiple sets of guardians/caregivers, each 15 minutes

© Copyright 2025 American Medical Association. All rights reserved.

Common Language Description

Multiple-family group adaptive behavior treatment guidance involves a structured approach where a physician or other qualified healthcare professional provides direct, face-to-face support to multiple sets of guardians or caregivers, without the patients being present. This guidance is focused on equipping family members with the necessary skills and knowledge to implement specific treatment protocols aimed at addressing maladaptive or deficient behaviors in their patients. The sessions are designed to foster collaboration among families, allowing them to share experiences and strategies while receiving expert advice. During these sessions, the professional facilitates discussions that may include role-playing scenarios and practical applications of behavioral techniques in daily tasks. The goal is to empower caregivers to effectively utilize behavior analytics and reinforcement strategies to enhance communication and encourage the development of target skills in their patients. Each session culminates in a summary where the professional addresses any questions and assigns practice tasks for the families to reinforce the skills learned. The billing for this service is structured in 15-minute increments, with a maximum of eight families participating in a single session.

© Copyright 2025 Coding Ahead. All rights reserved.

1. Indications

The multiple-family group adaptive behavior treatment guidance is indicated for situations where caregivers or guardians of patients require support in implementing treatment protocols aimed at improving specific behaviors. This service is particularly beneficial for families dealing with challenges related to maladaptive behaviors or deficiencies in adaptive skills. The guidance is designed to assist caregivers in understanding and applying behavioral strategies effectively, thereby enhancing the overall treatment outcomes for the patients involved.

  • Behavioral Challenges Caregivers are seeking strategies to address specific maladaptive behaviors exhibited by their patients.
  • Skill Development Families need assistance in fostering the development of target skills that are essential for the patient's adaptive behavior.
  • Collaborative Learning Multiple families are involved, allowing for shared experiences and collective learning in managing similar behavioral issues.

2. Procedure

The procedure for multiple-family group adaptive behavior treatment guidance consists of several key steps that ensure effective training and support for caregivers.

  • Initial Assessment The session begins with an assessment of the specific needs and challenges faced by the families. The professional gathers information about the patients' behaviors and the caregivers' experiences to tailor the guidance effectively.
  • Training on Treatment Protocols The physician or qualified professional provides detailed training on the treatment protocols that caregivers will implement. This may include explanations of behavioral techniques, reinforcement strategies, and the importance of consistency in applying these methods.
  • Role-Playing Exercises Caregivers engage in role-playing exercises to practice the application of the learned strategies in a controlled environment. This hands-on approach allows them to gain confidence in using the techniques with their patients.
  • Feedback and Discussion Throughout the session, caregivers are encouraged to provide feedback and share their experiences. This collaborative discussion helps identify additional strategies and reinforces the learning process.
  • Session Summary and Homework Assignment At the conclusion of the session, the professional summarizes the key points discussed, addresses any remaining questions, and assigns homework tasks for the families to practice the skills learned. This ensures that the training is reinforced outside of the session.

3. Post-Procedure

After the multiple-family group adaptive behavior treatment guidance session, caregivers are expected to implement the strategies discussed during the training in their daily interactions with the patients. They should focus on practicing the assigned homework tasks to reinforce the skills learned. Follow-up sessions may be scheduled to assess progress, address any challenges encountered, and provide further guidance as needed. Continuous support and training are essential to ensure the integrity of the treatment protocols and to facilitate the development of adaptive behaviors in the patients.
Short Descr MULT FAM ADAPT BHV TX GDN
Medium Descr MULTIPLE FAM GROUP BHV TX GDN PHYS/QHP EA 15 MIN
Long Descr Multiple-family group adaptive behavior treatment guidance, administered by physician or other qualified health care professional (without the patient present), face-to-face with multiple sets of guardians/caregivers, each 15 minutes
Status Code Carriers Price the Code
Global Days XXX - Global Concept Does Not Apply
PC/TC Indicator (26, TC) 0 - Physician Service Code
Multiple Procedures (51) 0 - No payment adjustment rules for multiple procedures apply.
Bilateral Surgery (50) 0 - 150% payment adjustment for bilateral procedures does NOT apply.
Physician Supervisions 09 - Concept does not apply.
Assistant Surgeon (80, 82) 0 - Payment restriction for assistants at surgery applies to this procedure...
Co-Surgeons (62) 0 - Co-surgeons not permitted for this procedure.
Team Surgery (66) 0 - Team surgeons not permitted for this procedure.
Diagnostic Imaging Family 99 - Concept Does Not Apply
APC Status Indicator Codes That May Be Paid Through a Composite APC
Type of Service (TOS) 1 - Medical Care
Berenson-Eggers TOS (BETOS) none
MUE 16
59 Distinct procedural service: under certain circumstances, it may be necessary to indicate that a procedure or service was distinct or independent from other non-e/m services performed on the same day. modifier 59 is used to identify procedures/services, other than e/m services, that are not normally reported together, but are appropriate under the circumstances. documentation must support a different session, different procedure or surgery, different site or organ system, separate incision/excision, separate lesion, or separate injury (or area of injury in extensive injuries) not ordinarily encountered or performed on the same day by the same individual. however, when another already established modifier is appropriate it should be used rather than modifier 59. only if no more descriptive modifier is available, and the use of modifier 59 best explains the circumstances, should modifier 59 be used. note: modifier 59 should not be appended to an e/m service. to report a separate and distinct e/m service with a non-e/m service performed on the same date, see modifier 25.
95 Synchronous telemedicine service rendered via a real-time interactive audio and video telecommunications system: synchronous telemedicine service is defined as a real-time interaction between a physician or other qualified health care professional and a patient who is located at a distant site from the physician or other qualified health care professional. the totality of the communication of information exchanged between the physician or other qualified health care professional and the patient during the course of the synchronous telemedicine service must be of an amount and nature that would be sufficient to meet the key components and/or requirements of the same service when rendered via a face-to-face interaction. modifier 95 may only be appended to the services listed in appendix p. appendix p is the list of cpt codes for services that are typically performed face-to-face, but may be rendered via a real-time (synchronous) interactive audio and video telecommunications system.
Date
Action
Notes
2019-01-01 Added Added
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Description
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