BHI · Physical Medicine & Rehab
BHI Qualifying Diagnoses
for Physical Medicine & Rehab.
10 ICD-10-CM codes cover physical medicine & rehab patients for Behavioral Health Integration (BHI).
Qualifying Codes
ICD-10 codes for physical medicine & rehab.
Neurologic and cognitive
Traumatic brain injury sequelae
F06, F07, G93.1, G93.424 codes in familyccmbhipcmCognitive and behavioural follow-up with structured instruments.
Traumatic brain injury sequelae
F06, F07, G93.1, G93.424 codes in familyccmbhipcmCMS other chronic or potentially disabling condition · CCW category: Traumatic Brain Injury and Nonpsychotic Mental Disorders due to Brain Damage · Devices: Patient-reported outcome app (RTM)
This family runs to 24 codes that differ mainly by anatomic site and laterality, which does not change whether the condition supports care management. The codes are not listed one by one here. Code to the site and side documented in the record, within F06, F07, G93.1, G93.4.
Musculoskeletal and pain
Chronic pain and fibromyalgia
M79.7, G89.2, G89.4, R52, G93.310 codesrtmccmbhiPain scores, sleep and function, with behavioural support where indicated.
Chronic pain and fibromyalgia
M79.7, G89.2, G89.4, R52, G93.310 codesrtmccmbhiCMS other chronic or potentially disabling condition · CCW category: Fibromyalgia, Chronic Pain and Fatigue · Devices: Patient-reported outcome app (RTM)
G89.4 (chronic pain syndrome) and G89.29 (other chronic pain) are secondary codes. Code the underlying condition alongside.
| Code | Official ICD-10-CM description | Programs | Risk adjustment |
|---|---|---|---|
| G89.21 | Chronic pain due to trauma | rtmccmbhi | not risk adjusted |
| G89.22 | Chronic post-thoracotomy pain | rtmccmbhi | not risk adjusted |
| G89.28 | Other chronic postprocedural pain | rtmccmbhi | not risk adjusted |
| G89.29 | Other chronic pain | rtmccmbhi | not risk adjusted |
| G89.4 | Chronic pain syndrome | rtmccmbhi | not risk adjusted |
| G93.31 | Postviral fatigue syndrome | rtmccmbhi | not risk adjusted |
| G93.32 | Myalgic encephalomyelitis/chronic fatigue syndrome | rtmccmbhi | not risk adjusted |
| G93.39 | Other post infection and related fatigue syndromes | rtmccmbhi | not risk adjusted |
| M79.7 | Fibromyalgia | rtmccmbhi | not risk adjusted |
| R52 | Pain, unspecified | rtmccmbhi | not risk adjusted |
No codes match those filters. Clear a filter to widen the search.
Clinical Context
Why physical medicine & rehab practices benefit from BHI.
Physical Medicine & Rehab practices can leverage BHI to improve patient outcomes through structured care management, generating $97–$220+ per patient per month in Medicare reimbursement while reducing avoidable hospitalizations.
FAQ
Common questions.
What ICD-10 codes qualify physical medicine & rehab patients for BHI?
CMS publishes no list of codes that qualify a patient for BHI: eligibility turns on the condition and on documented medical necessity. For physical medicine & rehab, 10 billable ICD-10-CM codes cover the conditions BHI manages, spanning 2 conditions including traumatic brain injury sequelae, chronic pain and fibromyalgia.
How does CCN Health support physical medicine & rehab practices with BHI?
CCN Health provides turnkey BHI services for physical medicine & rehab practices, including patient eligibility identification, enrollment documentation, device provisioning, clinical monitoring, and full Medicare billing support.
What is the revenue potential for BHI in physical medicine & rehab?
Reimbursement varies by locality and payer contract, so see the BHI billing guide for current figures. Physical Medicine & Rehab practices with a high prevalence of these conditions generally see the most benefit, particularly when BHI is combined with CCM and RPM for patients whose needs are distinct enough to document separately.
Sources & Compliance
Code set. Every code on this page is drawn from the official ICD-10-CM ICD-10-CM FY2026 (valid 2025-10-01 through 2026-09-30) released by CDC/NCHS, and only codes flagged valid for submission are listed. ICD-10-CM is published by the federal government and is in the public domain, so the descriptions here are the official long descriptors reproduced verbatim rather than summarized. The next code set, ICD-10-CM FY2027 (valid from 2026-10-01), is already reflected in the change flags.
Eligibility is not a code list. CMS does not publish a list of ICD-10 codes that qualify a patient for RPM, CCM, PCM, BHI, or RTM. Eligibility turns on the condition and on documented medical necessity. The programs shown against each condition are CCN Health’s clinical assessment of which programs that condition can support, not a statement of CMS approval.
Risk adjustment. HCC labels and category assignments come from the CMS-HCC V28 model for the 2026 payment year. Risk adjustment depends on the full encounter record, not on a single code, and the flags here are a prompt to check specificity rather than a payment guarantee.
CPT® notice. CPT is a registered trademark of the American Medical Association. CPT codes, descriptions, and other data only are copyright 2026 American Medical Association. All rights reserved. CPT is provided “as is” without warranty of any kind.
Sources. ICD-10-CM files, CDC/NCHS (cdc.gov); CMS Chronic Conditions Data Warehouse condition categories (ccwdata.org); CMS-HCC risk adjustment model software and ICD-10 mappings (cms.gov); AHRQ Clinical Classifications Software Refined (ahrq.gov).
Disclaimer. This page is informational and does not constitute billing, clinical, or legal advice. Diagnosis coding must reflect the documentation in the medical record. Verify all codes against the official CMS and CDC/NCHS publications and your contracted payer agreements before billing.