Your clinicians are already doing safety planning; make sure you’re getting paid for it

The greatest vulnerabilities occur when patients move between outpatient treatment, emergency care, hospitalization, and back again.

Despite its importance, timely follow-up after a suicide-related crisis remains inconsistent. A Joint Commission survey of 1,148 accredited hospitals, with 346 responding, found that 30.3% made post-discharge follow-up contact and 45.1% made none at all. While 61% reported formal safety planning, fewer than one in five of those hospitals included all the key components (Chitavi et al., 2024).

Patient experience tells a similar story. Among privately insured adolescents and young adults with suicide-related acute care, 65.7% of those discharged from the emergency department and 55.1% of those discharged from a mental health hospitalization did not receive outpatient mental health follow-up within seven days (Hugunin et al., 2022).

Alongside the gaps, the research points to clear strengths and opportunities for improvement. Outpatient care is one of them: patients with an established mental health provider were roughly 3.5 times as likely to receive follow-up within seven days of an emergency department visit (Hugunin et al., 2022). Effective safety planning is another. Paired with structured follow-up, it was associated with 45% fewer suicidal behaviors and more than twice the rate of outpatient treatment engagement (Stanley et al., 2018)

Timely follow-up after emergency mental health care and hospitalization has long been tracked through the National Committee for Quality Assurance's Healthcare Effectiveness Data and Information Set (HEDIS) measures, Follow-Up After Emergency Department Visit for Mental Illness (FUM) and Follow-Up After Hospitalization for Mental Illness (FUH), yet connecting patients back to outpatient care remains a persistent challenge. More recently, the Centers for Medicare and Medicaid Services (CMS) has put reimbursement behind two services aimed squarely at this problem, giving practices a way to dedicate resources to work that might otherwise be absorbed into an already full clinical schedule. These codes, effective January 2025, are both billable by psychologists, clinical social workers, marriage and family therapists, and mental health counselors alongside physicians and non-physician practitioners (CMS, 2026a; American Psychological Association Services, 2025).

(CMS, 2025; CMS, 2026a)

Note: Rates vary by locality and by place of service. Look up G0560 and G0544 for your Medicare Administrative Contractor in the CMS Physician Fee Schedule Look-up Tool (CMS, 2026b).

New codes take time to make their way into everyday practice, and knowing they exist is only the first hurdle. To make these services sustainable, practices also need to know who can perform them, what the documentation needs to show, and how the services fit into their existing billing workflow.

Staffing is one of the first places practices can get tripped up. G0560 must be performed by the billing practitioner, but G0544 offers more flexibility: under qualifying arrangements, the follow-up services may be performed by auxiliary personnel under general supervision. For practices already facing limited clinician capacity, that distinction can make or break the sustainability of a high-quality crisis program.

Documentation requirements also vary. G0560 is an intervention, not a suicide risk assessment. A record showing screening, scoring, and a risk level does not by itself support the service. Documentation needs to show the safety plan developed with the patient, the required elements, and the time spent. For G0544, practices need to capture patient consent and completed contacts and remember that the service is billed as a monthly bundle—not as individual calls.

Reimbursement is not uniform outside Medicare. State Medicaid programs, managed care plans, and commercial payers may treat the codes differently (e.g., California Medi-Cal currently lists G0560 but not G0544). So even where CMS has created a path to reimbursement, practices still have to navigate a patchwork of payer rules.

Getting the staffing model right still leaves the day-to-day work of actually running the program. A clinician needs to be able to find the current safety plan when risk emerges, understand what has changed, update it without starting over, and know what follow-up is due. Every extra step spent searching the record, reconstructing prior decisions, or figuring out what comes next adds to the labor of an already demanding clinical task.

That friction has a clinical cost, not just an administrative one. Plan quality predicts effectiveness, and plans that are more complete, personalized, and specific do more to reduce risk than plans that hit the headings and move on (Donnelly et al., 2026). How the plan gets made matters too: in a randomized comparison of three administration methods, what separated the higher-quality plans from the lower-quality ones was how much structure and prompting the tool provided (Hendley et al., 2025). In a high-risk encounter, friction competes for the same limited time and attention the organization needs to assess, make decisions, and provide care.

Start by understanding what is happening today. Look back at recent crisis encounters and post-discharge patients. How often was a safety plan completed? How many patients received timely follow-up? Where did follow-up break down? How much of that work was reimbursed? There’s your baseline.

Then build the workflow around the care you want to deliver and the outcomes you want to see. Decide who owns post-crisis follow-up and who can appropriately supervise it. Confirm coverage with your payers. Triage, safety planning, and follow-up should be built into the clinical workflow, not tacked onto it. Safety plans should be easy to find and update, with the information needed for care and reimbursement captured along the way. In high-risk care, saving clinicians steps and seconds preserves time and attention for the patient.

The same workflow should make gaps visible. Provider organizations should be able to identify who needs follow-up, see whether it happened, and audit the quality and completeness of the work. Reporting can then show whether safety planning and follow-up are happening consistently—and whether they are leading to better patient outcomes.

Provider organizations need to close the gaps in safety planning and follow-up, but electronic health records (EHRs) need to be built and have a crucial role in making that work possible.

If you want to see how we are approaching that work in an EHR built specifically for behavioral health, we’re happy to show you.

If you or someone you know is in crisis, call or text 988 to reach the Suicide and Crisis Lifeline, available 24 hours a day.