Back to Insights and Updates for ProvidersSeptember 2023

Metabolic monitoring for patients on antipsychotic medications

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Patients taking antipsychotic medications are at increased risk of developing health conditions including diabetes, high blood pressure, abnormal cholesterol and triglyceride levels, and obesity. Given these risks, yearly screening and regular metabolic monitoring is vital to the proper management of antipsychotics for children, adolescents, and adults.

Primary care physicians, behavioral health providers, and prescribers can help ensure that patients taking antipsychotic medications are receiving annual screenings by ordering HbA1c or fasting glucose tests for diabetes, along with regular cholesterol monitoring. For additional best practices in managing the care of patients on antipsychotic medications, refer to Point32Health’s Metabolic Monitoring for Children and Adolescents on Antipsychotics (APM) and Diabetes Screening for People with Schizophrenia or Bipolar Disorder who are Using Antipsychotic Medications (SSD) HEDIS Tips Sheets.

The following approved CPT codes can be used to bill for screenings:

Test   CPT Code
Glucose 80047, 80048, 80050, 80053, 80069,  82947, 82950, 82951
HbA1c 83036, 83037
LDL-C 80061, 83700, 83701, 83704, 83721
Cholesterol tests other than LDL 82465, 83718, 84478, 83722

Providers with Tufts Health Together members who are at least 18 years old are encouraged to refer them to the Behavioral Health (BH) Community Partners Program by forwarding patient name, date of birth, ID number or MassHealth ID number, along with a short summary of the patient’s needs to [email protected]. The BH Community Partners Program provides enhanced care coordination to individuals with Serious Mental Illness (SMI).

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