Motivational interviewing not employed (Updated for 2026)

Common Causes for MH32

Denials with code MH32 typically happen for the following specific reasons:

• The medical record lacked explicit documentation of motivational interviewing frameworks, such as the OARS technique (Open questions, Affirmations, Reflective listening, Summarizing).
• A preventive service code (e.g., CMS HCPCS code G0447 for intensive behavioral therapy for obesity) was billed, but the clinical note described general medical advice rather than active motivational interviewing.
• The clinical documentation failed to establish the patient's stage of readiness to change or address their ambivalence toward behavioral modification.
• EHR templates used by providers lacked dedicated fields to capture specific patient-centered goals and MI interventions utilized during the encounter.

How to Prevent MH32 Denials

To avoid receiving this denial in the future, implement these specific checks:

• Develop and mandate the use of EHR templates that prompt providers to document specific motivational interviewing strategies, patient goals, and readiness scales.
• Provide clinical documentation training focused on how to clearly translate MI conversations (such as exploring discrepancy and supporting self-efficacy) into compliant progress notes.
• Implement pre-billing audits for preventive counseling and intensive behavioral therapy codes to verify that the documentation explicitly references MI principles prior to claim submission.
• Ensure that the patient's treatment plan clearly states that motivational interviewing is the chosen modality to address specific behavioral healthcare goals.

Appeal Letter Template for MH32

If you believe this claim was denied incorrectly, you can use the following template to submit an appeal.

[Your Practice Header]
[Date]

[Payer Name]
[Appeals Department Address]

RE: Appeal for Claim [Claim Number]
Patient: [Patient Name]
ID: [Patient ID]
Date of Service: [Date]
Denial Code: MH32 - Motivational interviewing not employed

Dear Appeals Department,

I am writing to appeal the denial of the above-referenced claim, which was denied with code MH32: "Motivational interviewing not employed".

We are appealing the denial of this claim (Denial Code MH32) for date of service [Date of Service]. A comprehensive review of the clinical progress notes demonstrates that motivational interviewing (MI) was actively and appropriately employed during this session, fully meeting the criteria for CPT/HCPCS code [Insert Code]. The documentation explicitly details the provider's use of reflective listening, scaling of patient readiness to change, and collaborative goal-setting to resolve ambivalence regarding [state patient's issue, e.g., diet/substance use/medication adherence]. These interventions conform directly with CMS National Coverage Determinations (NCD) and AMA coding guidelines requiring MI components for this service. Because the clinical record proves the necessary counseling techniques were delivered and documented, we respectfully request that this denial be overturned and the claim be processed for full payment.

Attached please find:
1. A copy of the original claim.
2. The relevant medical records supporting the service.
3. [Any other supporting documents].

We respectfully request that you reprocess this claim for payment.

Sincerely,

[Your Name]
[Title]
[Practice Name]