Billing, Reporting, and Sustainability

The following resources can be used to help your organization track and report the quarterly collaborative care Medicaid metrics to OMH and learn about how to bill for collaborative care tasks and services for both Medicaid and Medicare recipients.

Medicaid Billing

  • Medicaid Collaborative Care Program Billing Guidance (pdf)
  • CMTS Retainage Report Tutorial for Article 28 Clinics (pdf)
  • Using CMTS to Help with Billing the Monthly Medicaid Case Rate (pdf)
  • Using the Patient Tracking Spreadsheet to Help with Billing and Retainage (pdf)
  • Collaborative Care Medicaid Program Retroactive Billing Request (Word doc)
  • 2018 Retainage Attestation (xlsx)
  • 2022 ICD Codes (xlsx)

Quarterly Data Reporting

  • NEW Collaborative Care Medicaid Program Metrics (updated 2022) (pdf)
  • Detailed Definitions of Collaborative Care Medicaid Program Metrics (updated 2022) (pdf)
  • Information about the NYS Office of Mental Health’s version of Care Management Tracking System (CMTS) for collaborative care, reporting to OMH, Medicaid billing, and Medicare billing (pdf) *including how to track minutes spent doing collabortive care

Financial Sustainment

Maternal Depression

  • Medicaid Maternal Depression Guidelines (pdf)
  • CMS Informational Bulletin Maternal Depression (pdf)

Documentation

  • Progress Notes vs. Psychotherapy Notes slide set (pdf)

 

Medicare Billing

The Centers for Medicare & Medicaid Services announced final rules in November 2016 for Medicare payments for services provided by primary care providers for patients participating in a collaborative care program or receiving other integrated behavioral health services.

The payment structure may be used to treat patients with any behavioral health condition that is being treated by the billing practitioner, including substance use disorders. For resources and to learn more, visit the Billing & Financing page on the AIMS Center website.