There are different ways to bill for integrated behavioral health care depending on your model and staffing. This handout gives a brief overview of basic CPT and Medicare billing codes for behavioral health integration and Collaborative Care.
Remember to check with your state and all payers to determine the necessary qualifications for the designated billing providers. Not all states or payers reimburse for every code.
This guide is for multi-disciplinary, primary care teams seeking to improve care access and behavioral health outcomes for children and adolescents through implementing Collaborative Care. Centered around the core principles of Collaborative Care, this guide serves as a roadmap to healthcare leaders, managers, clinicians, and staff in primary care as they:
For training support and technical assistance implementing Pediatric Collaborative Care reach out to the AIMS Center at: uwaims@uw.edu. Research has shown that clinics receiving implementation support from the AIMS Center have significantly better patient outcomes.
The Primary Care Provider (PCP) Champion plays a key role on the Clinic Implementation Team (CIT). The CIT is created when a medical practice is planning to implement Collaborative Care. This document outlines the PCP Champion’s key responsibilities with the team and their PCP colleagues, as well as the personal and professional characteristics that are most desirable in the role.
The Clinic Implementation Team Lead facilitates implementation and leads the Clinic Implementation Team (CIT). The CIT is created when a medical practice is planning to implement Collaborative Care. The document below outlines the CIT Leads’ key responsibilities, as well as the personal and professional characteristics that are most desirable in this role.
Integrated Care: Creating Effective Mental Health and Primary Health Care Teams provides the first comprehensive guide for teams to integrate effective mental health care into primary care clinics. Edited by a team of UW Medicine mental health experts, it includes practical information, skills, and clinical approaches needed to implement Collaborative Care, an evidence-based model of integrated care developed at the University of Washington. Importantly, it provides a common resource and framework for all members of the care team including care managers, psychiatrists, primary care providers, and administrators. Editors include UW psychiatrists Anna Ratzliff, MD, PhD, Jurgen Unutzer, MD, PhD, MA, and the late Wayne Katon, MD, as well as UW psychologist Kari Stephens, PhD.
Find resources for implementation within the free Integrated Care Online Appendix. These include a CoCM readiness checklist, BHCM documentation templates with examples, job descriptions, links to screening and symptom monitoring tools, and more.
Email uwaims@uw.edu with specific questions.
The Integrated Care Online Appendix can be found on the publisher’s website under ‘downloads’ at the bottom of the page.
Ensuring that a patient understands the Collaborative Care (CoCM) program before agreeing to participate is a crucial task for primary care providers. This resource provides general guidance on obtaining verbal consent from patients to participate in CoCM. Please note that these are general tips and that specific consent requirements may vary by state and patient insurance.
Since hosting monthly finance office hours, the AIMS Center has compiled the most asked questions and their answers. Answers address a variety of billing and financing topics including: reimbursement, the CoCM team, general BHI code, patient cost, registry options, telehealth, time tracking and more.
Updated 03/28/2023
In January 2021, the Centers for Medicare & Medicaid Services (CMS) announced that the bundled payments for the overall treatment of OUD can be used for any substance use disorder or treating several at one time. This quick guide summarizes the codes that can be used to bill for these services.