The role of a primary care provider (PCP) in Collaborative Care is to oversee all aspects of the patient’s behavioral health care including encouraging the patient’s participation, prescribing medications, and making referrals to specialty mental health care when needed. They work in close consultation and collaboration with the patient’s Behavioral Health Care Manager and to a much lesser extent, the designated Psychiatric Consultant.
Audience: Administrator
Qualis Health Behavioral Health Integration Implementation Guide
The Behavioral Health Integration Implementation Guide is the most recent addition to the landmark series of Safety Net Medical Home Initiative implementation guides produced by Qualis Health to help primary care practices become Patient-Centered Medical Homes (PCMH). The guide offers concrete strategies on behavioral health integration including creating a vision, building integrated care teams, monitoring progress, and providing population-level accountability, particularly important for organizations implementing Collaborative Care. For organizations looking for guidance and coaching that goes beyond this resource, the AIMS Center offers a wide range of coaching and implementation support.
Example Psychiatric Consultant Services Contract
An example of a Psychiatric Consultant services agreement between a Community Mental Health Center and a Federally Qualified Health Center for organizations that may be interested in contracting for Psychiatric Consult services.
Please note: Contract language and template example is provided with permission from Valley Cities Behavioral Health Care.
Quick Guide on Bundled Payments for Behavioral Health Integration Services
The Centers for Medicare & Medicaid Services (CMS) announced Medicare payments for services provided by primary care providers for patients participating in a Collaborative Care program or receiving other behavioral health integration services. This handout summarizes the four AMA CPT® codes that can be used to bill for these 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.
Quick Guide on Payments for Behavioral Health Integration Services in Federally Qualified Health Centers and Rural Health Clinics
The Centers for Medicare and Medicaid Services (CMS) published final rules that allow Federally Qualified Health Centers (FQHCs) and Rural Health Clinics (RHCs) to bill for Behavioral Health Integration services, Chronic Care Management, and the Collaborative Care Model.
Basic Coding for Integrated Behavioral Health Care
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.
Behavioral Health Integration Services Fact Sheet
The Centers for Medicare and Medicaid Services have an updated fact sheet detailing codes that can be used to bill for behavioral health integration (BHI) and Collaborative Care Model (CoCM) services.
Pediatric Collaborative Care Implementation Guide
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:
- start a new Collaborative Care program, or
- expand an existing integrated care or Collaborative Care program to pediatrics, and/or
- partner with community and behavioral health agencies.
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.
Quick Guide on Medicare Payments for Office-Based Substance Use Disorder Services
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.
Frequently Asked Questions for Billing Collaborative Care
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