Funding Mechanisms for Depression Care Management: Opportunities and Challenges

There is overwhelming evidence that depression care management works well for patients and is a cost-effective treatment. However, inconsistent third-party reimbursement for depression care management is a significant economic barrier to utilization and sustainability in primary care settings. Seven funding mechanisms, mostly under-utilized and not widely publicized, are described. While substantial obstacles remain in the way of fully implementing these depression care management funding mechanisms, several recent policy advancements provide some optimism for the potential adoption of financial mechanisms to support and disseminate these evidence-based practices.

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.

Broadly Defining Value for Your Model of Integrated Care

It is important to consider all the ways in which delivering effective, measurement-based integrated behavioral health treatment will add value to your organization. This resource can help you think about common domains of integrated care as you plan to launch your model of care.

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.