Eligibility

Primary Care practices that are interested in receiving Medicaid reimbursement for providing collaborative care services must be approved by the New York State Office of Mental Health. Collaborative Care Medicaid Program (CCMP) reimbursement is open to adult primary care practices, serving those 18 years of age and older. To qualify, practices must have the appropriate team members in place and adhere to the evidence-based principles of the collaborative care model as detailed in the Billing Approval Worksheet and reflected in the workflow. These include:

  • Behavioral Health Care Manager
  • Designated Program Lead
  • Data Manager
  • Billing Lead
  • Psychiatric Consultant (MD/PNP) and a minimum of 1 hour per week designated for consultation
  • Registry to manage your Collaborative Care Caseload
  • Standardized screening process using the PHQ-9
  • Warm hand-off to the Behavioral Health Care Manager
  • Utilize a treatment-to-target approach, using the PHQ-9 as a monitoring tool to identify patients that are not improving

Please contact us if you have any questions about any of the above readiness factors. If you believe you organization has addressed all of these, find information about how to qualify for Medicaid reimbursement here or find out about training and technical assistance resources available to support your implementation.