Behavioral health integration (BHI) services provide payment for the additional care management services patients with mental, behavioral health, or psychiatric conditions receive from their primary care team. The primary care team develops a care plan and coordinates treatment across the health care system.
The Centers for Medicare & Medicaid Services (CMS) pays for two types of BHI services:
General BHI and CoCM services are monthly time-based services that include:
CoCM includes additional services provided by:
Clinical staff providing care management services for general BHI are not required to have additional education or training in behavioral health.
BHI and CoCM can be billed in the same month as chronic care management or transitional care management services. However, the time and activities used to meet the criteria for another service cannot be counted toward BHI or CoCM.
BHI and CoCM cannot be billed in the same month for the same patient.
Patients who have not been seen within one year before the start of BHI services must have an initiating visit. An initiating visit can include the annual wellness visit, Welcome to Medicare, transitional care management, or other qualifying evaluation and management service.
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Collaborative Care Management (CPT codes 99492, 99493, 99494, HCPCS code G2214)
General BHI (CPT code 99484)
Shares common required service elements with CoCM, but has fewer requirements:
BHI is most commonly paid under fee-for-service. The shift toward value-based payment allows practices to provide additional services, like BHI, in new and innovative ways. Learn more about different behavioral health integration models in the FPM Supplement, “Innovative Care Delivery: Behavioral Health Integration and Home-based Primary Care.”
Family physicians are often a patient’s first point of contact with the health care system and care for the whole patient. BHI offers payment to primary care teams for care management services provided to patients with mental, behavioral health, or psychiatric conditions. By integrating behavioral health with primary care, patients can receive additional support through their usual and trusted source of care.