Reminder: Priority Health covers integrated medical and behavioral health care services in primary care settings

Integrating behavioral health care with primary care is an effective strategy for improving health outcomes for individuals with mental or behavioral health conditions. That’s why we want to remind you that Priority Health pays for services provided to patients receiving psychiatric collaborative care services (CoCM) or other behavioral health integration (BHI) services.

What is psychiatric collaborative care?

Psychiatric collaborative care (CoCM) is a model of behavioral health integration that enhances primary care by adding two key services:

  • Care management support for individuals receiving behavioral health treatment
  • Regular psychiatric inter-specialty consultation to the primary care team  

What is behavioral health integration?

BHI is the comprehensive integration of psychiatrists, psychologists and clinical social workers (e.g., behavioral health specialists).

How should I bill for CoCM and BHI services? 

Priority Health accepts the following CPT codes 

CPT Description
99492 Initial psych care mgmt, 70 min/month - CoCM
99493 Subsequent psych care mgmt, 60 min/month - CoCM
99494 Initial/subsequent psych care mgmt, additional 30 min - CoCM
99483 Assessment and care planning for patients with cognitive impairment
99484 Care mgmt. services, min 20 min – General BHI Services
G0511 Care coordination services and payments for RHCs and FQHCs only
G0512 Care coordination services and payments for RHCs and FQHCs only

Our care management measure in our 2019 PCP Incentive Program Manual includes all of the codes, except 99483.

BHI coverage

Priority Health covers CoCM and BHI in primary care settings for all plans. Members' cost share may vary based on benefit.

Learn more about CoCM and BHI with these external resources

Questions?

If you have questions about behavioral health services, call the Provider Helpline at 800.942.4765.