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
|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.
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
- Integrating BH into primary care
- Cheat sheet on CMS Medicare payments for FQHC and RHC
- CMS Fact sheet
- CMS FAQ
If you have questions about behavioral health services, call the Provider Helpline at 800.942.4765.