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Behavioral Health Integration Services

Integrating behavioral health care with primary care (“behavioral health integration” or “BHI”) is an effective strategy for improving outcomes for the millions of Americans with mental or behavioral health conditions. As of 1/1/2017, Medicare makes separate payments to physicians and nonphysician practitioners for BHI services they furnish to beneficiaries over a calendar month service period.

CoCM is an approach to BHI shown to improve outcomes in multiple studies.

This model of behavioral health integration enhances “usual” primary care by adding two key services to the primary care team, particularly regarding patients whose conditions are not improving:

    • Care management support for patients receiving behavioral health treatment
    • Regular psychiatric inter-specialty consultation

A team of three individuals provide CoCM, in addition to the beneficiary, they represent the care team.  

    • Behavioral Health Care Manager
      • Designated individual with formal education/specialized training in behavioral health, working under the direction and oversight of the billing practitioner
    • Psychiatric Consultant
      • Trained psychiatrist qualified to prescribe a full range of medication
    • Treating (Billing) Practitioner
      • Physician and/or nonphysician practitioner

Service components include an initial assessment, care planning, and follow up.

For complete details including appropriately utilizing BHI and CoCM CPT Codes, see MLN Booklet® Behavioral Health Integration Services  

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Posted 1/27/2021

Behavioral Health Integration Services
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