Mental health experts collaborate with primary care physicians to verify that the patient’s clinical objectives are achievable. The collaborative care design has been shown to reduce costs while improving access and patient outcomes. The Centre approved payment for services provided to patients with behavioral health disorders for Medicare and Medicaid Services (CMS) in 2017. The CMS classifies these services as Behavioral Health Integration, such as patients who participate in psychiatric collaborative care programs or receive behavioral health integration services.
These three codes 99492, 99493, and 99494 bill for psychiatric collaborative care management services (CoCM). 99484 is the code for general BHI service. The claims for these services must be submitted by the treating physician or Primary Care Provider. A physician coding company makes sure that claims are submitted on time, allowing physicians to provide a consistent experience to their patients without differentiating between Chronic Care Management and Behavioral Health Integration Services. Precise coding and timely submission of claims are required for medical providers to effectively monitor their patients’ health records and obtain medical reimbursement,
Billing for CoCM is done using CPT codes.
99492: Initial psychiatric collaborative care management, first 70 minutes of behavioral health care management activities in consultation with a psychiatric consultant, and directed by the treating physician with the following required elements:
- Treating physician directs access to and participation in delivering healthcare services.
- The patient’s initial assessment, which includes the administration of verifying the assessment scale, is marked by the development of an individualized treatment plan.
- A psychiatric consultant will review the plan, and modifications will be made to the project if necessary.
- Scientifically proven techniques such as behavioral activation, motivational interviewing, and other-oriented treatment approaches are used to deliver brief interventions.
99493: Psychiatric collaborative care management, first 60 minutes of behavioral health care management activities in consultation with a psychiatric consultant, and directed by the treating physician with the following required elements:
- Using registration system to track patient follow-up and progress with proper documentation.
- Involvement in the psychiatric consultant’s weekly caseload discussion.
- Collaboration and coordination of the patient’s mental health care with treating physician and any other treating mental health providers continuously.
- Additional review of suggestions for adjustments in treatment, including medications based on the psychiatric consultant’s suggestions.
- Provide brief interventions using scientific proof techniques like behavioral activation, motivational interviewing, and other focused treatment strategies.
- Patients’ outcomes are monitored using a validated scoring system, and relapse prevention plans are developed with them as they accomplish symptom remission and other treatment goals and are ready to be discharged from active treatment.
99494: Initial or subsequent psychiatric collaborative care management, each additional 30 minutes of behavioral health care manager activities in a calendar month, in consultation with a psychiatric consultant, and directed by treating physician or other qualified health care professional, in consultation with a psychiatric consultant. These codes are billed based on the amount of time that behavioral health care manager spends with the patient doing clinical work (face-to-face and non-face-to-face).
99484 is used for billing monthly services other than CoCM.
- Clinical staff members spend at least 20 minutes each month under the supervision of a physician coordinating and managing a patient’s behavioral health services.
Medical coding services can help health care providers correctly code their services. The most recent billing codes are available to qualified coders. Medical coding specifications can be outsourced to reduce billing errors and eliminate claim rejections. Additionally, revenue cycle can be effectively managed while the highest priority is given to patient care.
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