Integrating behavioral health care with primary care (“behavioral health integration” or “BHI”) is an effective strategy for improving outcomes for people with mental or behavioral health conditions.

Types of BHI Services

  • 1. General
  • 2. Psychiatric Coordinated Care Management (CoCM)
  •  
  •  

Care team members

  • 1. Treating (Billing) Practitioner
  • 2. Beneficiary
  • 3. Potential Clinical Staff
  • 4. Psychiatric Consultant

Service Components

Initial assessment

  • Initiating visit (if required, separately billed)
  • Administration of applicable validated rating scale(s)
  • Systematic assessment and monitoring, using applicable validated clinical rating scales
  • Care planning by the primary care team jointly with the beneficiary, with care plan revision for patients, whose condition is not improving
  • Facilitation and coordination of behavioral health treatment
  • Continuous relationship with a designated member of the care team

Billing Codes

  • Billing Code
  • BHI Type
  • Behavioral Healthcare Manager
    (or) Clinical staff threshold time
  • Average Reimbursement

  • Billing Code

    99484

  • BHI Type

    General BHI

  • Behavioral Healthcare Manager
    (or) Clinical staff threshold time

    20 minutes

  • Average Reimbursement

    $48.65

  • Billing Code

    99492

  • BHI Type

    CoCM First Month

  • Behavioral Healthcare Manager
    (or) Clinical staff threshold time

    70 minutes

  • Average Reimbursement

    $162.18

  • Billing Code

    99493

  • BHI Type

    CoCM Subsequent months

  • Behavioral Healthcare Manager
    (or) Clinical staff threshold time

    60 minutes

  • Average Reimbursement

    $129.38

  • Billing Code

    99494

  • BHI Type

    CoCM Add-on code

  • Behavioral Healthcare Manager
    (or) Clinical staff threshold time

    30 minutes

  • Average Reimbursement

    $67.03

  • Billing Code

    G0511

  • BHI Type

    General BHI for Rural Health Clinic
    (or) Federally Qualified Health Center

  • Behavioral Healthcare Manager
    (or) Clinical staff threshold time

    20 minutes

  • Average Reimbursement

    $67.03

  • Billing Code

    G0512

  • BHI Type

    CoCM for Rural Health Clinic
    (or) Federally Qualified Health Center

  • Behavioral Healthcare Manager
    (or) Clinical staff threshold time

    70 minutes First month and
    60 minutes Subsequent months

  • Average Reimbursement

    $145.96

  • Billing Code

    G2214

  • BHI Type

    CoCM First 30 Minutes
  • 30 minutes

  • Average Reimbursement

    $67.03