New payments for Psychiatric Collaborative Care Services (COCM) from Medicare

by  Christine Woolstenhulme, QCC, QMCS, CPC, CMRS
June 29th, 2017

Medicare has agreed to make separate payments to physicians and non-physicians for Behavioral Health Integration (BHI) services beginning Jan. 1st, 2017.

Any condition new or pre-existing behavioral health or substance use disorders are eligible.  Beneficiaries may have comorbid, chronic, or other medical conditions they are being treated for as well.

Using the new codes, you bill the Place-of-Service POS where the practitioner provides face-to-face care.  A separate payment can now be made to the hospital (including critical access hospitals) when a practitioner reports the POS as hospital outpatient.

G0502 Initial psychiatric collaborative care management, first 70 minutes in the first calendar month of behavioral health care manager activities, in consultation with a psychiatric consultant, and directed by the treating physician or other qualified health care professional, with the following required elements:

G0503 Subsequent psychiatric collaborative care management, first 60 minutes in a subsequent month of behavioral health care manager activities, in consultation with a psychiatric consultant, and directed by the treating physician or other qualified health care professional, with the following required elements:

G0504 Initial or subsequent psychiatric collaborative care management, each additional 30 minutes in a calendar month of behavioral health care manager activities, in consultation with a psychiatric consultant, and directed by the treating physician or other qualified health care professional (List separately in addition to code for primary procedure) (Use G0504 in conjunction with G0502, G0503).

G0507 Care management services for behavioral health conditions, at least 20 minutes of clinical staff time, directed by a physician or other qualified health care professional time, per calendar month.

References:

New payments for Psychiatric Collaborative Care Services (COCM) from Medicare. (2017, June 29). Find-A-Code Articles. Retrieved from https://www.findacode.com/articles/new-payments-for-psychiatric-collaborative-care-services-cocm-from-medicare-31395.html

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