AMA CPT® Assistant - 2017 Issue 11 (November)
Psychiatric Collaborative Care Management Services (November 2017)
November 2017 pages 3-5 Psychiatric Collaborative Care Management Services A new subsection and three new codes have been created in the Evaluation and Management Services/Care Management Services subsection of the Current Procedural Terminology (CPT®) 2018 code set to report psychiatric collaborative care management services. Because psychiatric problems are recognized as common and disabling health conditions that could benefit from collaborative care management services, the Centers for Medicare & Medicaid Services (CMS) and the American Psychiatric Association (APA) worked together to develop coding structures that could facilitate the appropriate valuation of these psychiatric collaborative care management services for different...
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Article Overview
This article covers the introduction of psychiatric collaborative care management services in the CPT 2018 code set and the related Medicare HCPCS codes developed for the same general service model. It is aimed at coders, physicians, and other health care professionals involved in behavioral health coordination in primary care settings. The article outlines the service framework, roles of the treating physician, behavioral health care manager, and psychiatric consultant, and summarizes reporting guidance, time-based service structure, and related companion services.
Why This Topic Matters
Psychiatric collaborative care is a growing care model that crosses primary care and behavioral health. Accurate understanding of the reporting structure helps organizations align documentation, roles, and claims processing with the applicable code sets.
Article Sections
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November 2017 pages 3-5
Introductory material explaining the topic, its place in the CPT 2018 update, and the broader Medicare context for the service model.
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Psychiatric Collaborative Care Management Services
Overview of the collaborative care model, the participating clinicians, and the general reporting framework for these services.
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Coding Tip
General reporting guidance related to overlapping services and how certain related services are handled alongside collaborative care.
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Psychiatric Collaborative Care Management Services
Presentation of the newly introduced code family and the general service components associated with each level of reporting.
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Coding Tip
Additional guidance on separating time and reporting for related behavioral health services.
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Table 1. Responsibilities and Reporting Requirements For Psychiatric Collaborative Services
Summary of the roles involved in collaborative care and the categories of services each may provide or report separately.
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Coding Tip
Notes on when other services provided by the psychiatric consultant may be reported separately.
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Table 2. Reporting Psychiatric Collaborative Care Services
Time-based reporting summary showing how monthly service duration aligns with the collaborative care codes.
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Coding Tip
Further guidance on excluding psychotherapy time from collaborative care reporting.
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Clinical Example (99492)
Illustrative scenario and procedure description showing a typical setting for the initial collaborative care service.
What You Will Learn
- How psychiatric collaborative care management is organized in primary care settings
- Which clinician roles are involved in collaborative care services
- How the article frames time-based monthly reporting for the service family
- What companion behavioral health services are discussed in relation to collaborative care
- How the article presents clinical example and procedure narrative material for the initial service
Who Should Read This
- Medical coders
- Physicians
- Primary care practices
- Behavioral health care managers
- Billing and reimbursement staff
Codes Discussed
Code Ranges Discussed
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