New primary care-based psych codes offer opportunity, challenges in 2017

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Note:  The following article synopsis was NOT provided by HCPro. It was created by Find-A-Code/innoviHealth.

Article Overview

This article discusses Medicare’s proposed coverage for primary care-based behavioral health integration services in 2017 and the operational issues practices may face when adopting the collaborative care model. It is relevant to primary care, behavioral health integration, and medical billing professionals who need a high-level understanding of the new temporary HCPCS coding framework, related service structure, and the participation and documentation requirements described in the proposed rule.

Why This Topic Matters

The article helps readers assess whether their practice is ready to support integrated behavioral health workflows and understand the general compliance and operational issues surrounding the proposed Medicare payment approach.

Article Sections

  1. Overview of the proposed payment approach

    Introduces the Medicare proposal and the broader opportunity and implementation challenges associated with behavioral health integration services in primary care settings.

  2. Interest from behavioral health leaders and implementation concerns

    Summarizes perspectives from behavioral health organizations and clinical experts on the expected impact and practical barriers to adoption.

  3. Defining 3 main elements of CoCM

    Describes the collaborative care model framework and the major components practices are expected to support under the proposal.

  4. Note 3 billing requirements

    Outlines the general billing and documentation topics tied to the proposed services, including patient eligibility, episode structure, initiating visits, and consent.

What You Will Learn

  • The general purpose of the proposed Medicare behavioral health integration payment approach
  • How the collaborative care model is described in the article
  • What types of operational resources practices may need to support integrated care services
  • The broad billing and documentation topics associated with the proposed services

Who Should Read This

  • Primary care practices
  • Behavioral health integration teams
  • Medical coders and billers
  • Practice administrators
  • Behavioral health consultants

Codes Discussed


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