Improving Payment for Collaborative Mental Health Care in Primary Care

Courtney Benjamin Wolk*, Carol L. Alter, Rachel Kishton, Jeffrey Rado, Jacob A. Atlas, Matthew J. Press, Neil Jordan, Michael Grant, Cecilia Livesey, Lisa J. Rosenthal, Justin D. Smith

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

1 Scopus citations

Abstract

Background: There is strong evidence supporting implementation of the Collaborative Care Model within primary care. Fee-for-service payment codes, published by Current Procedural Terminology in 2018, have made collaborative care separately reimbursable for the first time. These codes (ie, 99492-99494) reimburse for time spent per month by any member of the care team engaged in Collaborative Care, including behavioral care managers, primary care providers, and consulting psychiatrists. Time-based billing for these codes presents challenges for providers delivering Collaborative Care services. Objectives: Based on experience from multiple health care organizations, we reflect on these challenges and provide suggestions for implementation and future refinement of the codes. Conclusions: Further refinements to the codes are encouraged, including moving from a calendar month to a 30-day reimbursement cycle. In addition, we recommend payers adopt the new code proposed by the Centers for Medicare and Medicaid Services to account for smaller increments of time.

Original languageEnglish (US)
Pages (from-to)324-326
Number of pages3
JournalMedical care
Volume59
Issue number4
DOIs
StatePublished - Apr 2021

Keywords

  • behavioral health
  • collaborative care
  • financing
  • integrated care

ASJC Scopus subject areas

  • Public Health, Environmental and Occupational Health

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