Collaborative care codes now payable with no member cost sharing

Effective July 1, we’ll reimburse medical practices that perform collaborative care with no member cost share. This applies to the following collaborative care codes: *99492, *99493, *99494 and the general behavioral health integration code *99484.

Collaborative care includes mental health, behavioral health and substance abuse services provided in a primary care setting, often with the assistance of psychiatric consultations or social workers. These codes apply to BCN HMO, Blue Cross’ PPO, BCN Advantage, and Medicare Plus Blue PPO.

“These codes allow for reimbursement to the medical practice for behavioral health case management and psychiatric consultation to the practice to coordinate the best holistic care for members’ medical and behavioral health needs,” says Dr. William Beecroft, Behavioral Health Medical Director.

Collaborative care is designed to improve outcomes and empower patients and their families. This style of practice has been shown to alleviate provider burnout, increase behavioral health access and improve member outcomes for their medical and behavioral health issues, ultimately leading to improvement in members’ health and quality of life.

Check web-DENIS for benefits and eligibility and for specific policy limitations.