Establishing a revenue stream is necessary to support the sustained success of the Collaborative Care (CoCM) program. Health centers may use a variety of mechanisms to financially support their programs, such as billing codes and grant funding. In January 2018, the Centers for Medicare & Medicaid (CMS) issued codes reimbursing for CoCM services. In Michigan, many commercial payers and Medicare are reimbursing for CoCM.
The following CPT codes can be used: 99492, 99493, 99494, and 99484. The following G-codes can be used for rural and federally qualified health centers: G0511, G0512.
What Services Can I Bill Using the CoCM Codes?
All services delivered to the patient by the CoCM treatment team are included in this service. CoCM is billed:
- on a per member per month basis within a calendar month.
- incident to the primary care provider (PCP)
What How Do I Bill for Therapy Services?
Therapy services that are delivered separate from the CoCM program and not counted toward the monthly billable minutes for the CoCM program should be billed separately.
As CoCM billing codes are not universally available among payers, health centers may choose to bill alternative codes for services provided as a part of CoCM (e.g., PHQ-9 screening, psychotherapy) in effort to gather revenue to support the program.
This resource was developed by the University of Washington-Advancing Integrated Mental Health Solutions Center.
How Can We Maximize Our Revenue Stream?
Appropriately distributing time amongst the patients in the caseload will help optimize BHCM time, keep a fluid caseload, and maximize revenue. Use this guide to review the caseload and distribute resources appropriately.
How Do I Talk to Patients About Paying for CoCM Services?
Ensure your patients are aware of potential charges for CoCM services. Use this tool to guide the conversation.
The following resources have been developed by CMS and American Psychiatric Association to support the use of the CoCM billing codes: