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  • PDCM Billing Codes
    • G9001: Comprehensive Assessment
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    • 98966-98968: Telephonic
    • 99487, 99489: Care Coordination (without patient)
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CoCM FAQs

Q: CoCM Is a bundle payment model. Can all activities be included? 
A: Yes, best practice is view services provided by the BHCM activities. Services can’t be duplicated. (i.e., -10-minute case review with BHCM and psychiatrist counts as 10 minutes and not 10 minutes for the BHCM and 10 minutes for the psychiatrist.)

Q: In the same calendar month, can CoCM (99492, 99493, 99494, G0512) services be billed with General behavioral health integration (99484, G0511). 
A: No

Q: Can the PDCM codes be billed simultaneously with CoCM services in the same month? 
A:  Yes, if appropriate 

Q: Can CoCM services be billed alone or with another claim for another billable visit? 
A: Yes 

Q: To prevent duplication of services where can a BHCM determine if a patient is already enrolled in a similar program? 
A: Community Health Automated Medicaid Processing System (CHAMPS) * login required* 

Q: Can 99492 and G2214 be billed in the same month?
A: No, 99492 is initial month, so you wouldn’t combine with G2214, a code that could either be initial month or subsequent month.  If you need to bill more minutes than 99492 provides, you’d bill 99492 and units of 99494.  If you don’t have enough minutes to bill 99492, you would bill G2214 alone.

Q: Can a BHCM employed by a FQHC use add-on code 99494 to bill for additional time? 
A: No, FQHC/RHC do not recognize the CPT time rule nor the add-on code for additional time. You must provide the full 70 (initial) or 60 (subsequent) minutes before billing for the service and sites are not paid for any additional time. 

Q: Is documentation included in the time captured for billing the CoCM Codes?
A: Yes

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