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  • PDCM Billing Codes
    • G9001: Comprehensive Assessment
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General Behavioral Health Integration

Description: Care Management services for behavioral health conditions, at least 20 minutes of clinical staff time, directed by physician or qualified health care professional time

Delivery Method: Face-to-face, telephone or video

Provider Location Service Code Billing Allowances Minimum Time Threshold                                           Payable Groups - Requirements
 Commercial (BCBSM, BCN,
Priority Health, HAP)
 Medicare  Medicare
Advantage
Medicaid
Non FQHC/RHC General Behavioral Health Integration 99484 Per calendar month 11-20 minutes      
 FQHC/RHC Chronic Care Management/
General Behavioral Health
 G0511 Per calendar month  20 minutes    Cost share applies  Not Billable

All services should be billed in accordance with CPT and Center for Medicare & Medicaid service guidelines.

Recommended EMR Documentation: (Templates available here)

  • Behavioral Health Care manager responsible for overall care plan, his/her credentials, and patient’s provider and contact information
  • Patient Consent
  • Date, duration, and modality of contact (face-to-face or video)
  • Name and relationship of person contacted if other than patient
  • Assessment, treatment plan – including evidence-based interventions
  • Referrals if appropriate
  • Medication Management

Activities Include:

  • Advanced Consent:
    • Verbal or written, must be documented in the EHR
    • Permission to consult with relevant specialists (i.e., psychiatric consultant)
    • Inform the patient of cost sharing
  • Time spent completing initial assessment and follow-up
  • Establishing behavioral health care plan
  • Coordinating treatment options, and continuity of care with designed care-team member
Michigan Institute for Care Management and Transformation
2500 Green Rd, Suite 100
Ann Arbor, MI 48105

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Disclaimer Statement: Although Blue Cross Blue Shield of Michigan and MICMT work collaboratively, the opinions, beliefs and viewpoints expressed by the author do not necessarily reflect the opinions, beliefs and viewpoints of BCBSM or any of its employees.

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