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General Behavioral Health Integration

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  • PDCM Billing Codes
    • G9001: Comprehensive Assessment
    • G9002: Maintenance
    • 98966-98968: Telephonic
    • 99487, 99489: Care Coordination (without patient)
    • G9007: Team Conference
    • 98961, 98962: Group Education
    • G9008: Care Oversight
    • S0257: Counseling Regarding Advance Directives
    • PDCM Reference Materials
    • PDCM FAQs
  • Medication Reconciliation (Med Rec Post Discharge) 1111F
    • Medication Reconciliation (Med Rec Post Discharge) 1111F
  • CMS Care Management
    • Transitional Care Management
    • Advanced Primary Care Management Services
    • Chronic Care Management
    • Principal Care Management
  • CoCM Billing Codes
    • Collaborative Care Services
    • General Behavioral Health Integration
    • CoCM Billing FAQs

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 

 

Initial Subsequent Month (General Behavioral Health Integration) 

 

G0512

> 70 Minutes 

 

Initial Month

 

> 60 Minutes 

 

Subsequent Months 

 

G2114

 ≥ 30 Minutes 

 Any month (recommended only for subsequent months)

Billing opportunities and reimbursement may vary depending upon organization's specific payer value-based contracts. All services should be billed in accordance with CPT and Center for Medicare & Medicaid service guidelines.

MICMT does not have expertise related to the Centers for Medicare and Medicaid services coverage decisions related to billing. The information contained on this site comes from publicly available sources of CMS information. Any needed clarification should come from CMS or their representatives/contractors. 

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

 

Reviewed by Blue Cross Blue Shield of Michigan as of May 2024
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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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