Frequently Asked Questions

Do You Have Questions About Behavioral Health Integration?

Learn more about the revenue opportunities, requirements, and benefits of behavioral health integration (BHI) services below.

What do each of the various BHI codes mean? How much potential revenue can be earned from each?

The BHI model consists of behavioral services that are categorized into general behavioral health integration (BHI) and the psychiatric collaborative care model (CoCM).

General BHI Billing Code

CPT Code 99484 bills for at least 20 minutes of clinical staff time overseen by a physician, or time provided by a qualified healthcare professional.

• Revenue: $48.60 / 20 minutes

Psychiatric Collaborative Care Services (CoCM) Billing Codes

CPT code 99492 reimburses for 70 minutes of behavioral care services furnished during the first calendar month.

• Revenue: $161.28 / 70 minutes

CPT Code 99493 bills for the months following the initial assessment.

• Revenue: $128.88 / 60 minutes

CPT Code 99494 is used in conjunction with codes 99492 and 99493 for each additional 30 minutes of care provided per calendar month.

• Revenue: $66.60 / each additional 30 minutes

How will BHI be beneficial for my patients and practice?

Behavioral health integration (BHI) aims to improve care and outcomes for patients with mental, behavioral, and psychiatric conditions. In addition to this, BHI reduces the overall costs of patient care and avoidable hospital admissions.

Who is eligible to provide BHI services?

For general BHI services, the billing practioner provides the service elements, and may be a physcian or non-physician practioner. CoCM services are conducted by a care team comprised of a billing practitioner, behavioral health care manager, and a psychiatric consultant.

Those eligible to provide BHI services include:

• Behavioral care specialists

• Clinical nurse specialists

• Clinical psychologists

• Nurse practitioners

• Physicians assistants

• Physicians

• Psychiatrists

• Social workers

What are the program requirements?

Similar to other care management serves, consent from the beneficiary is required to perform BHI services. The beneficiary must give the billing practioner consent to consult with relevant specialists. Written consent from the patient is not required; consent may be obtained verbally if the physician documents it in the patient record. To begin BHI services, an initial assesment using validated rating scales is necessary. For general BHI services, the only required visit is the inital assesment. For CoCM, the behavioral care manager must be available to provide face-to-face services as needed, however, this is the only requirement for in-person care.

Which Medicare patients are qualified to participate in this program?

Before beginning the BHI program, the first step is to see which of your Medicare patients are eligible to participate in this program. In order to qualify for BHI, Medicare patients must have a mental, behavioral, or psychiatric condition, which includes substance abuse disorders. Beneficiaries may, but are not required to have, comorbid, chronic, or other medical condition(s) in addition to the mental health condition treatment is being sought for.

Which behavioral conditions are eligible for BHI services?

Any mental, behavioral health, or psychiatric condition being treated by the billing practitioner are eligible for BHI services.

These conditions include but are not limited to:

• Alcohol/Substance Abuse

• Anxiety Disorders

• Bipolar Disorder

• Depression

• Obesessive-Compulsive Disorder (OCD)

• Posttraumatic Stress Disorder (PTSD)

• Schizophrenia

How is a care plan constructed? Is there a certain format that must be followed?

A care plan should be constructed to meet the specific needs of your patient.

Are there specific technology requirements necessary to provide BHI?

There are no certified technology requirements necessary for BHI documentation, however a certified EHR is required for recording clinical information, which includes problems, medications, and medication allergies.

Is there an upfront fee to begin using AviTracks-BH?

No, there is no large upfront investment to begin using AviTracks-BH. Instead, we offer an affordable monthly subscription based on the number of patients you have enrolled in your BHI program.

How much payment will beneficiaries be responsible for every month?

CMS’ intent is to minimize the amount of out-of-pocket expenses for patients; however, beneficiaries will still be responsible for co-payments, deductibles, and remainder balances according to their insurance agreement.

What are the benefits associated with AviTracks-BH software?

Our cloud-based software, AviTracks-BH, enables you to maximize efficiency without adding overhead by automating your behavioral health integration workflow. Our flexible software supports your unique way of delivering care, while also adapting to the changing demands of the healthcare industry. AviTracks is designed to help you maximize your reimbursement from Medicare’s BHI program while improving the mental health outcomes of your patients.

How does AviTracks-BH software automate workflow?

AviTracks automates your entire care management workflow including enrolling the patient, creating patient-centered care plans, documenting medications, scheduling and tracking calls and other activities, and generating documentation needed for billing purposes.

What are AviTracks-BH’s security features?

AviTracks-BH is a HIPAA compliant web-based application that runs under encrypted technology, providing security for data in transit and at rest.

• Microsoft Azure cloud hosted environment

• Fully redundant data centers in the United States

• Full Chain of Business Associate Agreements

• Comprehensive suite of security technologies

• Antivirus protection

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