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Behavioral Health Integration

A Comprehensive Guide to
Behavioral Health Integration

Learn about the benefits and requirements of this Medicare program.

What is Behavioral Health Integration?

A way for primary care
to address mental health

BHI is a Medicare Part-B program for patients with at least one behavioral health condition. Clinical staff engage patients for at least 20 minutes per month to coordinate care activities.

Much of BHI can be provided to patients through telehealth or over the phone. This program has been shown to improve depression scores and reduce costs.

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For patients with at least one behavioral health condition

Eligible conditions include any mental, behavioral health, or psychiatric condition being treated by the billing practitioner. 

The diagnosis or diagnoses could be either pre-existing or made by the billing practitioner and may be refined over time.


Patients benefit from reduced stigma and improved outcomes

A RAND report found that “incorporating mental health into primary care removes cultural barriers and stigma.” 

Discussing behavioral health issues with a primary care clinician or related clinical professional normalizes it as part of overall health. Under the primary care umbrella, behavioral health can help patients seek care sooner and prevent additional risks. 

Qualified providers span care teams

BHI is primarily managed by the patient’s physician or a care manager. That said, a third-party psychiatric consultant or therapist may provide additional services.

Medicare Part B will cover up to 80% of the program’s cost. Other insurances, such as Medicaid or private health plans, may also cover this cost. 

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How do patients enroll in BHI?

Enrollment is completed at an in-person evaluation or Annual Wellness Visit. Written or oral consent must be documented.

The provider should explain to the patient:

  • How BHI can benefit them
  • Medicare Part-B's 80% coverage with co-pay
  • That they can opt out at any time
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Understanding Behavioral Health Integration CPT code 99484

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Billing code 99484 is for BHI care management with at least 20 minutes of allocated provider time per patient per calendar month. Individual care plans are created for, and in collaboration with, the patient upon BHI enrollment.

Care plans act as a comprehensive guide to the patient’s goals and health history. 

To bill for BHI, providers must meet specific requirements

Delivered through remote interactions, either by phone or a telehealth platform, BHI services can include:

  • A systematic assessment
  • Continuous patient monitoring
  • Care plan creation and revision
  • Facilitation and coordination of behavioral health treatment
  • A continuous relationship with a designated care team member

Providers can successfully submit
Behavioral Health Integration claims by:

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How to start a BHI program

Before starting a behavioral health program, it's important to consider: 

  • Your plan to enroll and deliver services to patients
  • Hiring a certified care manager
  • Targeting a specific population or conditions
  • Using software to manage care planning and billing

Initial steps to launching a BHI program

Apart from understanding BHI's rules and requirements, providers should:

Care managers engage patients and facilitate BHI program services

Care managers play a crucial role in delivering care management services to patients. They conduct a majority of patient engagement and execute nearly all program services.

Behavioral Health Integration can promote value-based care

Expand behavioral health access

Mental health greatly influences physical health. For example, according to the World Health Organization (WHO), older adults with heart disease experience higher rates of depression.

Additionally, seniors may experience new stressors, including physical limitations, loss, grief, loneliness, or chronic pain that they’ve never dealt with before.

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Improve care quality and outcomes

BHI has proven to increase access to treatment, producing better patient outcomes while reducing costs and improving the patient experience.

Integrated primary care programs can also support entry into value-based care arrangements for provider organizations.

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Lower utilization and overall costs

It’s estimated that integrated behavioral health in the US can create $38-68 billion in healthcare savings annually. 

Integrated behavioral health provides three cost-cutting benefits, including decreased utilization, such as lower emergency department and admission rates.

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Behavioral Health Integration can improve rural healthcare quality

BHI programs can directly influence and support quality improvement efforts, leading to better health outcomes and performance measures, as well as value- or performance-related financial incentives.

For rural communities, a BHI program can capitalize on providers’ strengths in nurturing personal relationships and maximizing limited resources. They can leverage close ties to the community and collaborate toward quality improvement efforts.

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Using HCPCS code G0511 for BHI

Rural health clinics and federally qualified health centers utilize this HCPCS code for "general care management” to bill for Behavioral Health Integration.

This code can be billed for multiple care management services per month, including Remote Patient Monitoring and Chronic Care Management. However, all service requirements and accounting must be met separately. 

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BHI can be combined
with other Medicare programs

This can further support patient outcomes and generate additional reimbursement.

Support chronic conditions
with behavioral healthcare

Clinicians and healthcare policymakers are accepting that physical and mental health are closely interconnected.

This view is now influencing the aims and focus of value-based care through Chronic Care Management, care coordination, and Behavioral Health Integration.

ThoroughCare streamlines Behavioral Health Integration

Our software platform is intuitive and designed for BHI’s rules and requirements. ThoroughCare can help providers:

  • Facilitate patient consent and enrollment
  • Manage the entire BHI function
  • Create and maintain goal-driven care plans
  • Simplify claim submission and documentation requirements
  • Integrate with leading EHRs for holistic patient records

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