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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.
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.
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:
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.
Apart from understanding BHI's rules and requirements, providers should:
Organize a multidisciplinary team of qualified providers to support a comprehensive BHI program, and determine appropriate roles and responsibilities.
Find eligible BHI patients by targeting specific conditions or populations, working with specialists and primary care partners, or reviewing current EHR records.
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Acquire a digital platform to streamline workflow, support documentation, capture and interpret data, enable patient care planning, track and report outcomes, and automate claims preparation.
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.
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.
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.
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.
This can further support patient outcomes and generate additional reimbursement.
Manage conditions with SMART goals, care plans, and evidence-based assessments.
Patients can use digital devices to capture health data for more informed care.
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Patients can receive support following a hospital discharge to avoid readmission.
Our software platform is intuitive and designed for BHI’s rules and requirements. ThoroughCare can help providers:
