Medicare Program

Behavioral Health Integration (BHI)

BHI enables primary care practices to formally address behavioral health conditions within the care team. Medicare reimburses monthly for the care manager time and psychiatric consultation required to support patients with depression, anxiety, and other behavioral health conditions.

What Is Behavioral Health Integration?

Behavioral Health Integration is a structured program that allows primary care practices to formally bill Medicare for the time their care team spends addressing behavioral health conditions. The program requires a designated care manager, an overseeing billing provider, and access to a psychiatric consultant who reviews cases and advises on treatment.

BHI recognizes that most behavioral health needs are managed in primary care settings rather than specialty mental health settings. By creating formal billing pathways, Medicare incentivizes practices to systematically screen, track, and treat patients with conditions like depression and anxiety.

Two models available: General BHI (99484) is simpler and requires only 20 minutes of care manager time per month. The Collaborative Care Model (CoCM, using 99492/99493) is more intensive but reimburses at a higher level and supports more complex patients.

Qualifying Behavioral Health Conditions

  • Depression (PHQ-9 score 5 or higher)
  • Generalized anxiety disorder (GAD-7 score 5 or higher)
  • Post-traumatic stress disorder (PTSD)
  • Bipolar disorder
  • Alcohol and substance use disorders
  • Eating disorders
  • Attention deficit hyperactivity disorder (ADHD)

CPT Codes and Requirements

CodeDescriptionRequirement
99484General BHI: Care Manager Activities
Psychiatrist or clinical psychologist serves as consultant
20 min/month
99492Initial PBHCI - First month
Psychiatric Collaborative Care Model, first calendar month
70 min
99493Subsequent PBHCI - Each subsequent month
Psychiatric Collaborative Care Model, ongoing
60 min
99494Add-on - Additional 30 minutes
Can be billed with 99492 or 99493
30 min

How CareStream Manages BHI

01

Patient Identification

We identify patients with qualifying behavioral health diagnoses or elevated screening scores (PHQ-9, GAD-7) from EHR data.

02

Enrollment and Consent

Patients are enrolled with documented consent and an initial behavioral health assessment.

03

Care Manager Engagement

Dedicated care managers conduct regular check-ins, administer validated screening tools, and track patient progress on a registry.

04

Psychiatric Consultation

A psychiatric consultant reviews cases on a scheduled basis, advises on treatment adjustments, and documents recommendations.

05

Time Tracking and Documentation

Every care manager and consultant interaction is documented with time, ensuring monthly thresholds are met before billing.

06

Compliant Monthly Billing

Claims are generated after compliance validation and submitted under the appropriate CPT code for each patient.

Address Behavioral Health in Your Practice

Most primary care practices are already managing behavioral health informally. BHI creates a structured, billable framework so you can get paid for the work your team is already doing.

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