What are Medicare’s Rules and Requirements for Behavioral Health Integration (BHI)?
Do you know the rules and requirements for managing
a Behavioral Health Integration program? In this video, we’ll go over
the general rules and requirements of BHI, so you’ll be set up for
success with the program. Hey, this is Jared from ThoroughCare . We specialize in helping practices
manage, bill, and streamline reimbursements for value based care programs
like Behavioral Health Integration. While we aren’t going to discuss
the CPT codes in this video, you can check out our video on the current
billing codes for BHI right here. So what are the provider requirements
for Behavior Health Integration? First,
let’s talk a little bit about the program. More than 20% of adults aged 60 and older are estimated to suffer
from a mental health disorder. With that in mind, elderly adults are more likely to seek
treatment for mental health conditions from their primary care physicians due
to the relationship they build over time. To help meet the needs of this
growing population, and to ease the care access burden, Medicare has introduced
BHI, or Behavioral Health Integration. BHI is a care management service
that is made up of several core elements. These include, but aren’t limited
to, a systematic assessment, continuous patient monitoring,
care plan creation and revision, and an ongoing relationship
with a designated care team member. With BHI, medical and behavioral
health clinicians work together as a team
to address a patient’s concerns. Care is delivered by these integrated teams
in the primary care setting, unless patients request
or require specialty services. BHI is typically managed by the patient’s
primary care physician or care manager. However, a third party
psychiatric consultant or therapist may provide additional services. It’s important to note that Medicare allows patients to enroll in both chronic
care and behavioral health programs. While you can bill for both programs
in one month, you must record 20 minutes of
independent service for each program – that’s 40 minutes total. Patients must have at least one
behavioral health condition to be eligible for the program. CMS classifies these as any
mental, behavioral health, or psychiatric condition
treated by the provider. This includes substance use disorders that
the provider believes call for BHI services. The diagnosis can be preexisting or made
by the practitioner and refined over time. In order to bill for BHI, providers must
use a certified EHR technology, spend 20 minutes of non-face-to-face
time per patient per month, document the time spent per patient, provide an initial assessment, facilitate
and coordinate treatment. In addition to the general rules
and requirements of the program, it’s important to know who
can build for BHI care. A patient’s primary care physician
or non physician practitioner, think PA, NP, CNS, or CNM can bill for BHI, but the provider
may be of another specialty. For example,
think cardiology, oncology or psychiatry. As you can see,
there are many important factors to keep in mind when offering
a Behavioral Health Integration program. If you’re interested in how
ThoroughCare can help you set up and manage your own BHI program, please
reach out using the link below. Please click like and subscribe
to our channel to learn about the many value
based care programs we offer. Thanks for watching.
In this video, we discuss Medicare’s current rules and requirements providers should be aware of when implementing a Behavioral Health Integration (BHI) program in their practice. From understanding why a practice would want to implement a BHI program, to who can deliver and bill for services, we’ll share the basic knowledge necessary to run a successful and profitable BHI program.
Download a Behavioral Health Integration Guide: https://hubs.li/Q01WdZwn0
Video Chapters:
► 00:00 What will I learn in this video?
► 00:37 BHI Facts and Statistics
► 01:34 Who can provide BHI services?
► 02:01 Qualifying Conditions for BHI
► 02:40 Who can bill for BHI?
► 02:58 Summary and Next Steps
Check out these helpful links to learn more about Behavioral Health Integration (BHI):
Behavioral Health Integration CPT Codes: 99484, G0323, G0511 Blog Article: https://hubs.li/Q01WdWyx0
Integrate Behavioral Health with Primary Care Blog Article: https://hubs.li/Q01WdWH-0
Implementing Value-Based Care With Behavioral Health Integration (BHI) Blog Article: https://hubs.li/Q01WdXXf0
2023 CMS Final Rule: What You Need to Know Blog Article: https://hubs.li/Q01WdWZQ0
Reimbursement rates are based on a national average and may vary depending on your location. heck the Physician Fee Schedule for the latest information: https://www.cms.gov/medicare/physician-fee-schedule/search/license-agreement?destination=/medicare/physician-fee-schedule/search%3F
Visit and Subscribe To Our Learning Center: https://hubs.li/Q01WdY3F0
If you’re ready to learn more about how care coordination software can help you manage value-based programs like BHI, contact ThoroughCare: https://hubs.li/Q01WdYJT0
Visit Our Website: https://www.thoroughcare.net/