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New Analysis: Trends in Behavioral Health Integration

In a recent article published in Psychiatric Services, VSSL members Dr. Leah Marcotte (first author) and Joshua Liao (senior author) led a team that evaluated early national trends in Collaborative Care Model and General Behavioral Health Integration Services in the Medicare fee-for-service program between 2017 and 2018.


As noted in a VSSL Issue Brief by Drs. Marcotte, Liao and team, the Centers for Medicare and Medicaid Services (CMS) implemented novel fee-for-service Psychiatric Collaborative Care Model (CoCM) billing codes in 2017 to reimburse health care organizations for delivering services supporting behavioral health integration, especially in primary care settings. These codes were created based on recognition about the importance of broadening access to mental health services in primary care and making these services financially sustainable.


Study findings: "Overall, 10,294 CoCM and general BHI services were delivered in 2017, totaling $626,292 in payments, and 81,433 CoCM and general BHI services were delivered in 2018, totaling $7,442,985 in payments. Medicare denied 5% of services in 2017 and 32% in 2018. Most CoCM and general BHI services were delivered by primary care physicians in office-based settings."


Key Points:

  • There was an eightfold increase in CoCM and general BHI use between 2017 and 2018

  • However, denied services represent a barrier

  • Use among eligible beneficiaries remains low