Billing for collaborative care

[MrFlyGuy]

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Hi all,

Do you know of any resources except for grants that can fund collaborative care? I know there are billing codes but that seems to be for primary care and case managers.

Ultimately my hospital system wants me to build and sustain a collaborative care model, which I think is great, but I think it would be quite difficult for the healthcare system to just pay me without me bringing anything in as far as reimbursement is concerned.

MrFlyGuy

 

[comp1]

What do you mean by collaborative care? Indeed the billing codes are for case managers usually. The goal is to reduce you having to do stuff that doesn't require a MD and to improve patient care, not to increase your own personal billing

 

[MrFlyGuy]

What do you mean by collaborative care? Indeed the billing codes are for case managers usually. The goal is to reduce you having to do stuff that doesn't require a MD and to improve patient care, not to increase your own personal billing

Well okay, that makes sense but I feel like most case managers aren't going to be experienced with a collaborative care model so I will have to train them in identifying cases that need a higher level of care.

Isn't there also an aspect of directly speaking with primary care physicians to assist them with managing patients in the primary care setting rather than seeing a psychiatrist? Is there anyway to bill for this?

 

[PsyDr]

99367, right?

 

[FatherPsychiatry]

Hi all,

Do you know of any resources except for grants that can fund collaborative care? I know there are billing codes but that seems to be for primary care and case managers.

Ultimately my hospital system wants me to build and sustain a collaborative care model, which I think is great, but I think it would be quite difficult for the healthcare system to just pay me without me bringing anything in as far as reimbursement is concerned.

MrFlyGuy

It has been a while since I was involved with CoCM but I remember this resource being helpful

https://www.psychiatry.org/File%20Library/Psychiatrists/Practice/Professional-Topics/Integrated-Care/APA-CoCM-and-Gen-BHI-FAQs.pdf

 

[MrFlyGuy]

It has been a while since I was involved with CoCM but I remember this resource being helpful

https://www.psychiatry.org/File%20Library/Psychiatrists/Practice/Professional-Topics/Integrated-Care/APA-CoCM-and-Gen-BHI-FAQs.pdf

Thank you for posting this but it seems to confirm that there is no way for psychiatrists to directly bill for their time dedicated towards non direct patient care in this model.

If anyone can tell me differently I would love to hear it.

 

[calvnandhobbs68]

Hi all,

Do you know of any resources except for grants that can fund collaborative care? I know there are billing codes but that seems to be for primary care and case managers.

Ultimately my hospital system wants me to build and sustain a collaborative care model, which I think is great, but I think it would be quite difficult for the healthcare system to just pay me without me bringing anything in as far as reimbursement is concerned.

MrFlyGuy

The point is they’re paying you to provide a service to that patient population, not because they’re making money a bunch of money by your direct billing. The idea is that you decrease wait times and increase the ability of easier patients to be managed by primary care instead of the psychiatry service line making people wait 3 months to see a psychiatrist to switch their Lexapro to Effexor. The system generally somewhat eats the cost of paying you for your time to do this in order to increase efficiency elsewhere.

If your system doesn’t understand this then they aren’t understanding the point of the collaborative care model. Incentives also have to align for this…like if the hospital system actually makes more money by having everyone go to a specialist because they get the billing for the specialist visit as well, they don’t care if everyone gets referred to psychiatry. If you have patients who are part of an MCO or if your hospital runs its own health insurance plan though, they have more of an incentive to control referral costs.

 

[splik]

Traditionally its been funded by block grants but now it's billable. The CPT codes include payment for the psychiatric services even though the psychiatrist doesn't bill for it. Basically, they would pay you for your time to attend the meetings. They would either pay you based on an hourly rate, monthly % FTE or with wRVU credit. The hospital I worked at had a population health department who basically worked out that as well as payment for e consults.

 

[aquatic ape]

Any idea what the 9949x codes reimburse? Or how many a psychiatrist can do per hour?

Really my question is what type of hourly rate or pay structure is best for this model