Behavioral Health Integration
Monthly codes for integrating behavioral health care into a primary care or specialty practice, from a general model to the structured Psychiatric Collaborative Care Model (CoCM).
What it is
Behavioral Health Integration (BHI) pays for monthly care management for patients with a behavioral health condition, delivered by clinical staff under the direction of the billing practitioner.
There are two structural models: general BHI (99484 for clinical staff time, or G0323 when a clinical psychologist or clinical social worker personally furnishes the time), a lighter-weight option for practices without a formal collaborative-care team, and the Psychiatric Collaborative Care Model, or CoCM (99492, 99493, 99494, or the lower-time alternative G2214), which requires a behavioral health care manager and systematic, regular consultation with a psychiatric consultant.
Starting January 1, 2026, CMS added three optional add-on codes, G0568, G0569, and G0570, for practices furnishing BHI or CoCM to a patient who is also receiving Advanced Primary Care Management (APCM) in the same month, used instead of (not in addition to) the standalone BHI/CoCM codes.
Who qualifies
- Patient has a behavioral health condition (or conditions) being treated by the billing practitioner, such as depression, anxiety, or substance use disorder
- For general BHI (99484): at least 20 minutes of clinical staff time per calendar month directed by the billing practitioner
- For CoCM (99492/99493): a behavioral health care manager is assigned, a validated rating scale is used to track symptoms, and a psychiatric consultant reviews the caseload systematically, typically on a weekly basis
- Documented patient consent to the BHI or CoCM service
Codes at a glance
| Code | What it covers | Threshold | Approx. payment | Details link |
|---|---|---|---|---|
| 99484 | General BHI: at least 20 minutes of clinical staff time, per calendar month | 20 minutes clinical staff time | ~$57 | Details → |
| G0323 | General BHI, clinical psychologist or clinical social worker time, per calendar month | 20 minutes clinical psychologist/social worker time | ~$58 | Details → |
| 99492 | Psychiatric Collaborative Care Model (CoCM), first calendar month | 70 minutes behavioral health care manager time | ~$160 | Details → |
| 99493 | Psychiatric Collaborative Care Model (CoCM), subsequent calendar months | 60 minutes behavioral health care manager time | ~$145 | Details → |
| 99494 | CoCM add-on, each additional 30 minutes (used with 99492 or 99493) | Each additional 30 minutes | ~$61 | Details → |
| G2214 | CoCM, lower-time alternative to 99492/99493, first 30 minutes | 30 minutes behavioral health care manager time | ~$61 | Details → |
| G0568 | CoCM add-on for patients also receiving APCM, initial month | Parallels 99492's initial-month CoCM requirements, billed alongside an APCM code | ~$162 | Details → |
| G0569 | CoCM add-on for patients also receiving APCM, subsequent months | Parallels 99493's subsequent-month CoCM requirements, billed alongside an APCM code | ~$146 | Details → |
| G0570 | General BHI add-on for patients also receiving APCM | Parallels 99484's requirements, billed alongside an APCM code | ~$58 | Details → |
Approximate CY2026 Medicare Physician Fee Schedule national non-facility payment benchmark for non-QP clinicians, before geographic, sequestration, and claim-specific adjustments. Actual reimbursement varies by locality, practitioner status, payer, and billing circumstances. Verify the applicable amount with CMS or your Medicare Administrative Contractor.
What's required to bill
- Documented patient consent for the specific BHI model being billed
- Only one BHI model (general BHI or CoCM) billed per patient per month, not both
- For general BHI: care plan revision, systematic assessment and monitoring using validated tools where appropriate, and brief interventions
- For CoCM: an assigned behavioral health care manager, initial assessment with validated rating scales, ongoing symptom tracking, and regular systematic caseload review with a psychiatric consultant
- Continuity of care and coordination between the treating practitioner, care manager, and (for CoCM) psychiatric consultant
Documentation checklist
- Consent to the specific BHI model billed
- Time log for clinical staff (99484) or behavioral health care manager (CoCM codes)
- Validated rating scale results and tracking over time
- Evidence of psychiatric consultant caseload review for CoCM months
- Care plan revisions based on measurement-based care
Common billing mistakes
- Billing both general BHI (99484) and a CoCM code for the same patient in the same month
- Billing CoCM without documented, regular psychiatric consultant caseload review
- No validated rating scale tracking for CoCM patients
- Billing 99494 without first meeting the base 99492 or 99493 time threshold
- Missing documented consent specific to the behavioral health service
FAQ
Can a practice bill both general BHI and CoCM for the same patient?
No. A practice should choose the model that matches how care is actually delivered for that patient and bill only one BHI code per patient per month.
Does CoCM require a psychiatrist on staff?
Not on staff, but it does require a psychiatric consultant who conducts systematic, typically weekly, caseload reviews with the behavioral health care manager: this can be an outside consulting relationship.
What counts toward the 20 minutes for general BHI (99484)?
Clinical staff time directed by the billing practitioner spent on care plan revision, systematic assessment and monitoring, brief interventions, and continuity of care for the patient's behavioral health condition.
When is G0323 billed instead of 99484?
G0323 is billed when a clinical psychologist or clinical social worker personally furnishes the 20 minutes of general BHI time, rather than clinical staff directed by the billing practitioner (99484).
Can BHI or CoCM be billed alongside Advanced Primary Care Management (APCM)?
Not with the standalone codes (99484, 99492, 99493). Starting in 2026, CMS added add-on codes (G0568, G0569, G0570) specifically for furnishing CoCM or general BHI to a patient also receiving APCM in the same month, use those instead of the standalone codes.