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August 2025 Top of Mind
Confused about Behavioral Health Integration and collaborative care billing?
As a New Hampshire behavioral health provider, you likely bill services under the Behavioral Health Integration (BHI) program. However, because BHI and collaborative care (CoCM) both aim to improve whole-person care, they’re often confused. The following guidance outlines the differences, so you can submit accurate behavioral health integration claims for fully insured commercial plan members ages 21 and younger – and avoid delays and denials.
The difference between CoCM and BHI
Collaborative care:
- Starts in and is led by teams in the primary care setting
- Primary care teams manage a variety of medical care and consult with behavioral health providers as needed
- Is billed under the patient’s medical benefits
Behavioral Health Integration care:
- Starts in and is led by teams in the behavioral care setting
- Integrates mental health, substance use and behavioral health services into those primary care or other medical settings
- Focuses on non-preventative behavioral health issues and systematic care management
- Is billed under behavioral care
Behavioral Health Integration has different billing guidance and codes than collaborative care models, including those specific to commercial plan members and specific BHI services that are billed under “CoCM care models” as shown below.
BHI Billing Guidance
| Billable services | Proper billing code | Who can bill for it |
|---|---|---|
General BHI services |
99484 |
Most often billed by psychiatrists |
G0323 (Medicare only) |
PhD and certified social workers |
|
G0511 (Medicare only) |
Federally Qualified Health Centers or Rural Health Clinics |
|
Interprofessional phone and electronic health record consultations |
99446-99449, |
Optum prescribers only. See Optum Consultation Services Reimbursement Policy. |
Non-billable service |
Proper billing code |
Who can bill for it |
|---|---|---|
BHI codes under the Psychiatric CoCM model |
99482-99483, 99494, G2214, G0512 |
Optum Behavioral Health doesn’t contract or reimburse these codes. Billed by treating medical provider, mostly primary care providers, who then pays psychiatric consultants and behavioral care managers through contract or direct hire. |
Additional treating practitioner billing notes
BHI services delivered by a behavioral health provider must be billed by the treating practitioner using the proper BHI billing codes.
Resources
- New Hampshire: Billing for Behavioral Health Integration Services Quick Reference Guide
- Behavioral Health Integration Services Guidance: Provides more information, billing codes, roles and key terms specific to general BHI services and CoCM care models, including those BHI services billed under the psychiatric CoCM model
- Additional phone and electronic billing guidance
- New Hampshire billing mandate
Questions? We’re here to help.
Please contact the Optum Provider Service Line at 1-877-614-0484, 7 a.m.–9 p.m. CT, Monday–Friday.
