There are a number of new advances in payment to support integration of behavioral health services into medical settings. In July 2017, the WA State Legislature passed a bill (SSB 5779) that required the HCA to review and revise payment rules for behavioral health services delivered in primary care as well as allocated $4 million to reimburse for Collaborative Care services. HCA provides information on this ongoing review process. Feedback and questions can be provided to the HCA at HCABHIMatrices@hca.wa.gov.
The guidance around these payments from the HCA was released in 4 phases, addressing funding for Medicaid services. Guidance on these phases can be found on the HCA website under Behavioral Health – Primary Care Integration. Phase 1 includes Health and Behavior Codes intended to support behavior interventions for patients with primarily physical health problems. Phase 2 includes additional Behavioral Health Codes that include SBIRT, Smoking and Tobacco Cessation. Phase 3 focused on the Collaborative Care model that is used in the CHPW Mental Health Integration Program (MHIP).
The final guidance for Medicaid can be found on the HCA website, see latest version of the Physician-Related Services/Health Care Professional Services Billing Guide in the Provider billing guides and fee schedules page (see Collaborative Care Guidelines).
An attestation form is required for billing for the new codes. This form can be found on the HCA website under the Forms & publications page, search for 13-0017. The form needs to be sent to the HCA at firstname.lastname@example.org prior to billing for these codes.
For more information contact Customer Service.