Department of Psychiatry, Perelman School of Medicine.
Leonard Davis Institute of Health Economics, University of Pennsylvania, Philadelphia, PA.
Med Care. 2021 Apr 1;59(4):324-326. doi: 10.1097/MLR.0000000000001485.
There is strong evidence supporting implementation of the Collaborative Care Model within primary care. Fee-for-service payment codes, published by Current Procedural Terminology in 2018, have made collaborative care separately reimbursable for the first time. These codes (ie, 99492-99494) reimburse for time spent per month by any member of the care team engaged in Collaborative Care, including behavioral care managers, primary care providers, and consulting psychiatrists. Time-based billing for these codes presents challenges for providers delivering Collaborative Care services.
Based on experience from multiple health care organizations, we reflect on these challenges and provide suggestions for implementation and future refinement of the codes.
Further refinements to the codes are encouraged, including moving from a calendar month to a 30-day reimbursement cycle. In addition, we recommend payers adopt the new code proposed by the Centers for Medicare and Medicaid Services to account for smaller increments of time.
有强有力的证据支持在初级保健中实施协作式护理模式。2018 年《当前操作术语》发布的按服务收费代码首次使协作式护理可以单独报销。这些代码（即 99492-99494）报销护理团队中任何参与协作式护理的成员每月所花费的时间，包括行为护理经理、初级保健提供者和咨询精神科医生。这些代码的基于时间的计费给提供协作式护理服务的提供者带来了挑战。
根据多个医疗保健组织的经验，我们反思了这些挑战，并为这些代码的实施和未来的改进提供了建议。
鼓励进一步改进这些代码，包括从日历月改为 30 天的报销周期。此外，我们建议付款人采用医疗保险和医疗补助服务中心提出的新代码，以考虑到更小的时间增量。
