{"id":2357,"date":"2017-11-10T07:00:17","date_gmt":"2017-11-10T14:00:17","guid":{"rendered":"https:\/\/dsiohn098w.mpqhf.org\/blog\/?p=2357"},"modified":"2017-12-14T13:57:23","modified_gmt":"2017-12-14T20:57:23","slug":"steps-establish-primary-care-behaviorist-model","status":"publish","type":"post","link":"https:\/\/dsiohn098w.mpqhf.org\/blog\/steps-establish-primary-care-behaviorist-model\/","title":{"rendered":"Steps to Establish a Primary Care Behaviorist Model"},"content":{"rendered":"<p><img loading=\"lazy\" decoding=\"async\" src=\"https:\/\/dsiohn098w.mpqhf.org\/blog\/wp-content\/uploads\/2017\/10\/10.27.2017-Behavioral-Health-Integration.png\" alt=\"\" width=\"1200\" height=\"300\" class=\"alignnone size-full wp-image-2310\" srcset=\"https:\/\/dsiohn098w.mpqhf.org\/blog\/wp-content\/uploads\/2017\/10\/10.27.2017-Behavioral-Health-Integration.png 1200w, https:\/\/dsiohn098w.mpqhf.org\/blog\/wp-content\/uploads\/2017\/10\/10.27.2017-Behavioral-Health-Integration-300x75.png 300w, https:\/\/dsiohn098w.mpqhf.org\/blog\/wp-content\/uploads\/2017\/10\/10.27.2017-Behavioral-Health-Integration-768x192.png 768w, https:\/\/dsiohn098w.mpqhf.org\/blog\/wp-content\/uploads\/2017\/10\/10.27.2017-Behavioral-Health-Integration-1024x256.png 1024w\" sizes=\"(max-width: 1200px) 100vw, 1200px\" \/><\/p>\n<h1>Steps to Establish a Primary Care Behaviorist Model<\/h1>\n<h5>November 10, 2017<\/h5>\n<h6>Written by Kristen Schuster, Practice Facilitator<\/h6>\n<p>The <a href=\"https:\/\/dsiohn098w.mpqhf.org\/blog\/providing-care-management-mental-illnesses\/\" rel=\"noopener\" target=\"_blank\">10\/27 blog<\/a> outlined the care management model of behavioral health integration.  This blog is going to establish steps for establishing a primary care behaviorist model.  Remember, Track 1 practices, you are not off the hook.  Program Year 2 changes were outlined in the <a href=\"https:\/\/dsiohn098w.mpqhf.org\/blog\/care-delivery-requirements-program-year-2\/\" rel=\"noopener\" target=\"_blank\">10\/20 blog<\/a> and now Track 1 practices need to choose a BHI model and begin implementation for 2018.<\/p>\n<p>The Primary Care Behaviorist model integrates behavioral health into the PC workflow through warm handoffs to a co-located behavioral health professionals to address mental illness in the primary care setting and behavioral strategies for management of chronic general medical illnesses. It also facilitates specialty care engagement for those with serious mental illness.  The PC behaviorist model integrates a licensed clinical social worker, someone with a master\u2019s degree in behavioral health or a nurse practitioner with behavioral health training to provide brief therapy and evidence-based treatment for patients with behavioral health diagnosis.  The PC behaviorist model is designed to take work off the primary care provider\u2019s plate and provide immediate access to behavioral health care.<\/p>\n<p><strong>Key Elements<\/strong><\/p>\n<ul>\n<li>Masters degree, PHD in relevant field, or an LCSW<\/li>\n<li>Same-day access to behavioral health services<\/li>\n<li>Provide brief therapy (limited to six 15-20 minute sessions)<\/li>\n<ul>\n<li>These sessions are brief because the PCP will do all pharmacological reviews and other evidence-based care for the patient<\/li>\n<\/ul>\n<li>Integration and communication between PC behaviorist and the care team<\/li>\n<li>Evidence-based behavioral health treatments are developed by the PC behaviorist<\/li>\n<\/ul>\n<p><strong>Remember:<\/strong> This model of behavioral health would have a full-time behaviorist seeing 80% of the mental health patients in a CPC+ practice.<\/p>\n<p><strong>Steps for implementation<\/strong><\/p>\n<ul>\n<li>Assess your patient population<\/li>\n<ul>\n<li>A population with severe behavioral health needs may benefit more from this model<\/li>\n<\/ul>\n<li>Assess the availability of an onsite behaviorist<\/li>\n<li>Determine how much time a PC behaviorist is needed<\/li>\n<li>Ensure office space needs can be met<\/li>\n<li>Develop a contingency plan for care if the provider is part-time<\/li>\n<ul>\n<li>Telemedicine <\/li>\n<li>Care manager for warm handoff to fill the gap until the behaviorist can reach out to the patient<\/li>\n<\/ul>\n<li>Identify patients in need based on established evidence based screening tools (PHQ-9 score)<\/li>\n<\/ul>\n<p><strong>Remember:<\/strong> Communicate the job duties and establish a workflow before the behaviorist starts working in the CPC+ practice.<\/p>\n<p><strong>Challenges to Anticipate<\/strong><\/p>\n<ul>\n<li>Provider and staff understanding of PC behaviorist\u2019s job duties<\/li>\n<li>Identifying a target population (don\u2019t start too big!)<\/li>\n<li>Adequate space for sessions<\/li>\n<\/ul>\n<p><strong>Billing for Behavioral Health<\/strong><\/p>\n<p>The following payment structure may be used for patients with any behavioral health condition that are being treated this includes substance use disorders. <\/p>\n<ul>\n<li><strong>G0502<\/strong> \u2013 first 70 minutes in the first calendar month for behavioral health care manager activities, in consultation with a psychiatric consultant and directed by the treating provider<\/li>\n<ul>\n<li>$142.84<\/li>\n<\/ul>\n<li><strong>G0503<\/strong> \u2013 first 60 minutes in a subsequent month of behavioral health care manager activities<\/li>\n<ul>\n<li>$126.33<\/li>\n<\/ul>\n<li><strong>G0504<\/strong> \u2013 each additional 30 minutes in a calendar month of behavioral health care manager activities listed above<\/li>\n<ul>\n<li>$66.04<\/li>\n<\/ul>\n<li><strong>G0505<\/strong>&#8211; Assessment and care planning for patients with a cognitive impairment<\/li>\n<ul>\n<li>$238.30<\/li>\n<\/ul>\n<\/ul>\n<p>Please review the cheat sheets below for billing requirements for these codes.  <\/p>\n<p><strong>Remember:<\/strong> Practices still are not able to bill <strong>G0506 and G0507<\/strong>.<\/p>\n<p>If your organization has not chosen a BHI model, the recordings for the BHI action groups are available on CPS+ Connect.  Stay tuned for the Mountain-Pacific\u2019s blog next week where we will outline the Primary Care Behaviorist Model.  Don\u2019t forget On the Plus Side is a weekly email newsletter, that lists upcoming educational events, CPC+ tasks and links to CMS resources.  As always, complete CPC+ information from CMS can be found on the CPC+ Connect Portal.  We encourage you to access the portal and check out all available CMS CPC+ resources. <\/p>\n<p>If you have any questions, or run into issues with any of the CPC+ objectives and would like help please use the \u201cLeave a Reply\u201d section below, or email <a href=\"mailto:kschuster@mpqhf.org?subject=CPC+%20Assistance\" target=\"_blank\">Kristen Schuster<\/a> directly with your questions or comments.<\/p>\n<p><strong>Other Resource Links<\/strong><\/p>\n<p><a href=\"http:\/\/www.mpqhf.org\/corporate\/health-and-technology-services\/resources\/cpc-resources\/\" rel=\"noopener\" target=\"_blank\">Other Resource Links<\/a><br \/>\n<a href=\"https:\/\/aims.uw.edu\/sites\/default\/files\/CMS_FinalRule_2017_CheatSheet_0.pdf\" rel=\"noopener\" target=\"_blank\">Cheat Sheet for BHI Billing<\/a><br \/>\n<a href=\"https:\/\/www.alz.org\/careplanning\/downloads\/cms-consensus.pdf\" rel=\"noopener\" target=\"_blank\">G0505 Billing<\/a><br \/>\n<a href=\"https:\/\/dsiohn098w.mpqhf.org\/blog\/wp-content\/uploads\/2017\/10\/BHI-menu-of-options.pdf\" rel=\"noopener\" target=\"_blank\">BHI Menu of Options<\/a><br \/>\n<a href=\"https:\/\/dsiohn098w.mpqhf.org\/blog\/wp-content\/uploads\/2017\/11\/BCH-BH-Specialist-referral-Workflow.pdf\" rel=\"noopener\" target=\"_blank\">Behavioral Health Specialist (BHS) Referral Flow<\/a><br \/>\n<a href=\"https:\/\/dsiohn098w.mpqhf.org\/blog\/comprehensive-primary-care-plus-cpc-blog\/\">See all CPC+ Blog Posts<\/a><\/p>\n<hr \/>\n<p>&nbsp;<\/p>\n<p><strong>Subscribe to the HTS CPC+ Blog<\/strong><br \/>\n<a href=\"http:\/\/eepurl.com\/cH6b4n\" class=\"su-button su-button-style-flat\" style=\"color:#ffffff;background-color:#385173;border-color:#2d415c;border-radius:5px\" target=\"_blank\" rel=\"noopener noreferrer\"><span style=\"color:#ffffff;padding:0px 30px;font-size:22px;line-height:44px;border-color:#74869d;border-radius:5px;text-shadow:0px 0px 0px #f4f4f4\"> Subscribe<\/span><\/a>\n<p>&nbsp;<\/p>\n<hr \/>\n<p><img loading=\"lazy\" decoding=\"async\" src=\"http:\/\/www.mpqhf.org\/corporate\/wp-content\/uploads\/2017\/02\/Untitled-3-300x95.png\" alt=\"\" width=\"300\" height=\"95\" class=\"alignnone size-medium wp-image-3035\" \/><\/p>\n<div id=\"boxzero\">\n<section id=\"boxone\">\n<p id=\"boxparagraph\"><strong>See a list of upcoming webinars<\/strong><\/p>\n<p><a href=\"http:\/\/www.mpqhf.org\/corporate\/health-and-technology-services\/webinars-and-events\/upcoming-webinars\/\"><span class=\"link-spanner\">See a list of upcoming webinars<\/span><\/a><\/p>\n<\/section>\n<section id=\"boxtwo\">\n<p id=\"boxparagraph\"><strong>Check out any webinars you missed<\/strong><\/p>\n<p><a href=\"http:\/\/www.mpqhf.org\/corporate\/health-and-technology-services\/webinars-and-events\/webinar-materials\/\"><span class=\"link-spanner\">Check out any webinars you missed<\/span><\/a><\/p>\n<\/section>\n<aside id=\"boxthree\">\n<p id=\"boxparagraph\"><strong>See our CPC+ resources<\/strong><\/p>\n<p><a href=\"http:\/\/www.mpqhf.org\/corporate\/health-and-technology-services\/resources\/cpc-resources\/\"><span class=\"link-spanner\">See our CPC+ resources<\/span><\/a><\/p>\n<\/aside>\n<\/div>\n<p>&nbsp;<\/p>\n","protected":false},"excerpt":{"rendered":"<p>Steps to Establish a Primary Care Behaviorist Model November 10, 2017 Written by Kristen Schuster, Practice Facilitator The 10\/27 blog outlined the care management model of behavioral health integration. This blog is going to establish steps for establishing a primary care behaviorist model. Remember, Track 1 practices, you are not off the hook. Program Year [&hellip;]<\/p>\n","protected":false},"author":13,"featured_media":1738,"comment_status":"open","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"_genesis_hide_title":false,"_genesis_hide_breadcrumbs":false,"_genesis_hide_singular_image":false,"_genesis_hide_footer_widgets":false,"_genesis_custom_body_class":"","_genesis_custom_post_class":"","_genesis_layout":"","footnotes":""},"categories":[135],"tags":[],"class_list":{"0":"post-2357","1":"post","2":"type-post","3":"status-publish","4":"format-standard","5":"has-post-thumbnail","7":"category-cpc","8":"entry"},"yoast_head":"<!-- This site is optimized with the Yoast SEO plugin v23.5 - https:\/\/yoast.com\/wordpress\/plugins\/seo\/ -->\n<title>Steps to Establish a Primary Care Behaviorist Model - Mountain Pacific Blog<\/title>\n<meta name=\"robots\" content=\"index, follow, max-snippet:-1, max-image-preview:large, max-video-preview:-1\" \/>\n<link rel=\"canonical\" href=\"https:\/\/dsiohn098w.mpqhf.org\/blog\/steps-establish-primary-care-behaviorist-model\/\" \/>\n<meta property=\"og:locale\" content=\"en_US\" \/>\n<meta property=\"og:type\" content=\"article\" \/>\n<meta property=\"og:title\" content=\"Steps to Establish a Primary Care Behaviorist Model - Mountain Pacific Blog\" \/>\n<meta property=\"og:description\" content=\"Steps to Establish a Primary Care Behaviorist Model November 10, 2017 Written by Kristen Schuster, Practice Facilitator The 10\/27 blog outlined the care management model of behavioral health integration. 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