FOR RELEASE OCTOBER 25, 2018

Media Contact: Chris Sardelli, christopher.sardelli@atriumhealth.org

Providers who have assisted patients with psychiatric collaborative care management in primary care settings can now be reimbursed for the services, per a recent statement from N.C. Medicaid.

Karen Melendez, MD, CCPGM Network Psychiatrist

Community Care Partners of Greater Mecklenburg (CCPGM) Network Psychiatrist Karen Melendez, MD, said in recent years the Collaborative Care model has been at the forefront of multiple discussions at the national, state and regional level.

The collaborative care model works by involving a multidisciplinary group of healthcare professionals to deliver coordinated care to a patient. In this case, behavioral health care managers work alongside primary care providers and psychiatrists to customize care for behavioral health patients who are being followed through a patient registry.

“The CCNC (Community Care of North Carolina) central office Behavioral Health team has been meeting with DMA monthly and advocating for the collaborative care codes to be reimbursed by N.C. Medicaid,” Melendez said. “The Collaborative Care Codes became active on N.C. Medicaid on Oct. 1. This means that North Carolina is the third state in the country, only behind New York and Washington, where the model was developed, to approve reimbursement of the codes by Medicaid.”

The reimbursement rates are as follows:

  • 99492: $73.86, $130.64 (facility rate, non-facility rate)
  • 99493: $66.78, $104.54 (facility rate, non-facility rate)
  • 9949
    4: $35.63, $54.08 (facility rate, non-facility rate)

The full description of the approved codes can be found starting on page 18 of the N.C. Medicaid September Provider Bulletin at: https://files.nc.gov/ncdma/documents/files/Medicaid-Bulletin-2018-09_0.pdf.

“The American Psychiatric Association, along with the University of Washington AIMS Center, has been working diligently on training psychiatrists in this new consulting role,” Melendez said.

The goal, she said, is to train 3,500 psychiatrists over four years.

“The collaborative care model will impact the 50 percent of patients that do not follow through when referred to psychiatric services and improve the care of the 70 percent of patients who obtain mental health care in primary care clinics,” she said.

Primary care providers who want to learn more about the model can earn free CME through the American Psychiatric Association at:

https://education.psychiatry.org/Users/ProductDetails.aspx?Activityid=4743&ProductID=4743&_ga=2.200146861.229620433.1536002332-1018866782.1527004955

About CCPGM

Community Care Partners of Greater Mecklenburg is a community-based healthcare network participating in the statewide Community Care of North Carolina (CCNC) physician-led program. Since 2002, CCPGM has provided care coordination and care management for Medicaid recipients and others in Anson, Mecklenburg and Union counties. CCPGM works with primary care providers, hospitals, health departments, behavioral health management entities, Departments of Social Services, housing agencies, crisis providers, and other local community agencies and resources to provide the best coordinated care for its patients. The network has about 190,000 enrollees and 189 medical homes practicing family medicine, obstetrics, internal medicine and pediatrics.

To learn more, visit CCPGM online at www.ccpgm.org, or on Facebook, Twitter (CCPGM) and Instagram (CCPGM_NC).

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