Priority Health supports psychiatric collaborative care management (PCCM)

Priority Health recognizes that there is a great shortage of psychiatric specialists and that primary care providers often have to treat members with behavioral health conditions.

Effective Jan. 1, 2018, we began supporting collaboration between primary care providers and psychiatric specialists who participate in a collaborative model of care, both by paying collaborative care codes and through care management incentives.

Collaborative care models

We encourage primary care practices to develop practice alignment with the Compass or Diamond models of collaborative care, or with any evidence-based model.

A collaborative model uses a psychiatrist embedded within the treatment team who helps the primary care providers provide comprehensive care to patients. Services are reported by the treating primary care physician or qualified health care professional (QHP). The psychiatric specialist is paid under contractual arrangement with the primary care practice.

Collaborative care codes paid

Priority Health allows payment of psychiatric collaborative care management codes 99492, 99493 and 99494 effective January 1, 2018. These codes are covered for all products.

Care management incentives

For more coding and incentive details, see our CPC+ Incentive Program or our PCP Incentive Program.