Behavioral Health Integration

BHI & CoCM Period: Calendar month Source: CMS-1832-F (CY 2026 PFS Final Rule)

What it is

Behavioral Health Integration (BHI) covers care management for patients with a diagnosed behavioral health or substance use condition. Two tracks:

General BHI (99484) — clinical staff time providing behavioral health care management, monthly.
Psychiatric Collaborative Care Model (CoCM) — a structured team-based model with a primary care practitioner, a behavioral health care manager, and a psychiatric consultant (99492 / 99493 / 99494).

How willowbridge bills it: general BHI as 99484, or G0570 when the same practitioner's APCM month for the patient has closed; Collaborative Care as 99492–99494, or G0568 / G0569 in that same case. A Collaborative Care month bills only when its three elements are on the record for that month.

Who qualifies

Patient has a diagnosed behavioral health or substance-use disorder (ICD-10 F-code or behavioral diagnosis on file).
Consent on file.
General BHI: ≥ 20 min of clinical staff time per month directed by the billing practitioner.
CoCM: structured team in place (BH care manager + psychiatric consultant) with registry tracking, weekly case load review, and validated symptom measurement. willowbridge checks for the psychiatric consultant, the behavioral diagnosis and a rating scale in the month before the month can bill.

Codes & when to bill them

How the minutes add upGeneral BHI bills a single 99484 at 20 minutes of staff and provider time combined. Collaborative Care bills 99492 in the first month at 70 minutes, 99493 in later months at 60, and 99494 for each additional 30 — but only when the month shows its three elements: a psychiatric consultant on the care team, a behavioral diagnosis on the care plan, and a validated rating scale (such as the PHQ-9 or GAD-7) given in the month. Until they are recorded the month holds instead of billing. For an APCM patient whose APCM month under the same practitioner has already closed, the month bills as the APCM add-on instead: G0570 for general BHI, G0568 (first month) or G0569 (later months) for Collaborative Care.

Each billable code, with the requirements that must be on file to bill it.

99484General Behavioral Health Integration — at least 20 minutes of clinical staff time per calendar month.

RequirementsBehavioral diagnosis; consent; 20+ min documented; signed care plan.
G0570APCM behavioral-health add-on for general BHI for an APCM patient. willowbridge bills it in place of 99484, so the month still needs 20 minutes.

RequirementsOnly with the same practitioner's APCM claim (G0556–G0558) for the month; never in the same month as 99484. willowbridge swaps it in once that APCM month has closed.
99492Initial 70 minutes of CoCM in the first calendar month of enrollment.

RequirementsFirst Collaborative Care month only; 70+ min; psychiatric consultant on the care team, behavioral diagnosis on the care plan, validated rating scale in the month.
99493Subsequent months: 60 minutes of CoCM care management.

RequirementsMonths after the first; 60+ min; the same three elements on the record for the month.
99494Each additional 30 minutes of CoCM in any month (with 99492 or 99493).

RequirementsAdd-on to 99492 / 99493.
G0568APCM behavioral-health add-on — first month of Collaborative Care for an APCM patient (time-de-linked mirror of 99492).

RequirementsOnly with the same practitioner's G0556–G0558 for the month; never in the same month as 99492–99494; the same three Collaborative Care elements.
G0569APCM behavioral-health add-on — later months of Collaborative Care for an APCM patient (time-de-linked mirror of 99493).

RequirementsOnly with the same practitioner's G0556–G0558 for the month; never in the same month as 99492–99494; the same three Collaborative Care elements.

Documentation required every cycle

Behavioral diagnosis documented (or rationale for override).
Time log for clinical staff or care manager.
For CoCM: registry of patients, measurement-based care tracking (e.g., PHQ-9, GAD-7), and weekly psychiatric-consultant caseload review documented.
Patient consent.
Practitioner sign-off.

What's new in CY 2026

CY 2026: when the same practitioner bills a patient's APCM, behavioral integration bills through the APCM add-on codes alongside that practitioner's G0556–G0558 for the month — not through 99484 / 99492–99494. The two families are mutually exclusive within a calendar month. G0570 mirrors general BHI, G0568 the first Collaborative Care month, and G0569 the months after.

Built-in patient consentwillowbridge exclusive

Every program ships with compliant, CY-2026 patient consent language — read verbatim into the in-app consent capture flow, captured with date + modality, and version-pinned to each claim, so the consent on file always matches the consent that was billed. No more chasing signatures or re-papering when the rule changes.

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