DHCF Unveils Reimbursement Rates for New Behavioral Health Integration Services

Last December, the DC Department of Health Care Finance (DHCF) announced reimbursement rates for two new services that integrate behavioral health care with physical health care: Interprofessional Consultations and Collaborative Care. The rates for both services are based on an ongoing behavioral health rate study between the Department of Behavioral Health (DBH) and DHCF and are included in the Physician Fee Schedule, effective January 1, 2024.

The new reimbursement rates enable billing for consultative and management services by clinicians when conducted on behalf of DC Medicaid beneficiaries, even when the beneficiary is not present. For instance, interprofessional consultation codes permit referring providers or specialists to discuss a patient’s case electronically or by phone. Econsults can enhance the primary care provider’s ability to address complex conditions, reducing waiting times for specialty care and improving overall patient and specialty satisfaction. Similarly, the Collaborative Care model supports integrated care by delivering more services in the medical home (primary care) and efficiently triaging complex cases for specialty care, such as psychiatry.

More details about these new codes and care models are forthcoming. Integrated Care DC coaches are also readily available to provide guidance for your practice on ways to implement and maximize these services to support high-quality, whole-person care.