Wiki Can PCP's bill w/a Behavorial Health diag?

[KolarSue]

Morning fellow coders!
Can a PCP bill with a behavioral health (mental health or substance abuse) diagnosis?
Also, can the PCP bill for the drugs Suboxone or Buprenorphine?

Thanks!

 

[mitchellde]

Of course you can do this. However the payer may make the determination that your provider is not a behavioral health specialist and they can decline to pay for these services in he PCP office setting. If you are in an area that is underserved for behavioral health then the answer is probably different. You should check with the payers first.
You may wNt to check into the psychiatric collaborative care management (PCCM) introduced January 1, 2018 : 99492, 99493 and 99494. These are for PCP providers to deliver psychiatric services. You will need an additional provider designated as the behavioral care manager and a contractual arrangement with a behavioral health provider. But it could be a way for your office to deliver psychiatric services to a population that might not otherwise receive this service.