Blue Cross NC Launching Phase 1 of Behavioral Health Collaborative Care for Health Systems, Provider Groups and Providers

Blue Cross and Blue Shield of North Carolina (Blue Cross NC) will continue to support the improved quality and decreased total cost of care through integrated treatment of mental and physical health – a Collaborative Care Model (CoCM).  

The CoCM is a specific type of integrated care developed at the University of Washington that treats common mental health conditions such as depression and anxiety that require systematic follow-up due to their persistent nature. Based on principles of effective chronic illness care, Collaborative Care focuses on defined patient populations tracked in a registry, measurement-based practice and treatment to target.  

Blue Cross NC will pay for collaborative care codes in a phased approach. The phased implementation will give all qualifying providers an opportunity to be reimbursed for CoCM on a fee-for-service basis, given that they have demonstrated their ability to deliver to key components of the CoCM (ie: registry, screening, case managers, psychiatric consultation in primary care).  

• Phase 1: Providers must complete an attestation to demonstrate their ability to deliver Collaborative Care. Blue Cross NC will reimburse those providers for Collaborative Care codes. 
• Phase 2: Participants will provide clinical quality data to Blue Cross NC. Blue Cross NC will help providers develop a CoCM program and evaluate effectiveness. 

Next Steps

Blue Cross NC is currently in phase 1 – we are welcoming all providers to develop a CoCM program and be considered for collaborative care reimbursement. If you are interested, you will need to attest that you can deliver the key components of CoCM (see below) by filling out this form. We will accept attestation on a rolling basis. 

The following are high level components of the attestation.  

• Behavioral Health Care Management  
• Behavioral Health Screening  
• Behavioral Health Registry  
• Psychiatry Consultation  

Below are the codes Blue Cross NC will reimburse during phase 1, starting July 1, 2022.

(NCDHHS, MC Medicaid, Division of Health Benefits, 2022)

Coverage for Psychiatric Collaborative Care Management Updated | NC Medicaid (ncdhhs.gov)

If you have any questions about the launch of our Collaborative Care Model or about participating, please email us at BehavioralHealth@bcbsnc.com. We look forward to partnering with you!