Integrated Behavioral Health Services Gain Traction in Primary Care

How Medicare billing changes are helping primary care and mental health finally share the same office

Summary: Insurers are increasingly supporting the integration of behavioral health services into primary care settings, driven by Medicare billing codes that make collaborative care financially viable. This model, involving coordination among primary care providers, behavioral health managers, and psychiatric consultants, has seen significant growth, enhancing access to mental health services for Medicare Advantage enrollees.

Integrated behavioral health services are gaining traction in primary care, thanks in part to new Medicare billing codes that support collaborative care. This model—bringing together primary care providers, behavioral health managers, and psychiatric consultants—has seen steady growth and may help solve America’s fragmented mental health access problem.

Why Behavioral Health Is Finally Sitting at the Primary Care Table

For decades, the U.S. healthcare system treated mental health as a separate and often neglected silo. Primary care doctors managed blood pressure and cholesterol. Meanwhile, patients struggling with depression or anxiety were told to seek care elsewhere—often from an overstretched, underfunded mental health system.

That’s starting to change.

Integrated behavioral health is a model that embeds mental health services directly into primary care settings. Think of it as bringing a therapist or psychiatric consultant into your regular doctor’s office—not just in spirit, but often in person or via real-time consults. With new billing incentives from Medicare, and growing interest among insurers and policymakers, the U.S. is finally moving toward a more connected model of care.

A 2023 report by the Commonwealth Fund explained it plainly: “When behavioral health and primary care work together, outcomes improve, costs fall, and access widens.”

Understanding the Collaborative Care Model

The most widely supported version of integration is the Collaborative Care Model (CoCM), which coordinates care among:

• A primary care provider (PCP)

• A behavioral health care manager (typically a licensed counselor or social worker)

• A psychiatric consultant (such as a psychiatrist available for consults)

Using a patient registry, this team identifies patients in need of mental health support, monitors treatment outcomes, and adjusts care plans collaboratively. The model is evidence-based and has been shown to improve treatment of common disorders like depression and anxiety.

This care framework is made financially viable through Medicare’s introduction of specific billing codes for collaborative care management. The most significant of these include CPT codes 99492, 99493, and 99494, which reimburse PCPs for coordinating behavioral health services.

And the payoff? A study published in Health Affairs found that integrated care can reduce overall healthcare spending by up to 10% by decreasing emergency room visits and hospitalizations.

Medicare Advantage and the Growth of Integration

Medicare Advantage plans—privately run alternatives to traditional Medicare—have played a key role in accelerating adoption. According to a 2022 report from the Bipartisan Policy Center, nearly 80% of Medicare Advantage enrollees now have access to some form of integrated behavioral health services.

This is not just a fringe initiative. In fact, the American Medical Association has identified behavioral health integration as a top priority for improving care access nationwide.

As of 2024, over 5,600 primary care practices in the U.S. have adopted the Collaborative Care Model, up from just 1,200 in 2016.

What’s Driving the Shift?

Several trends are aligning at once:

1. Increased demand for mental health care, especially since the COVID-19 pandemic.

2. Shortages in psychiatric providers, making primary care involvement essential.

3. Policy momentum, including bipartisan interest in fixing mental health access.

4. Evidence of cost-effectiveness and improved outcomes from integration.

Dr. Arpan Waghray, Chief Medical Officer at Providence, summed it up best: “Mental health is health. You can’t treat one without the other.”

Barriers Still Exist

Despite momentum, challenges remain. Many clinics lack trained behavioral health care managers. Reimbursement models vary by state and payer. And stigma—both among patients and providers—can hinder adoption.

Still, industry experts see integrated care as one of the most promising developments in U.S. health delivery. With Medicare and Medicare Advantage paving the way, private insurers are also exploring how to adapt these models for their networks.

We’re a long way from solving America’s mental health crisis—but integrated care is a step toward progress. The real test will be scaling these models without watering them down and ensuring they reach the communities that need them most.

Medical Disclaimer

The information provided in this article is for educational and informational purposes only and is not intended as medical advice. It should not be used to diagnose, treat, cure, or prevent any medical or mental health condition. Always seek the guidance of a qualified healthcare professional or licensed mental health provider with any questions you may have regarding a medical condition, diagnosis, or treatment. Never disregard professional medical advice or delay seeking it because of something you have read here.