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2026.36 - Provider Bulletin - Behavioral Health Integration - Psychiatric Collaborative Care Model (CoCM)
Effective date
Jul 1, 2026
Identified
Jul 11, 2026
Summary
Effective for dates of service July 1, 2026, CMAP covers and reimburses the psychiatric Collaborative Care Model (CoCM) for HUSKY Health A, B, C and D members, using CPT codes 99492, 99493 and 99494 and HCPCS code G2214. All CoCM elements are required, and services must be furnished within the calendar month, not a rolling 30-day period. Outpatient hospitals cannot bill CoCM because it is a professional service, and FQHCs are reimbursed for CoCM at a set rate on the FQHC fee schedule separate from the medical encounter rate.
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What to do
Action · 11 steps
01Already effective July 1, 2026: Before CoCM referral, the treating/billing practitioner must obtain and document the HUSKY Health member's written or electronic consent, including permission to consult with specialists such as a psychiatric consultant.
02A new consent is required after a break in care of 6 consecutive months without CoCM services.
03Start CoCM with a face-to-face E/M visit or preventive physical exam with the treating/billing practitioner for new patients or patients not seen within the prior 12 months, and document CoCM in that visit; otherwise the visit does not qualify as the initiating visit.
04Only the treating/billing practitioner may furnish the initiating visit, determine medical necessity and refer to the behavioral health care manager.
05Bill CoCM only with the time thresholds in the CPT/HCPCS code descriptions, counting only direct member clinical work and collaboration with care team members, and do not count administrative or clerical time.
06Keep a record for each member with name, address, birth date, Medicaid ID number, pertinent diagnostic information, dates, time and mode of delivery (telehealth or in-person) for each CoCM service, the referral, and the treating/billing practitioner's co-signature in the calendar month billed.
07Confirm that the treating/billing practitioner, behavioral health care manager and psychiatric consultant are active and fully enrolled in HUSKY Health (the psychiatric consultant at minimum as an OPR provider).
08Use only HIPAA-compliant telehealth software and verify member and provider identity before telehealth services.
09List T1015 on an FQHC claim only when a separately payable and distinct medical encounter visit was furnished on the same date of service.
10All elements of CoCM are required, and services must meet every element to be eligible for reimbursement under CMAP.
11Refer to the CoCM FAQs on ctdssmap.com for care team member roles.
Codes mentioned
994929949399494G2214T1015
Original notice
2026.36 - Provider Bulletin - Behavioral Health Integration - Psychiatric Collaborative Care Model (CoCM)
ctdssmap.com · Always check the source before changing claims.
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