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New Payment Codes Represent a Big Win for Psychiatry, Collaborative Care

     

Last week, the Centers for Medicare & Medicaid Services (CMS) announced that Medicare plans to begin coverage and reimbursement for "Psychiatric Collaborative Care Management Services" as part of its proposed Medicare Physician Fee Schedule rule starting in 2017. This represents a huge win for our patients struggling with mental health and substance use disorders and for psychiatrists.

"Psychiatric Collaborative Care Management Services," — based upon the "Collaborative Care Model" (CoCM) developed by Jürgen Unützer, M.D., and pioneered by the late Wayne Katon, M.D., at the AIMS Center of the University of Washington — are designed to improve care for patients who receive treatment for mental health and substance use disorders through their primary care provider. CoCM is the only evidence-based model of its kind, proven effective in more than 80 randomized controlled trials.

It is no secret that there is a shortage in the psychiatric workforce. In light of this, psychiatrists can work with primary care physicians to ensure access and quality of care for our patients.

APA Resources

Under the CoCM, a consulting psychiatrist provides the primary care practice with the benefit of their specialized expertise through regular case review and recommendations for therapeutic and pharmacological treatment, medication adjustments, and the need for additional specialty care.

APA is committed to ensuring patient access to the quality care they need. To do this, we must ensure that psychiatrists are leaders in new delivery models and that our health care systems fully implement collaborative care models across the country. As part of that effort, APA was awarded a grant from CMS to train psychiatrists and primary care physicians in collaborative care and to encourage health care systems to implement this evidence-based model of CoCM.

We are delighted with the success of our training efforts in our first year, having already exceeded our year one goals for the number of psychiatrists trained on May 17, 2016. In fact, one of the first trainings was here in New York, hosted by my home institution. So far, we have trained 547 psychiatrists either via online sessions or live trainings at our district branch meetings and APA’s Annual Meeting. Once they complete their advanced training and begin practicing the CoCM, these psychiatrists will be ready to participate in learning collaboratives and become certified in collaborative care. Those who become certified will connect with other physician training networks and participating practices to implement CoCM programs.

Our work in the Transforming Clinical Practice Initiative (TCPI) will eventually train 3,500 psychiatrists in collaborative care and offer them the skills needed to support primary care practices implementing collaborative care programs for mental health and substance use disorders.

Having the payment codes for these collaborative care services will only help to strengthen an initiative that is sure to become a key component of mental health care in the future. The final CMS rule is expected in November. Until then, APA will be actively engaged and offer comments to CMS.

What APA is Doing for You

This blog post is part of an occasional series highlighting how APA advocates on your behalf to support the profession of psychiatry and put our interests before key policymakers.

     

Post by Maria A. Oquendo, M.D., Ph.D.

Maria A. Oquendo, M.D., Ph.D., is the President of APA. Read Dr. Oquendo's full biography.

President BlogWhat APA is Doing for You

 

Comments (1) Add a Comment

  • LaTonia Sweet

    So wonderful to hear. We are finally making progress towards making more efficient care sustainable.

 

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