This article is intended for primary care providers and mental health providers
Patients with co-existing medical and mental health conditions benefit when their primary care providers and mental health providers collaborate. The benefits can include lower readmission rates, improved follow-up, and fewer complications with prescribed treatment and medication.
- Nationally, almost 40% of family physicians reported collaborating with mental health providers1.
- In our network, only 20% of PCPs reported receiving consultation reports from mental health therapists and only 22% reported receiving them from psychiatrists, compared to rates above 80% from medical specialists to whom PCPs make referrals, such as cardiologists, pulmonologists, endocrinologists, and oncologists.
We’d like to share some frequent misconceptions that inhibit greater coordination between primary care and mental health providers.
Misconception #1: Privacy laws prevent coordination of care.
Many providers believe that privacy laws that protect patients’ personal health information prevent them from sharing information for effective care across disciplines. In reality, HIPAA and 42 CFR Part 2 support sharing information required for coordination of care.2 Some tips for how to coordinate care in compliance with these laws include the following:
- Talk to your patient about how care collaboration can lead to better results.
- Explain to them that to get an overall picture of their health, their providers need to understand each patient’s history, including diagnoses, treatment plans, and medications.
Misconception #2: Coordination of care isn’t valued or reimbursed by patients’ insurance.
In fact, CPT codes account for time used for collaboration. For example, each time-based psychotherapy CPT code includes the specified minutes face-to-face with the patient AND an additional 15 minutes for pre- and post-work, writing notes, and collaborating.
We encourage primary care providers to offer Psychiatric Collaborative Care Management services. These services allow your patients—our members—to be cared for through a team approach, involving a primary care provider, mental health care manager, and a psychiatric consultant.
For more information on care management coding, see our Collaborative Care Management fact sheet Collaborative Care Management fact sheet.
Misconception #3: Coordination of care with a primary care provider isn’t necessary to a patient’s treatment.
While not every patient’s mental health care require coordination with a primary care provider, there are situations in which it improves clinical outcomes. For example, patients with serious medical conditions may have co-occurring mental health conditions, such as insomnia, depression, anxiety, or substance use disorder, that can exacerbate their medical condition. Informing the primary care provider of your treatment plan can be an effective way to treat the whole person and improve health outcomes.3
“When primary care providers have information about the mental health care that their patients are receiving,” notes Greg Harris, Blue Cross Senior Medical Director, Mental Health, “they are better able to guide the delivery of safe, appropriate, and effective care for the patients’ medical conditions.”
1 The Annals of Family Medicine March 2023, 21 (2) 157-160; DOI: https://doi.org/10.1370/afm.2947
2 HIPAA Privacy Rule
3 Medicine (Baltimore). 2022 Dec 30; 101(52): e32554.
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