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.
We’d like to share some frequent misconceptions that inhibit greater coordination between primary care and mental health providers.
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:
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.
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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