[PC-BH-Integration] PC-BH-Integration Digest, Vol 28, Issue 5

[Barbara Mauer]

Michael is correct, each state is different. Medicare has adopted the
96000 codes, but each state Medicaid agency must independently adopt the
codes and, if they have a managed care system, include them in their
contracts with MCOs. 

HRSA PIN 2004-05 mandates that FQHCs must be reimbursed for BH care, but
not specifically the 96000 codes. Several states chose to use them as
their way of responding to the HRSA directive. Sandy Blount is right on
when he says it is a matter of advocacy. The codes came out during the
Medicaid crunch of the last few years, when states were cutting
Medicaid, not adding to costs--and Medicaid directors have asked me,
"where will the $ come from to cover these new codes?" 

Unfortunately, the research on medical cost offset (mostly done on
privately insured individuals)is equivocal. We need to advocate for
research on the benefits of integration for the Medicaid
population,including medical cost offsets, which Marshall Thomas at
Colorado Access was able to demonstrate.


Barbara J. Mauer
MCPP Healthcare Consulting
414 Olive Way, Suite 207
Seattle, WA 98101
Direct phone/voice mail: 206-352-2662
Office phone/voice mail: 206-613-3339, X 104
Fax: 206-332-1710
barbara at mcpp.net
www.mcpphealthcare.com
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