Reimbursement Models and Financing

Reimbusement models and financing play an important part in the success of integrating behavioral health into the patient-centered medical home. However, multiple barriers currently exist for the reimbursement of mental health services in primary care settings.  In recent years, several studies and reports have been developed by both the public and private sectors in efforts to provide resources and solutions to this problem.

Examples & Reports

Reimbursement of Mental Health Services in Primary Care Settings, Substance Abuse and Mental Health Services Administration, Center for Mental Health Services

Mental Health and Substance Abuse Procedure Codes, The National Association of State Alcohol and Drug Abuse Directors, Center for Substance Abuse Treatment

Primary Care Depression Reimbursement “Myths vs Facts," Mid-America Coalition on Healthcare;

Aetna launched their Depression Management Initiative in 2005 based on the MacArthur Initiative on Depression and Primary Care's Three-Component Model (3CM) and added to it reimbursement for primary care physicians for administration of the PHQ-9.

Financing: Strategies & Opportunites. The Business Case for Integration.  SAMHSA-HRSA Center for Integrated Health Solutions

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