BHI Billing Guide

What is Behavioral Health Integration (BHI)?

Behavioral Health Integration (BHI) connects behavioral and medical health providers together to collaborate with patients to address the crossing of behavioral and medical conditions that affect health and well-being. BHI aims to create one setting to address health concerns.

Components of Implementing BHI

Patient Consents & Initial Setup

Acquire consent from patient to provide BHI services (Verbal and written(Annually)

Daily Recordings and Data Transmission

Assign systematic validated clinical Rating Scales for monitoring

Monitoring Data and Billing

Coordinate with other Care Memebers and billing for BHI services

The Workflow



Create an BHI work-flow, establish documentation, and BHI billing procedure



Train qualified clinical staff to help remotely monitor patients' vitals.



Acquire consent from patient to be monitor under Behavioral Heath Integration



Educate patients on services and get care members involved in the program.



Patient sync and health data remotely monitor by physician/clinical staff.



Submit eligible patients for billing and get reimburse for monthly monitoring.

RTM CPT Billing Code Guide

CPT 99421

BHI Care Management
$ 35 Once per Episode Of Care
  • 20-minutes of behavioral health services in subsequent months

Qualified Care Members

Clinical Staff

  • Continuous relationship with the beneficiary and a collaborative, integrated relationship with the rest of the care team
  • May or may not be a professional who meets all the requirements to independently deliver and report services to Medicare
  • Does not include administrative or clerical staff time may include (but is not required to include) a behavioral health care manager

Frequently Ask Questions

Prior beneficiary consent is required for all of the BHI codes, recognizing
that any applicable rules continue to apply regarding privacy. The consent

will include permission to consult with relevant specialists, including a psychiatric consultant, and inform the beneficiary that cost sharing will apply to

in-person and non-face-to-face services
provided. Consent may be verbal (written consent is not required)

No, new consent is only required if the patient changes billing practitioners, in which case a new consent must be obtained and documented by the new billing practitioner prior to furnishing the service.

There are many conditions covered under the BHI umbrella. Eligible conditions include any mental, behavioral health, or psychiatric condition, including substance use and other disorders.

A beneficiary is eligible for Behavioral Health Integration Services (BHI) if he/she is being treated by the billing healthcare provider for any mental, behavioral health, or psychiatric diagnosis that the billing healthcare