BHI Software & Services
Behavioral Health Integration Software and Services
HealthArc gives primary care and specialty practices everything needed to launch, operate and bill a compliant Behavioral Health Integration program: clinical workflows, validated screening tools, care team coordination and CPT billing support in one platform.
From PHQ-9 screening to CPT 99484 billing, HealthArc operationalises BHI (and the higher-intensity Collaborative Care model (CoCM)) without adding administrative burden to your existing care team.
HIPAA Compliant
AICPA SOC 2 Type II
42 CFR Part 2 aligned
Primary care, FQHCs, cardiology & endocrinology
PHQ-9 · GAD-7validated, trended, in-platform
BHI & CoCM codesMedicare + most commercial plans
99484General BHI: 20+ min / month~$49
99492CoCM initial month: 70+ min~$290
99493CoCM subsequent month: 60+ min~$193
99494Each additional 30 min of CoCM~$90
1 in 5U.S. adults experiences mental illness each year
40%higher CVD risk with a mental health condition
<50%of affected adults receive any treatment
30–45 daystypical time to first billable month
Program Overview
What Is Behavioral Health Integration (BHI)?
Behavioral Health Integration (BHI) is a structured care model in which mental and behavioral health services are delivered inside primary care or specialty settings, rather than referred out to a separate behavioral health provider. Under CMS guidelines, BHI is a reimbursable service: care teams can bill for coordinating, monitoring and treating behavioral health conditions alongside a patient’s primary medical diagnoses.
BHI isn’t a referral model with better paperwork. In a true BHI program a designated behavioral health care manager (typically a licensed clinical social worker, psychologist or trained nurse) works within the practice team, maintains a caseload registry, conducts regular assessments and coordinates with the treating physician and, where the model requires it, a consulting psychiatrist. Care is systematic and population-based, not reactive.
CMS reimburses two primary pathways. General BHI (CPT 99484) covers at least 20 minutes per calendar month of behavioral health care management for a patient with a behavioral health condition. Psychiatric Collaborative Care Management (CoCM, CPT 99492, 99493, 99494) is a more structured model requiring a designated care manager and a consulting psychiatrist who performs regular caseload review.
HealthArc provides the software infrastructure and the care team to run both pathways: patient registries, screening workflows, care manager task queues, psychiatrist consultation documentation and billing-ready time logs.
Care model
Behavioral health delivered inside primary care or specialty settings
General BHI
CPT 99484: 20+ minutes / month, designated care manager, no psychiatrist required
CoCM
CPT 99492 · 99493 · 99494: care manager plus consulting psychiatrist caseload review
Screening tools
PHQ-2, PHQ-9, GAD-7, AUDIT, PC-PTSD-5, C-SSRS
Who bills
The treating physician or qualified NPP overseeing the patient’s care
Code reference
BHI or CoCM? BHI (99484) is the lower-complexity pathway: a designated care manager, no psychiatric consultant, and the right starting point for a practice new to behavioral health. CoCM (99492–99494) adds a consulting psychiatrist reviewing the caseload, generates materially higher reimbursement, and suits higher-acuity populations. HealthArc supports both and will help you decide which fits your panel and staffing.
Who It’s For
Who Uses HealthArc’s BHI Program?
Built for outpatient practices that want to deliver mental health support within their existing clinical model, without standing up a separate behavioral health department.
Practice Types
- Primary care practices: independent, multi-site and FQHC
- Internal medicine and family medicine groups with complex panels
- Cardiology and endocrinology specialists whose outcomes are affected by untreated behavioral health conditions
- Federally Qualified Health Centers serving high-prevalence populations
- ACOs and value-based care groups tracking behavioral health HEDIS measures
Patient Populations
- Major depressive disorder and persistent depressive disorder
- Generalised anxiety, panic disorder and social anxiety disorder
- Post-traumatic stress disorder (PTSD)
- Bipolar disorder managed in a primary care or specialty setting
- Substance use disorders: alcohol, opioid, stimulant and others
- Behavioral health conditions comorbid with diabetes, heart failure, COPD or hypertension
Care Team Roles
- Behavioral health care managers: LCSWs, LPCs, psychologists or trained RNs
- Consulting psychiatrists performing CoCM caseload review
- Treating physicians and NPPs as the billing practitioner
- Billing staff managing monthly CPT threshold attainment
When a Patient Is a BHI Candidate
Patients are candidates for BHI enrolment when both of the following are true:
- The patient has a documented behavioral health condition: depression, an anxiety disorder, PTSD, substance use disorder, or a behavioral health comorbidity alongside a chronic condition
- The treating provider determines the patient requires ongoing care management beyond a standard office visit
There is no CMS-published exhaustive list of qualifying diagnoses. The standard is that the patient has a recognised behavioral health condition and the treating provider has determined systematic care management is medically appropriate.
The Platform
Behavioral Health Integration Software Features
HealthArc consolidates every clinical and administrative function needed to operate a compliant BHI or CoCM program: no separate scheduling system, no paper registries, no manual billing logs.
Patient Registry & Caseload Management
- Real-time registry of all enrolled BHI patients
- Filter by risk tier, screening score, last contact date or care manager
- Prioritised outreach queues so no patient falls through the gaps
- Caseload balancing across care managers and sites
Validated Screening Tools
- PHQ-2, PHQ-9, GAD-7, AUDIT, PC-PTSD-5 and C-SSRS administered in-platform
- Scores recorded, trended over time and surfaced on the patient record
- Automatic contribution to the patient’s Behavioral Health Index score
- Reassessment cadences set by risk tier
Care Manager Task Workflows
- Assign, track and document outreach, coordination calls, counselling sessions and care plan updates
- Time-stamped entries that feed billing-ready monthly summaries
- Activity-type tagging so documentation matches the code billed
- Overdue-task escalation to supervising clinicians
Psychiatrist Consultation & Caseload Review
- Structured caseload review sessions between care manager and consulting psychiatrist
- Documentation templates aligned to CMS requirements for 99492 / 99493 / 99494
- Treatment recommendation capture and routing to the treating provider
- Consultation participation log for CoCM audit defence
Virtual Visits: Individual and Group
- HIPAA-compliant video sessions with assessment history and care plans on screen
- Text and audio alternatives for patients with connectivity barriers
- Session documentation attached to the encounter record
- Group session support for practices running structured programs
Billing-Ready Time Logs
- Care management time aggregated per patient, per calendar month, automatically
- Mapped to the applicable threshold: 20 min for 99484, 70 min for 99492, 60 min for 99493
- Patients approaching but not yet meeting thresholds flagged before month end
- Documentation exported or synced to your EHR in structured formats
Care Team Model
BHI Services: What HealthArc’s Care Team Delivers
HealthArc isn’t a software-only vendor. For practices without existing behavioral health staff, HealthArc provides embedded care team support, so a clinic can launch BHI without hiring a behavioral health care manager before it has the volume to justify the headcount.
Behavioral Health Care Management
Licensed care managers (LCSWs or equivalent) manage enrolled caseloads: initial assessments, brief behavioral health interventions, screening score monitoring and coordination with the primary care provider.
Care Plan Development
Individualised behavioral health care plans aligned to each patient’s diagnosis, goals and treatment setting.
Systematic Patient Outreach
Outreach cadences set by risk tier (weekly contact for high-acuity patients, monthly for stable patients) with full documentation of every interaction.
Psychiatrist Caseload Consultation
For CoCM-enrolled patients, a consulting psychiatrist reviews cases, provides treatment recommendations and documents participation per CMS requirements.
Warm Handoffs & Referral Coordination
When a patient needs a higher level of care (inpatient psychiatric care, IOP or substance use treatment) the care manager facilitates the referral and maintains continuity documentation.
Billing Documentation Support
All activity is documented in a format that supports CPT submission, reducing the load on your billing department.
Option 1
Software only
Your existing behavioral health or nursing staff run the program in HealthArc: registry, screening, documentation, time tracking and billing summaries.
Best for: practices with existing BH staff
Option 2
Embedded care management
HealthArc provides care managers who operate as an extension of your care team, billed at the program level.
Best for: practices with no BH headcount yet
Option 3
Full-service BHI
HealthArc manages the whole program (care management, psychiatrist consultation for CoCM and billing support) so small and mid-size practices can launch without incremental FTEs.
Best for: launching CoCM without a psychiatrist on staff
The most common objection to starting a BHI program is “we don’t have the staff for this.” All three configurations exist so that staffing is a choice rather than a precondition.
Billing & Reimbursement
BHI and CoCM CPT Code Billing Workflow
Behavioral Health Integration and Collaborative Care Management are reimbursable under Medicare and most commercial plans when documentation and time requirements are met. HealthArc automates the tracking and documentation each code requires.
~$49 / mo
99484
General BHI: 20+ Minutes
- 20+ minutes of BH care management per calendar month
- Designated care manager: no specific licence required by CMS
- Billed by the treating physician or qualified NPP
- Monthly time log with activities, dates and duration
~$290
99492
CoCM: Initial Month
- 70+ minutes of care manager time in the first month
- Required psychiatric caseload consultation
- Consulting psychiatrist may participate remotely
- Billed by the physician / NPP where services are furnished
~$193 / mo
99493
CoCM: Subsequent Months
- 60+ minutes of care management activity per month
- Ongoing psychiatric consultation
- Continuous documentation of caseload review
- Billed monthly for as long as the patient is enrolled
~$90
99494
CoCM: Each Additional 30 Min
- Each additional 30 minutes beyond the 99492 / 99493 threshold
- For higher-acuity patients in the same calendar month
- Requires continuous time documentation
- Billed as an add-on only
What Must Be Documented
- The patient’s behavioral health diagnosis and the provider’s determination that care management is appropriate
- A designated care manager performing the clinical activities
- A monthly time log recording specific activities, dates and durations
- For CoCM: documented psychiatric caseload consultation and treatment recommendations
- Screening results and score trends supporting clinical decision-making
- The care plan and its updates over the enrolment period
The Monthly Billing Workflow in HealthArc
1
Care managers document every patient interaction in HealthArc, with activity type and duration captured at point of entry
2
At month end HealthArc aggregates total care management minutes per patient and maps them to the applicable CPT threshold
3
The billing dashboard lists patients who have met each code’s threshold, with supporting documentation ready for submission or export
4
Patients below the minimum threshold are flagged so teams can decide whether to extend outreach before the month closes
A 150-patient CoCM caseload billed at the 99493 subsequent-month rate is an estimated $29,000 per month, before 99494 add-ons for higher-acuity patients.
Calculate Your RevenueReimbursement figures are approximate national non-facility Medicare averages and vary by geographic locality, facility status, payer and calendar year. CMS updates them annually in the Physician Fee Schedule, so don’t treat the numbers here as a quote. Verify current rates at cms.gov or with your MAC before you bill.
Implementation
How HealthArc BHI Implementation Works
Most practices are fully operational within 30 to 45 days of contract execution. Implementation minimises disruption to existing clinical workflows while ensuring the program meets CMS documentation and billing standards from day one.
1
Days 1–7
Program Design
HealthArc works with your practice to define the BHI model: which CPT pathway you will pursue (99484 or CoCM), which patient populations are eligible for enrolment, how care managers are assigned, and how HealthArc connects to your EHR environment.
2
Days 8–21
Platform Configuration & EHR Connection
Your instance is configured with eligibility criteria, care team assignments, screening cadences and alert thresholds. EHR connections are established so demographic and clinical data flow into the registry without manual entry.
3
Days 14–28
Staff Training
Care managers, supervising physicians and billing staff receive role-specific training on HealthArc workflows. Training is delivered live (remote or on-site) with recorded modules for ongoing staff onboarding.
4
Days 28–45
Pilot Enrolment & Go-Live
An initial cohort of 20–50 patients is enrolled. HealthArc’s clinical operations team monitors the first billing cycle alongside yours to confirm documentation completeness and CPT threshold attainment before full-panel rollout.
5
Ongoing
Program Management
After go-live, HealthArc provides monthly program performance reviews, billing cycle support and access to ongoing clinical consultation as the BHI caseload scales.
Interoperability
EHR and Health System Integrations
HealthArc’s integration layer enables bidirectional exchange with major EHR platforms, so care managers work from a complete clinical picture and documentation isn’t duplicated across systems.
- HL7 FHIR R4: integration with any EHR or population health platform exposing a FHIR-compliant endpoint
- Patient demographics and problem list pulled into the BHI enrolment registry
- Assessment scores and care manager notes pushed back to the EHR encounter record
- Medication reconciliation and care plan data synchronised between systems
- No-integration option: run standalone with CSV exchange while integration is configured in the background
Bidirectional
Demographics and problem list in; scores, notes and care plans back out.
FHIR R4 API
Standards-based connection wherever your vendor exposes an endpoint.
Launch Without It
Standalone with CSV exchange means EHR integration never blocks a program go-live.
Sensitive by Default
Behavioral health assessment data is stored in isolated, access-controlled environments.
Commonly Integrated Systems
Epic
athenahealth
eClinicalWorks
Cerner (Oracle Health)
Allscripts / Veradigm
NextGen Healthcare
HL7 FHIR R4 endpoints
Additional connectors are available for other HL7 FHIR-compatible systems. Contact HealthArc to confirm integration status for your specific EHR version and configuration.
Reporting & Analytics
BHI Program Reporting and Analytics
Real-time visibility at patient, care manager and practice level, so you can manage quality, demonstrate outcomes and support payer reporting requirements.
Clinical Performance
- Enrolment and active caseload by care manager and site
- Screening completion rates (PHQ-9, GAD-7, AUDIT) by month and cohort
- Score trend analysis: aggregate improvement across 90, 180 and 365 days
- Patients overdue for contact or reassessment, surfaced by risk tier
Billing & Revenue
- Monthly CPT threshold attainment by patient and code
- Projected monthly revenue from BHI and CoCM based on documented time
- Patients approaching but not yet meeting thresholds, for proactive outreach
- Denial tracking and resubmission status
Quality & Compliance
- Documentation completeness rates for CMS audit readiness
- Care plan completion and update cadence
- Psychiatric consultation documentation log for CoCM programs
- Access and activity audit trail per user
Behavioral Health Index
- HealthArc’s BHI score aggregates PHQ-9, GAD-7 and other validated results with care plan adherence and contact frequency
- One trendable patient-level metric instead of five disconnected instruments
- Population-level trends for ACO and value-based care partner reporting
- Export in CSV, PDF or via API to downstream population health systems
Compliance & Security
Compliance and Security
Behavioral health data carries privacy protections beyond standard HIPAA requirements for medical records. HealthArc is built for that higher bar.
Regulatory Compliance
- HIPAA: HealthArc operates as a Business Associate; a BAA is executed with every customer practice at contract
- 42 CFR Part 2: documentation and access controls aligned to the stricter consent and disclosure rules governing substance use disorder records
- SOC 2 Type II: infrastructure and operational controls independently audited for security, availability and confidentiality
Data Security
- Encrypted in transit (TLS 1.2+) and at rest (AES-256)
- Behavioral health assessment data in isolated, access-controlled environments
- Role-based access: users see only records relevant to their clinical function
- MFA required for all platform users
Audit Logging
- Every access to a patient record logged with user, timestamp and action
- Supports internal compliance monitoring and payer or regulatory audit response
- Immutable activity trail across care manager documentation
- One-click export of a patient’s full documentation package
42 CFR Part 2 is where behavioral health procurement usually stalls. Substance use disorder records are governed by consent and disclosure rules that are stricter than HIPAA, and a platform that treats them as ordinary PHI creates exposure that a BAA doesn’t cover. HealthArc handles them as a distinct class of data.
Results
The Case for an Integrated Behavioral Health Program
The figures below are published population data and CMS rate arithmetic. Practice-level outcome data from HealthArc programs is shared under NDA during evaluation rather than published here.
1 in 5U.S. adults experiences mental illness in a given year
40%higher cardiovascular disease risk among adults with mental health conditions
<50%of adults with a mental health disorder receive treatment
30–45Days from contract execution to first billable BHI month
Untreated behavioral health is a chronic disease multiplier. The patients whose diabetes, heart failure and COPD outcomes won’t move are frequently the patients whose depression or anxiety was never addressed, which is why cardiology and endocrinology practices run BHI alongside CCM and RPM rather than instead of them.
Ask our clinical team for the outcome data and reference practices relevant to your specialty and payer mix.
FAQ
Frequently Asked Questions About Behavioral Health Integration
The questions practices ask most when evaluating BHI programs and software vendors.
What is the difference between Behavioral Health Integration (BHI) and Collaborative Care Management (CoCM)?
Both are CMS-recognised models that reimburse practices for systematic behavioral health support inside primary care or specialty settings, but they differ in clinical structure and billing requirements.
BHI (CPT 99484) requires at least 20 minutes per month of care management activity and a designated care manager, but does not require a consulting psychiatrist. It is the lower-complexity pathway and suits practices beginning a behavioral health program.
CoCM (CPT 99492, 99493, 99494) requires a structured team including a designated care manager and a psychiatric consultant who reviews the caseload regularly and provides treatment recommendations. CoCM is more intensive, generates higher reimbursement and suits higher-acuity populations.
Which CPT codes are used for billing BHI and CoCM services?
Four CPT codes cover reimbursable behavioral health integration services under Medicare:
- 99484: general BHI, 20+ minutes of care management per calendar month, ~$49 per patient per month
- 99492: CoCM initial month, 70+ minutes with psychiatric consultation, ~$290
- 99493: CoCM subsequent months, 60+ minutes with ongoing consultation, ~$193 per month
- 99494: each additional 30 minutes beyond the 99492 or 99493 threshold, ~$90
Most commercial payers cover these codes, though rates and documentation requirements vary. See the full BHI code reference.
What patient conditions qualify for BHI enrolment?
Patients are eligible when they have a diagnosed behavioral health condition that the treating physician determines warrants ongoing care management. Qualifying conditions include major depressive and persistent depressive disorder; generalised anxiety, panic and social anxiety disorder; PTSD; bipolar disorder managed in a primary care or specialty setting; substance use disorders; and behavioral health conditions comorbid with chronic disease such as diabetes, heart failure, COPD and hypertension.
There is no CMS-published exhaustive list of qualifying diagnoses. The standard is a recognised behavioral health condition plus a provider determination that systematic care management is medically appropriate.
Who can serve as the behavioral health care manager in a BHI program?
Under CMS guidance for CPT 99484, the care manager does not need to hold a specific clinical licence, but must be a care team member with appropriate training in behavioral health care management. In practice most programs use LCSWs, LPCs, psychologists, registered nurses or medical assistants with specialised training.
For CoCM (99492/99493/99494) the care manager must have formal education in a health-related field and experience working with the target population in a behavioral health care management role. HealthArc can provide embedded licensed care managers for practices without existing behavioral health staff.
Is Behavioral Health Integration covered by Medicare and commercial insurance?
Yes. CMS formally recognised BHI and CoCM as reimbursable services beginning in 2017, with CPT codes available under the Medicare Physician Fee Schedule. Coverage has expanded since, and most major commercial payers (including Aetna, UnitedHealthcare, Cigna and BCBS plans in most states ) now cover BHI-related CPT codes.
Coverage terms vary by payer and state; some commercial contracts require prior authorisation. Medicaid coverage varies significantly by state. HealthArc’s implementation team conducts a payer-specific coverage analysis as part of program launch.
How long does it take to launch a BHI program with HealthArc?
Most practices complete implementation and bill their first month of BHI services within 30 to 45 days of contract execution. The timeline depends on EHR integration complexity, care team availability for training, and whether you use HealthArc’s embedded care management or your own staff.
Practices using the full-service model typically go live faster, because no internal hiring is required.
What makes HealthArc different from other behavioral health integration software?
Most behavioral health platforms address one component of a BHI program, usually the screening tool or the telehealth visit. HealthArc covers the whole program workflow: patient registry management, validated screening, care manager task documentation, time tracking for CPT billing, virtual visits, psychiatrist consultation documentation for CoCM, and reporting.
HealthArc also offers embedded clinical services as well as software, so a small primary care practice can run a fully compliant, fully billable BHI program on the same platform a multi-site health system uses, regardless of existing behavioral health staffing.
Get Started
Start Your Behavioral Health Integration Program
Whether you are evaluating BHI for the first time or moving an existing program onto a more capable platform, HealthArc provides the clinical workflows, billing infrastructure and care team support to run a compliant, reimbursable BHI or CoCM program.
- How the patient registry and screening workflows operate in your practice model
- How HealthArc maps documented time to CPT 99484, 99492, 99493 and 99494
- Integration options with your current EHR
- Care team staffing options: software-only, embedded care management or full-service
- Which pathway fits your panel: general BHI or CoCM
Schedule a Demo
BHI CPT Code Guide
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Resources
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