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Variation in Use of Psychiatric Collaborative Care Model Codes and Episodes of Care for Commercially Insured
Brianna M Lombardi1,2, Lisa de Saxe Zerden2,3, Brooke N Lombardi2
1Department of Family Medicine, University of North Carolina School of Medicine, Chapel Hill.
Objective:
The collaborative care model (CoCM) of integrated behavioral health has a strong evidence base and specified reimbursement codes for implementation, yet uptake of CoCM billing is reported to be minimal. This study aimed to examine the frequency and length of CoCM treatment among commercially insured individuals.
Methods:
The sample was drawn from MarketScan, a commercial claims database, and included individuals with at least one CoCM claim between 2018 and 2022. Multivariate logistic regression analyses were used to examine factors related to length of CoCM episodes of care (EOCs), including provider type, diagnosis, rurality, sex, and age.
Results:
Between 2018 and 2022, a total of 16,537 individuals received at least one CoCM EOC; of these EOCs, 40.6% lasted ≥3 months and 14.7% lasted ≥6 months. Less than 0.01% of all individuals with a depression or anxiety disorder diagnosis who were continuously enrolled in the database received a CoCM EOC during this period. The most frequent diagnoses listed on CoCM claims were anxiety-related disorders (60.7%), depressive-related disorders (45.4%), trauma-related disorders (14.0%), and substance use disorders (4.2%). Year of treatment initiation was significantly associated with having an EOC of ≥3 months (OR=1.13, p<0.001). All types of diagnosis were significantly associated with having ≥3 months and ≥6 months of CoCM treatment.
Conclusions:
Although the number of CoCM claims increased across the study period, use of CoCM billing codes appeared to be low for commercially insured individuals. Study findings suggest that additional factors (e.g., training gaps or workforce shortages) should be studied to assess rates of CoCM code use.
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