HB 278 by Rep. Echols passed the House on April 27 with a vote of the 98 to 0. It was received in the Senate and placed on the calendar.
The measure provides requirements for the Psychiatric Collaborative Care Model and requires mental health or substance abuse benefits for services delivered through the model. The bill is pending in the Insurance Committee.
The proposed law requires a health coverage plan delivered or issued for delivery in this state that provides mental health and substance abuse benefits to reimburse for such benefits that are delivered through the psychiatric Collaborative Care Model. The model includes the current procedural terminology (CPT) billing codes 99492, 99493, and 99494.
The new proposed law requires the commissioner of insurance to update the CPT codes if there are any alterations or additions to the billing codes for the Collaborative Care Model.
Proposed law authorizes a health coverage plan to deny reimbursement of any CPT code provided in proposed law on the grounds of medical necessity, provided that such medical necessity determinations are in compliance with certain federal and state law.
Defined are: (2) “Mental health or substance abuse benefits” means benefits for the treatment of any condition or disorder that involves a mental health condition or substance use disorder that falls under any of the diagnostic categories listed in the mental disorders section of the current edition of the International Classification of Diseases or that is listed in the mental disorders section of the most recent version of the Diagnostic and Statistical Manual of Mental Disorders. (3) “Psychiatric Collaborative Care Model” means the evidence-based, integrated behavioral health service delivery method described in 81 FR 80230.