Collaborative Care Model
The Collaborative Care Model (CoCM) is the integrated behavioral health care model with the strongest evidence base for addressing mental health needs within the primary care space. CoCM brings together an interdisciplinary team including a primary care provider (PCP) or specialty medical provider (ex. OBGYN, oncologist etc), a behavioral health care manager (BHCM), and a psychiatric consultant to deliver high-quality, patient-centered, mental health care where the patient is already receiving care.
By leveraging validated mental health screening, measurement-based care, care coordination, and evidence-based interventions, CoCM enhances early detection, treatment, and relapse prevention for mental health conditions like depression, anxiety, and substance use. A shared electronic health record and patient registry ensure seamless communication and proactive follow-up, preventing patients from falling through the cracks.
Medicaid Adoption of Collaborative Care Codes
A comprehensive summary of Medicaid adoption of the Collaborative Care Management (CoCM) codes 99492-99494 and G2214.
This resource provides:
- Coverage status of CoCM codes by state Medicaid agencies.
- Availability of reimbursement rates on Medicaid fee schedules.
- Comparisons of Medicaid and Medicare reimbursement rates by state.
- State-specific restrictions or requirements.
This summary is based on extensive research of state Medicaid policies and publicly available guidance. While a valuable reference, we recommend verifying details with state Medicaid agencies and managed care organizations.
For questions or updates, contact cocm@mmhpi.org.
Behavioral Health Care Manager Qualifications
State Medicaid agencies vary widely in their requirements for Behavioral Health Care Managers (BHCMs). While some states align closely with Centers for Medicare and Medicaid Services (CMS) guidance, others establish more specific standards related to education, training, or licensure. This document summarizes the minimum BHCM qualifications required by state Medicaid programs to bill for CoCM services.
Collaborative Care Evidence Base
CoCM is extensively evidence-based, with its efficacy being demonstrated by more than 90 randomized controlled trials and several meta-analyses across diverse diagnoses (e.g., depression, anxiety, bipolar disorder), patient populations (e.g., older adults, patients with chronic medical problems) and treatment settings (e.g., Federally Qualified Healthcare Centers, the Veterans Health Administration). CoCM has been shown to reduce racial and ethnic treatment outcome disparities and is effective when implemented in rural or underserved urban treatment settings. Finally, CoCM has designated billing codes that are reimbursed by Medicare, most commercial payers, and a growing number of state Medicaid plans, leading the model to be financially sustainable. Below are several research, review, and practice-based articles that demonstrate the effectiveness of Collaborative Care in research and real-world settings.
- Archer, J., Bower, P., Gilbody, S., Lovell, K., Richards, D., Gask, L., ... & Coventry, P. (2012). Cochrane Database of Systematic Reviews. Collaborative care for depression and anxiety problems, 10(10.1002), 14651858.
- Hu, J., Wu, T., Damodaran, S., Tabb, K. M., Bauer, A., & Huang, H. (2020). The effectiveness of collaborative care on depression outcomes for racial/ethnic minority populations in primary care: a systematic review. Psychosomatics, 61(6), 632-644.
- 3. Unützer, J., Carlo, A. C., Arao, R., Vredevoogd, M., Fortney, J., Powers, D., & Russo, J. (2020). Variation In The Effectiveness Of Collaborative Care For Depression: Does It Matter Where You Get Your Care? Health Affairs, 39(11), 1943-1950.
Collaborative Care (CoCM) Key Reference List
Implementation Case Studies
UT Health San Antonio
As part of the American Rescue Plan Act (ARPA) Pediatric Collaborative Care Model (CoCM) initiative, the Meadows Institute partnered with UT Health San Antonio to bring integrated mental health care directly into pediatric primary care in San Antonio. UT Health San Antonio launched a pediatric CoCM program in two University Health (UH) pediatric clinics, opening the door to timely, cost-effective care for thousands of children and families across Bexar County, Texas.
Moore County Hospital District
The Moore County Hospital District (MCHD) partnered with the Meadows Institute to launch a Collaborative Care Model (CoCM) program, bringing integrated mental health services into four primary care sites: two internal medicine clinics, a rural health clinic, and an OBGYN clinic. CoCM is an evidence-based, financially sustainable model for integrating behavioral health services into primary care. Supported by the Amarillo Area Foundation, this initiative increases access to high-quality mental health care for thousands of patients across the Texas Panhandle, reaching people who might otherwise face substantial barriers to accessing care.
JPS Health Network
JPS Health Network (JPS) partnered with the Meadows Institute to launch Collaborative Care Model (CoCM) programs in three primary care clinics across Tarrant County. Supported by the Meadows Foundation and Lyda Hill Philanthropies, this initiative advances a regional commitment to reducing the burden of depression in North Texas by expanding access to evidence-based, measurement-informed care. Through targeted training and technical assistance (TA) from the Meadows Institute, JPS is driving system-level transformation, and delivering timely, coordinated, and cost-effective behavioral health services that strengthen outcomes for the communities they serve.
Family Medicine Centers
The Meadows Mental Health Policy Institute (MMHPI) technical assistance (TA) team partnered with Family Medicine Centers (FMC) to successfully implement a full-fidelity Collaborative Care Model (CoCM) program, integrating mental health services into primary care. This initiative has significantly improved access to cost-effective behavioral health care for hundreds of patients across the Texas Panhandle, a predominantly rural region with limited mental health resources. FMC's dedicated team was instrumental in driving CoCM integration, making meaningful progress in expanding access to essential mental health services.
Texas A & M
With technical assistance support from the Meadows Mental Health Policy Institute (MMHPI), Texas A&M University Health Services (UHS) implemented the Collaborative Care Model (CoCM) to integrate mental health care within primary care delivered through their student health clinic. These efforts have improved access to cost-effective care for over 77,000 students. Texas A&M is one of the first universities nationally to implement CoCM through their student health clinic as a service to their student population.
Technical Assistance Tools for Subpopulations
Technical assistance tools were developed by the Meadows Institute, in collaboration with select partners, to meaningfully support care teams seeking to implement high-fidelity Collaborative Care (CoCM).
Top 5 Recommended CoCM Metrics
Tracking metrics is essential for understanding how your CoCM program is performing, in terms of program process and clinical
patient outcomes. Metrics help identify areas for improvement, support continuous quality improvement efforts, and provide a
clear picture of progress over time.
CoCM Implementation Checklist
A comprehensive checklist outlining key considerations, essential steps, and program requirements to implement a full-fidelity Collaborative Care program.
Delivering Quality Mental Health Care in Women’s Healthcare Settings
A policy brief providing an overview of CoCM in Women’s health care settings.
Women’s Health Clinical Workflow
Clinical workflow details to support the implementation of CoCM in Women’s healthcare settings. This document illustrates how a patient is referred to the CoCM team.
Women’s Health Clinical Team
An overview of the CoCM clinical team structure, explaining each team member’s distinct role in CoCM, with key clinical, administrative, and billing responsibilities.
Women’s Health Transformation Team
An overview of the extended multidisciplinary transformation team that works together at every level of the organization to plan, build, and maintain CoCM in Women’s health care settings.
Delivering Quality Mental Health Care in the Primary Care Setting
A policy brief providing an overview of CoCM while also highlighting evidence supporting the model and financing strategies.
Adult Clinical Workflow
Clinical workflow details to support the implementation of CoCM for adults. This document illustrates how an adult patient is referred to the CoCM team.
Adult Clinical Team
An overview of the CoCM clinical team structure, explaining each team member’s distinct role in CoCM, with key clinical, administrative, and billing responsibilities.
Adult Transformation Team
An overview of the extended multidisciplinary transformation team that works together at every level of the organization to plan, build, and maintain CoCM.
Delivering Quality Mental Health Care in Pediatric healthcare settings.
A policy brief providing an overview of CoCM in pediatric health care settings.
Pediatric Collaborative Care Pathway
A pathway to support the implementation of pediatric CoCM. This document outlines an initial framework developed by national experts and includes evidence-based practices for screening, differential diagnosis, and symptom monitoring for patients aged 6 to 11 within pediatric primary care.
Pediatric Clinical Workflow
Clinical workflow details to support the implementation of CoCM for children and youth. This document illustrates how a pediatric patient is referred to the CoCM team.
Pediatric Clinical Team
An overview of the CoCM clinical team structure, explaining each team member’s distinct role in CoCM, with key clinical, administrative, and billing responsibilities.
Pediatric Transformation Team
An overview of the extended multidisciplinary transformation team that works together at every level of the organization to plan, build, and maintain CoCM in pediatric health care settings.
Patient Registry
Guidance on establishing and using a CoCM registry, including key functions and a decision matrix to help health systems and clinical teams decide which type of registry to use.
Billing Basics
An overview of CoCM billing codes, including time thresholds, patient cost-sharing, and claim submission requirements.
Learn More
For information on Collaborative Care technical assistance and implementation, contact:
CoCM Technical Assistance (TA) Team