Effective 10/01/22, Blue Cross and Blue Shield of New Mexico (BCBSNM) implemented an incentive program for non-behavioral health providers to render behavioral health screenings to Blue Cross Community CentennialSM members. This program helps identify and measure the number of members with a behavioral health diagnosis.
* This incentive program excludes long term care facilities and emergency department utilization.
Reimbursement
Providers can render the screening during a member’s physical health visit. Providers will need to follow the steps below to receive payment:
- If a behavioral health diagnosis is identified, bill the diagnosis as one of the first three codes on the claim to BCBSNM along with the codes for the services that are being provided during the member’s visit.
- Bill one of the services as code 96127 - Brief emotional/behavioral assessment with scoring and documentation, per standardized instrument.
- Code 96127 will be reimbursed at $25.00 per member.
Note: If the behavioral health diagnosis code is billed fourth or higher, the diagnosis will not be captured in our measurement. However, the provider will still receive the incentive payment.
Previous Claims
A claims project has been submitted to adjust claims billed with code 96127 for dates of service 10/01/22 through 11/22/22.
If you have any claims that were missed during this timeframe, please work with your provider representative to have them adjusted.
For More Information
Please contact your assigned BCBSNM provider representative if you have any questions or need further information on this incentive program.