In crisis?
Behavioral health and recovery
Apple Health clients have access to behavioral health (mental health and substance use disorder treatment) services, including crisis services, short-term mental health treatment, and inpatient psychiatric services.
Learn more about this program and how to become a behavioral health provider.
Are you ready for integrated managed care? Find out using the Practice Transformation Support Hub’s billing and information technology (IT) toolkit.
Behavioral health covered services
How do providers identify the correct payer?
In most of Washington
All behavioral health services are covered by:
- Apple Health Integrated Managed Care plans, or
- Apple Health managed care plans under the Behavioral Health Service Only benefit package, or
- Apple Health fee-for-service (FFS) program.
If you live in one of the following areas that has not implemented integrated managed care:
- Great Rivers (Cowlitz, Grays Harbor, Lewis, Pacific, and Wahkiakum counties)
- Salish (Clallam, Jefferson, and Kitsap counties)
- Thurston-Mason (Mason and Thurston counties)
Services for mental health are covered by the Behavioral Health Organizations (BHO).
Behavioral Health - Primary Care Integration
SSB 5779 passed in the 2017 legislative session.
The purpose of SSB 5779 is to promote efforts towards bi-directional behavioral health and primary care integration. One component of this bill requires the Health Care Authority to review payment codes related to primary care and behavioral health, create, and publish a matrix.
The project has been divided into three phases of code matrix creation. The intention of the matrix is to provide information to providers for successful reimbursement. Each matrix will be posted on the website as they are completed. A proposed implementation plan will be developed by the end of 2017. Please note that there are no changes in coding procedures at this time.
- Stakeholder letter (Phase 1)
- Stakeholder letter (Phase 2)
- Health and behavior codes assessment (Matrix - Phase 1)
- Health and behavior codes assessment (Matrix - Phase 2)
- Collaborative Care Model (Matrix - Phase 3) - located on pages 60 - 68
- Maternal and Youth Depression Screening Tools (Matrix - Phase 4)
- Developmental, caregiver/maternal depression, and youth depression screening tools - located on pages 38 - 39
- Phase 4 screening tool part II
- 5779 stakeholder meeting (slide presentation) (12-6-17)
- 5779 stakeholder meeting summary (12-6-2017)
- 5779 meeting FAQs (12-6-2017)
- Bi-Directional BHI quarterly meeting summary (4-13-18)
- Bi-Directional BHI meeting (slide presentation) (4-13-18)
- Bi-Directional BHI meeting questions and responses (4-13-18)
- Bi-Directional BHI quarterly meeting summary (7-13-2018)
- Bi-Directional BHI meeting (slide presentation) (7-13-2018)
- Bi-Directional BHI quarterly meeting summary (10-19-2018)
- Bi-Directional BHI meeting (slide presentation) (10-19-2018)
- Health and Behavior Codes (Matrix 1) Effective January 1, 2019
