What is the Collaborative Care Model (CoCM)?

The Collaborative Care Model (CoCM) is an evidence-based approach to integrating behavioral health services into primary care. Designed for patients with mental health conditions such as depression and anxiety, CoCM uses a team-based structure that includes the primary care provider, a behavioral health care manager, and a psychiatric consultant.

Together, they deliver coordinated, measurement-driven care that improves outcomes while supporting value-based payment models.

Key Components of the Collaborative Care Model

The Collaborative Care Model is built on a team-based approach to behavioral health treatment. At its core are three key roles:

Primary Care Provider (PCP):
Oversees the patient’s overall medical care and initiates behavioral health screening and referrals.
Behavioral Health Care Manager:
Coordinates care, monitors patient progress, delivers brief evidence-based interventions (like behavioral activation), and tracks outcomes using validated rating scales.
Psychiatric Consultant:
Reviews caseloads weekly, provides treatment recommendations, and advises on medication or therapy adjustments based on patient response.

Together, these professionals follow a structured, data-driven workflow designed to support continuous monitoring and iterative treatment improvement — a model often referred to as “measurement-based care.”

Table illustrating the three roles in the Collaborative Care Model (CoCM): Primary Care Provider, Behavioral Health Care Manager, and Psychiatric Consultant. Each role includes responsibilities across patient care, communication, and billing.

How the Collaborative Care Model Works in Practice

CoCM is designed to bring behavioral health treatment into the primary care setting—where most patients already receive care. Here's how it works:

Initial Identification:
A patient screens positive for depression, anxiety, or another behavioral health concern during a primary care visit.
Engagement & Assessment:
The behavioral health care manager conducts an initial assessment, including symptom rating scales and patient history, then enters the case into a patient registry.
Care Planning:
The care team—including the psychiatric consultant—reviews the case and develops a treatment plan, often including medication, brief therapy, or both.
Weekly Case Review:
The care manager and psychiatric consultant review progress weekly. If symptoms persist or worsen, treatment is adjusted.
Ongoing Monitoring & Follow-Up:
Patients are followed proactively for at least a month. Outcomes are tracked quantitatively using rating scales (e.g., PHQ-9), and progress is documented for review and billing.
Graduation or Referral:
Patients who improve may be stepped down from CoCM or referred to specialty care if their needs exceed the scope of primary care.

Flowchart showing the Collaborative Care Model (CoCM) lifecycle: Patient Identified, Care Manager Assessment, Treatment Adjustment, Ongoing Review Cycle, and Graduation or Referral.

Benefits of the Collaborative Care Model for Providers and Patients

The Collaborative Care Model (CoCM) delivers measurable improvements in both patient outcomes and provider efficiency—making it a key strategy in modern, value-based primary care.

For Providers:

Integrated workflows: Behavioral health support happens within the primary care setting—no separate referral needed.
Scalable model: A single psychiatric consultant can support multiple care managers and primary care teams.
Improved reimbursement: CPT codes 99492–99494 allow for structured, recurring billing of psychiatric collaborative care activities.

For Patients:

Faster access to mental health care: No long waitlists or off-site referrals.
Improved continuity of care: Behavioral and physical health needs are treated together.
Reduced stigma: Patients receive behavioral health support in a familiar, trusted environment.

Table comparing the Collaborative Care Model (CoCM) with traditional mental health referrals. CoCM is delivered within primary care, team-based, measurement-based, and has shorter wait times. Traditional referrals require separate providers, use one-on-one models, are often subjective, and have longer delays.

Billing and Reimbursement for the Collaborative Care Model (CoCM)

The Collaborative Care Model is supported by three time-based CPT codes that reflect non-face-to-face care management delivered by a collaborative team.

CPT 99492 – Initial 70 minutes of psychiatric collaborative care in the first calendar month
CPT 99493 – Subsequent 60 minutes of care in following months
CPT 99494 – Each additional 30 minutes of time spent during any month

These codes are typically billed by the treating primary care provider, while the behavioral health care manager and psychiatric consultant contribute services under their supervision. Accurate time tracking, patient registry use, and structured documentation are essential for compliance.

Frequently Asked Questions about the Collaborative Care Model

1. What is the goal of the Collaborative Care Model?

The goal of CoCM is to integrate behavioral health services into primary care settings, improving access, outcomes, and continuity of care for patients with mental health conditions such as depression or anxiety.

2. Who is involved in delivering CoCM services?

CoCM uses a three-person care team: a primary care provider, a behavioral health care manager, and a psychiatric consultant. Together, they provide coordinated, measurement-based care.

3. What conditions are typically treated using CoCM?

Common conditions include depression, generalized anxiety disorder, PTSD, and other mild to moderate mental health diagnoses that can be managed in primary care with psychiatric oversight.

4. How does CoCM differ from a traditional referral to a mental health specialist?

Unlike standard referrals, CoCM keeps behavioral health care within the primary care clinic. Patients receive care from a team they already know, and psychiatric input is provided indirectly through care manager collaboration.

5. Is the Collaborative Care Model reimbursable?

Yes. CoCM is reimbursable through time-based CPT codes (99492, 99493, and 99494) that cover non-face-to-face behavioral health care coordination and consultation under a primary care provider’s supervision. conditions such as depression or anxiety.