Behavioral Health

Behavioral health interventions are brief courses of care with a focus on the worker's ability to return to work by addressing psychosocial barriers that impede their recovery.

These psychosocial barriers are not components of a diagnosed mental health condition; instead, they are typically a natural reaction to an injury, although they can also arise due to other factors. Because they arise from and are related to recovery of a physical injury, they use the physical injury diagnosis of the accepted condition. Common barriers are impaired recovery expectations, catastrophic thinking, and fear avoidance behavior. To learn more, refer to Psychosocial Barriers Influencing Recovery.

Intervention can take many forms. Cognitive behavioral therapy, problem solving therapy, and motivational interviewing are popular methods. 

Behavioral health interventions are appropriate if the provider has reason to believe that psychosocial factors, difficulty coping, or additional barriers may be affecting the worker’s medical treatment and management of an injury, or affecting their return to work efforts. It is important to note that these services are not a replacement for mental health services. If there is suspected mental health, please refer to our mental health services resource.

Billing & Payment Policy

There are several provider types that may offer behavioral health services. 

All providers billing separate behavioral health codes should utilize the Behavioral Health Interventions documentation form in place of standard chart notes.

Provider Type Requirements Coverage Policies
Psychologists Requires AP referral
No prior authorization required​
Chapter 22 MARFS
Master’s Level Therapists (MLTs) Requires AP referral
No prior authorization required​
Chapter 22 MARFS
Attending Provider (AP) Bundled with E/M codes, not separately billed​ Chapter 10 MARFS

Note: Behavioral health interventions aren’t covered if a diagnosed mental health condition has been accepted or denied by order on a claim. See Chapter 17 of MARFS for details on treating mental health conditions.

Resources

Here are a selection of resources and more information on behavioral health services and how they can influence a worker's recovery:

  • Educational resources for attending providers to learn more about identifying, recognizing, and addressing Psychosocial Determinants Influencing Recovery
  • Providers offering BHI services may be found by going to Find a Doctor.
    • Search your local area using the “all providers” category.
    • Choose psychologists and MLT under the “behavioral or mental health care” specialty.
  • Activity Coaching is appropriate for workers who have not returned to work or not to their usual hours, and need a structured reactivation program to address psychosocial barriers impacting their recovery.