MAT: Team-based care Part II, leveraging team-based
care, sustainability
Session #5
February 10th, 2021
careoregon.org
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Welcome
Please write your name, role and organization
in the chat box.
careoregon.org | page 2
A collaboration with:
careoregon.org | page 3
10 Collaborative Sessions
10/14/2020 Trauma Informed care-foundations, integration into clinic culture, patient centered care,
treatment documents
11/11/2020 Fundamentals of MAT - Introduction and overview of MAT
12/9/2020 Identifying staff roles and responsibilities: Prescriber, RN, pharmacist, behavioral health, CADC,
peer, case manager, panel manager, introduction
1/13/2021 MAT and SUD: Review of current best practices around prescribing MAT in the presence of other
substance use
2/10/2021 Staffing models: Clinical coverage, leveraging team-based care, sustainability
3/10/2021 Intersection of persistent pain, OUD and buprenorphine
4/14/2021 Policies and procedures, workflows, EHR tools
5/12/2021 Culturally sensitive and responsive services and care
6/9/2021 Pregnancy- best practices for OUD; in pregnant population, including DHS reporting and
Prevention
7/14/2021* Harm reduction in primary care and behavioral health setting- HR principals, spectrum of HR,
new end date relating to OUD and other chronic diseases
| page 4
What about CME & CEU?
Look out for a follow up email
with a survey and additional
information about CME & CEU
| page 5
Technology
Keep your phone muted when (Feel free to use your video
you are not speaking when you speak)
Use the chat function or unmute yourself to ask questions.
We will refer over to the chat box throughout the meeting
Hygiene
Agenda and materials have been shared in an email from
Andrew Huff
•PowerPoint slide deck will be emailed out after the
meeting
•We are noting takeaways and will send them after the
meeting
careoregon.org | page 6
MAT Collaborative Hosts
Melissa Brewster, PharmD, BCPS
on the chat box
CPCCO Innovation Specialist
Andrew Huff,
LPC
careoregon.org | page 7
Pharmacy
Behavioral Health in Primary Care
Panel Featuring!
Peers
careoregon.org | page 8
Stacie Andoniadis - Medication for
Presenter
Addiction Manager
careoregon.org | page 9
Disclosures
• Speaker: Stacie Andoniadis has nothing to
disclose.
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Understand potential options for sustainability of team-based
Understand care
Learning Review Review current options for MOUD billing in the primary care
setting- focus on prescriber and behavioral health
Objectives
Overview of COVID-related billing changes, focusing on
Overview telehealth
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I: Team-based care
- Clinical role review
- Clinical sustainability and workflow
- Panel
Refresh- Our Team-Based Care Journey
DECEMBER FEBRUARY
• Deep dive into Team Based Care • Sustaining team-based care
• Importance of engaged • Maximizing billing options
leadership and clinical • Dive into care team roles
champions
Who’s on Your Primary Care
Provider
MAT Prescriber Registered Nurse
Team?
Behavioral Health Peer, Certified
Depends on Clinic Psychiatrist
Provider Recovery Mentor
Resources and Patient
Population Panel Coordinator,
administrative Medical Assistant Pharmacist
coordinator
Engaged Leadership
always necessary
CADC, Wellness
coach
Three ways to think about sustainability- Likely need
to incorporate all three in sustainability plan
Team-Based 1) Financial opportunities: Billing/coding and
alternative payment options
Care: 2) Leadership support for the service and care
Sustainability provided
3) Maintains focus on TBC principles- Clearly defined
roles, direct communication, shared workspace.
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Determine practice structure- MOUD office
Determine visits integrated or specific time/days allotted
for care
Maximize Utilize EMR- Consider visit templates, imbed
clinic visit Utilize COWS scores, flow charts for induction,
maintenance, resources and referrals
time
Home induction for most patients, utilizing
Home “share the care” staff for follow-up care that
does not need prescriber time
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Review charts/prepare for visit-
maximize time with patients/client,
address chronic conditions in one
visit. Prep UDS ahead of time
Maximize clinic visit SBIRT/Screeners- Detailed workflow
which includes dot phrase for referral
time to treatment
Behavioral health- Warm hand-offs,
shared visits, utilize skills set to
maximize clinic space/availability
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Panel discussion
Diana Fischer, Trista Boudon David Casey,
PharmD, BCPS CADC I, CRM LCSW, CADC II
careoregon.org | page 18
Questions for the panel
1. Organization and Roles/names within interdisciplinary
team
2. Why you do this work?
3. What are the unique tangible aspects of your role on
the MAT team?
• What does your day to day look like on the team?
• What do you bring to the team?
• How do you support the MAT work?
4. Open Q and A after all panelists
careoregon.org | page 19
II: Billing considerations for
sustainability
Behavioral Health
Certified recovery mentor (CRM)
Prescriber
Pharmacist
Who on your Typical roles which can bill
• Prescriber
team can bill and • Behavioral Health Consultant- Primary care
who can share • Specialty Behavioral health- CADC, LCSW, Certified
Recovery Mentor
the care? • RN- Injections, flip visits not always reimbursed
Share the Care
Different • Pharmacists- Some payors allow for clinical
pharmacist to bill. CDTM, Naloxone teaching,
opportunities medication reconciliation, UDS interpretation
• Medical Assistant- UDS, SBIRT, flu shots
based clinical on • Panel coordinator/case manager- review charts,
setting. review chronic conditions, support social service
needs
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Behavioral Health- how can they support?
Remember- BH is not required to prescribe.
• Support prescriber during their appointments: review
Team-Based Care symptoms, recovery plans, needed resources, etc. before
prescriber comes into the room to allow for efficient
appointments and improved access to care
• Follow up with patient/client and service providers to help
coordinate between systems (SUD, ED, etc.)
Coordination • Monitor real time data/Collective to identify newly diagnosed
patients/client who need outreach and support
• Support the clinic system in understanding trauma informed
service delivery
Trauma Informed Care • Support the clinic in learning supportive, trauma informed
language that is patient centered
Primary Care: Making IBH Billing Successful
• Consider your BHC’s credentials and license level when hiring and/or when
deciding which set of codes you’re going to use
• Consider your payer mix
• Different payers cover different codes and it can vary depending on the
license of your BHC
• Clarify your values
• Will you provide services regardless if a person can pay?
• Will you have a co-pay
• Will your policies align with medical visits?
• Make sure these policies meet all governing bodies rules/regulations (e.g.
HRSA, CMS, Medicaid, etc)
Prescribers- E&M codes, focusing on time, complexity, type of care
Take away- Prescribes should be able to drop EM codes for office and telephone visits
Widely used EM codes and visit types Understand options for:
99203, 99204,
• Inductions- home or office
New patient- 99205 • Prolonged visits
• Telephonic provider to provider
Established 99213, 99214, consult time w/out patient
patient- 99215
• Pharmacists- CareOregon
provides billable options for
Telephone 99441, 99442, clinical pharmacists.
codes- 99443
III: Special considerations for Covid and
telemedicine
COVID-
Related billing
changes,
specifically
for telehealth
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What you can incorporate into your
organization today
01 02 03
Clearly identify Understand who can Set-up clinical care
MOUD clinic care bill- Review options team structure to
team for billing with your maximize
coder sustainability of
team-based
environment
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Questions?
Reflections?
Thank you!
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Thank You
Stacie Andoniadis
Medication for Addiction- Program Manager
CareOregon
Thank you!
Next session:
Wednesday March 10th, 2021
Brandon “BJ” Lynch MD,
MAT and Pain: Intersection of
persistent pain, OUD and
buprenorphine
