Integrated behavioral health brings medical and behavioral health care into a coordinated approach. AHRQ's Integration Academy describes clinicians working together with patients and families around shared concerns, rather than treating the connection between services as the patient's responsibility alone.
Behavioral health in this context includes mental health, substance-use concerns, health behaviors and other factors affecting well-being. A behavioral health clinician may work on site or participate through integrated team procedures and information systems.
Ask what integration means in the practice
The label can cover different arrangements. Ask how a concern moves from identification to discussion, assessment, an agreed plan and follow-up.
Being in the same building does not tell you who communicates with whom. Conversely, a remote team member may have a defined role in shared care. Look for the actual process: who accepts the request, how information reaches the right person and how unresolved concerns return to the team.
For a fictional example, a patient agrees to a behavioral health appointment but cannot use the offered telephone format privately. The coordination task is to explain the barrier and explore an acceptable arrangement with the patient and responsible service, rather than recording the appointment as a completed connection.
Distinguish collaborative care from the broader idea
Medicare's behavioral health integration guidance distinguishes psychiatric collaborative care, often abbreviated CoCM, from general behavioral health integration services. The psychiatric CoCM team includes a treating practitioner, a behavioral health care manager and a psychiatric consultant.
This is a defined service model. Do not assume that every practice using “collaborative” in its description meets the requirements for those Medicare services.
CMS describes the behavioral health care manager as having relevant formal education or specialized training, which may include nursing. That does not make every RN automatically qualified for every function. Match the role to training, scope, supervision and the practice's requirements.
Make the patient's experience understandable
Explain who each person is and how they work with the existing team. Ask what the patient understands about the proposed service and whom they prefer to involve.
Separate the clinical explanation from payment questions. For Medicare BHI services, CMS requires advance consent and information about applicable cost sharing. Use the practice's current consent and billing process rather than promising that an additional service has no cost.
Check the organization's privacy procedures before sharing information across teams. This overview does not replace the rules applicable to a particular record or service.
Define follow-up and escalation
A nurse should know who reviews progress, who can modify the treatment plan and how concerns receive timely clinical attention. Review the approved response when the patient cannot be reached, declines a proposed step or needs more specialized services.
Use the practice's established urgent-response procedures for immediate concerns. Do not treat a routine referral queue as the response to an urgent situation.
For collecting patients’ accounts of care, compare what a patient-experience survey measures.
Related pages cover warm handoffs, care plans across organizations and patient-centered medical homes.
Sources
- What Is Integrated Behavioral Health? (accessed 2026-09-17) — AHRQ Integration Academy, reviewed July 2024.
- Behavioral Health Integration Services (accessed 2026-09-17) — CMS, MLN909432, January 2026.