If your Georgia primary care doctor offers to manage your depression or anxiety as a monthly service, that is Medicare's Behavioral Health Integration (BHI) benefit. It is real care, billed as a recurring monthly charge, and in 2026 you pay the annual Part B deductible of $283 plus 20% of the cost after that. For a Georgia Medicare beneficiary already enrolled in a Medicare Savings Program at the QMB level, that cost drops to $0. This guide explains what the benefit covers, what it costs you, how to get it without a surprise bill, and how to ask for it where behavioral health providers are scarce.

What Georgia Medicare's Behavioral Health Integration Benefit Covers

Behavioral Health Integration is a Medicare benefit that pays a primary care practice to manage a diagnosed behavioral health condition over time, inside the medical office you already use. Instead of referring you out and hoping you find a therapist, your doctor's team checks in monthly, tracks how you are doing with a standard questionnaire, adjusts treatment when you are not improving, and coordinates any medication.

It is built for the conditions primary care sees most: major depression, generalized anxiety, panic disorder, post-traumatic stress disorder, bipolar disorder, and substance use disorders. There is no severity cutoff. What qualifies you is having a diagnosed condition that needs ongoing management, and a primary care provider willing to bill the service.

BHI comes in two forms, and the difference matters to you because it changes who is on your care team:

General BHI Collaborative Care Model (CoCM)
Who manages your care A care manager on your primary care team A behavioral health care manager plus a psychiatric consultant
Psychiatrist involved? No, your doctor refers out if needed Yes, a psychiatric consultant reviews your case behind the scenes
Best for Practices coordinating routine behavioral health care More complex or stubborn depression and anxiety
Billing code family CPT 99484 (general BHI) CPT 99492, 99493, 99494 (CoCM)
Your cost Same Part B cost-sharing either way Same Part B cost-sharing either way

The Collaborative Care Model is the more evidence-backed of the two. Decades of clinical research, much of it led by the University of Washington, found that adding a psychiatric consultant and structured follow-up to primary care produces better outcomes for late-life depression than usual care. You will not meet that psychiatrist; their role is to review your progress with your care manager and recommend adjustments. Practically, for you as a Georgia beneficiary, both versions feel similar: regular check-ins, a short questionnaire each time, and a single point of contact on your care team. Both carry the same standard Part B cost-sharing, starting with the 2026 Part B deductible of $283.

What Behavioral Health Integration Costs a Georgia Medicare Beneficiary in 2026

BHI is an ordinary Part B service, not a free preventive benefit. In 2026 you pay the annual Part B deductible of $283 first, and after that 20% of the Medicare-approved amount each month the service is billed. The standard Part B premium of $202.90 a month applies as it does for all of Part B.

The part that surprises people is the shape of the charge. BHI is billed monthly, so you may see a recurring line item for what can feel like a few phone calls. The coinsurance is modest in dollar terms (20% of a low monthly payment), but it is real, and it is not waived the way the Annual Wellness Visit or a depression screening is. Medicare itself describes BHI as a service with a monthly fee and standard cost-sharing on its Behavioral Health Integration page.

If you carry a Medicare Supplement (Medigap) policy, it covers some or all of this Part B coinsurance depending on your plan letter. If you are in a Medicare Advantage plan, the plan sets its own cost-sharing, so confirm the amount with the plan before you agree to the service.

How to Get Behavioral Health Integration at $0 With a Medicare Savings Program

The single most important thing to know if cost is your worry: a Medicare Savings Program can erase your BHI cost entirely. Beneficiaries enrolled at the Qualified Medicare Beneficiary (QMB) level have their Part B deductible and 20% coinsurance paid by Georgia Medicaid, which makes BHI free to them.

In 2026, Georgia's QMB program covers a single applicant with monthly income at or below $1,350 ($1,824 for a couple) and countable assets at or below $9,950 ($14,910 for a couple). The Specified Low-Income Medicare Beneficiary (SLMB) and Qualifying Individual (QI) levels have higher income limits but cover the Part B premium rather than your BHI coinsurance. Those are the federal standard rather than an absolute cutoff, and SSA tells staff to encourage people to apply even when income or resources appear somewhat higher, so apply rather than rule yourself out. Georgia processes these applications through the Division of Family and Children Services on Georgia Gateway.

If your income is anywhere near those limits, apply before you start BHI. Even a few dollars of monthly coinsurance is enough to make some people decline care they would benefit from, and the QMB path removes that barrier completely.

Medicare requires your consent before BHI begins, and the consent has to be documented in your record. Your provider must tell you what the service is, that you will owe Part B cost-sharing unless another program covers it, and that you can stop at any time. Verbal consent is allowed as long as it is documented; you do not have to sign a long contract.

Read the consent as your chance to ask two questions: what will this cost me each month, and what am I getting for it. A good answer names the care manager you will work with and describes the monthly check-ins. If the cost is a concern, that is the moment to mention QMB or to call for a benefits check before agreeing.

Getting Behavioral Health Care in Rural Georgia

The promise of BHI is care where you already are, which matters most where psychiatrists are scarce. Much of Georgia, especially its rural counties, is federally designated by the Health Resources and Services Administration (HRSA) as a mental health professional shortage area, with behavioral health providers concentrated in metro Atlanta and a handful of other cities.

BHI is built to bridge that gap. The care manager and the psychiatric consultant can work with you by phone or video, so a rural primary care practice can run a Collaborative Care program using behavioral health staff based in a larger city. Medicare's permanent behavioral health telehealth rules let these check-ins happen by phone, which matters for beneficiaries without reliable video. Federally Qualified Health Centers and Rural Health Clinics across Georgia deliver BHI this way. In the most rural areas, primary care may run through a Critical Access Hospital, a small rural facility (no more than 25 beds) that Medicare pays at 101% of reasonable cost to keep care available where no other hospital is nearby.

How to Ask Your Primary Care Provider About BHI

You do not need a referral or a special form. BHI starts with a conversation at your primary care office. Here is the practical path:

1
Step 1

Name the symptom, not the code

Tell your primary care provider you have been struggling with mood, anxiety, sleep, or drinking, and ask whether they can manage it with ongoing care management. You do not need to mention "BHI" or a CPT code.

2
Step 2

Ask which version they offer

Some Georgia practices run the full Collaborative Care Model; others bill general BHI. Either one gives you tracked, monthly support.

3
Step 3

Confirm the cost before you consent

Ask what you will owe each month, and whether your Medigap or Medicare Advantage plan covers it. If money is tight, ask about QMB.

4
Step 4

Get a free benefits check

Call GeorgiaCares, Georgia's State Health Insurance Assistance Program, at 1-866-552-4464 (option 4) for free, unbiased help confirming what BHI will cost you and whether you qualify for a Medicare Savings Program.

5
Step 5

Use crisis lines for emergencies

BHI is ongoing care, not crisis care. If you or a loved one is in crisis, call or text the 988 Suicide and Crisis Lifeline or the Georgia Crisis and Access Line at 1-800-715-4225.

BHI does not replace therapy or a psychiatrist when you need one. You can receive counseling from an outside therapist and BHI from your primary care team at the same time; they are billed separately and do not cancel each other out.

Frequently Asked Questions

What is Medicare Behavioral Health Integration (BHI)?

Behavioral Health Integration is a Medicare benefit that pays your primary care practice to manage a diagnosed behavioral health condition, such as depression or anxiety, as an ongoing monthly service inside the medical office. It includes regular check-ins, tracking your progress with a standard questionnaire, adjusting treatment, and coordinating any medication.

How much does BHI cost in Georgia in 2026?

You pay the annual Part B deductible of $283, then 20% coinsurance of the Medicare-approved amount each month the service is billed. It is not a free preventive service. A Medicare Supplement plan may cover the coinsurance, and a Medicare Advantage plan sets its own cost-sharing.

Can I get BHI for free?

Yes, if you qualify for the Qualified Medicare Beneficiary (QMB) program through Georgia Medicaid. QMB covers your Part B deductible and coinsurance, which makes BHI cost you nothing. In 2026, QMB covers a single applicant with monthly income at or below $1,350 and assets at or below $9,950.

What is the difference between general BHI and the Collaborative Care Model?

General BHI is the simpler version: a care manager on your primary care team coordinates your behavioral health care. The Collaborative Care Model (CoCM) adds a psychiatric consultant who reviews your case behind the scenes and recommends treatment changes. CoCM has the stronger evidence base, but both cost you the same and feel similar from your side.

Does BHI require my consent?

Yes. Medicare requires documented consent before the service starts. Your provider must explain the service, tell you about the cost-sharing you will owe, and confirm that you can stop at any time. Verbal consent is allowed as long as it is recorded in your medical record.

Can BHI be delivered by phone in rural Georgia?

Yes. BHI check-ins can happen by phone or video, and Medicare's behavioral health telehealth rules permanently allow telephone delivery. This lets rural primary care practices run Collaborative Care programs using behavioral health staff based in a larger city.

Does BHI replace seeing a therapist or psychiatrist?

No. BHI is care coordination inside your primary care office, not a substitute for therapy or specialty psychiatric care. You can receive outside counseling and BHI at the same time; they are billed separately.

Learn More

MedicareMedicare Behavioral Health Integration: What It CostsMedicare covers behavioral health integration, mental-health care managed through your own doctor. What it is, what it costs, and the QMB path to $0. MedicaidGeorgia Medicare Chronic Care Management (CCM)Medicare Chronic Care Management (CCM) pays Georgia providers to coordinate care for people with two or more chronic conditions. Learn what CPT 99490 covers. MedicaidGeorgia Medicare Transitional Care Management (TCM)After a Georgia hospital or observation discharge, Medicare Transitional Care Management pays the doctor to manage your first 30 days. What to expect and cost. MedicaidGeorgia Medicare Principal Care Management (PCM)Medicare Principal Care Management (PCM) helps Georgians manage one complex chronic condition. What PCM covers, what it costs in 2026, why duals pay nothing. MedicaidGeorgia Medicare Annual Wellness Visit (AWV)Medicare's yearly Annual Wellness Visit is free for Georgia beneficiaries, but a new symptom can turn it into a bill. What it covers and how to keep it $0. MedicaidGeorgia Medicare Depression ScreeningMedicare covers one annual depression screening (G0444) at $0 for Georgia beneficiaries in a primary care setting. Coverage, tools, cost, and referrals. MedicaidGeorgia Medicare Outpatient Mental Health ServicesHow Georgia Medicare covers outpatient mental health: 20% coinsurance, new MFT and counselor providers, PHP, IOP, and the 190-day inpatient psychiatric cap. MedicaidGeorgia Medicaid Behavioral Health CoverageGeorgia Medicaid behavioral health coverage in 2026: mental health and substance use services, the CMO and community service board system, and how to get care.

Find personalized help understanding your Georgia Medicare behavioral health benefits at brevy.com.

The information on Brevy.com is for educational purposes only and is not a substitute for professional legal, financial, or medical advice. Rules vary by state and program and change frequently. Always verify with the relevant agency or a qualified professional. Brevy is not a law firm, financial advisor, or healthcare provider.

BC

Brevy Care Team

Expert eldercare guidance from Brevy's team of healthcare professionals and researchers.