The Primary Care Behavioral Health Provider Adherence Questionnaire (PPAQ) - Beehler and colleagues created it? It's a measure of fidelity to the PCBH model specifically. More information about it is available here including reference articles and a version to download - https://www.mirecc.va.gov/cih-visn2/PPAQ.asp
Integrated Practice Assessment Tool (IPAT) put out by SAMSHA.
The practice integration profile (PIP) http://pip.w3.uvm.edu/pip.php is a good measure of integrated behavioral health in general. It operationalizes the AHRQ Lexicon from 2013. I would imagine the PPAQ along with one of these tools should give you a good picture of the practice as a whole and clinician adherence to a PC practice pattern. The IPAT is also a good tool. While not PCBH specific, these should help.
An overview of assessing levels of integration is discussed in the CFHA podcast and can be accessed here: <http://cirrus.mail-list.com/cfha/67066606.html>
In 2015, I developed a matrix of the available measures comparing key items - <http://cirrus.mail-list.com/cfha/02134068.html>
The left column provides a set of proposed broader domains.
From that matrix, the attached evaluation form was developed incorporating Peek's Three Worlds as an additional guiding framework (i.e., clinical, operational, and financial). Each item provides behavioral anchors and specific target areas for the evaluator to focus the evaluation (attached). <http://cirrus.mail-list.com/cfha/72356959.html>
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The Primary Care Behavioral Health Provider Adherence Questionnaire (PPAQ)
https://www.mirecc.va.gov/cih-visn2/PPAQ.asp
The PPAQ self-report form can be downloaded here
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https://soundcloud.com/user-747093558/ep-15-assessing-levels-of-integration