CMS Looking to Establish New Behavioral Health Intensive Outpatient Medicare Program

The U.S. Centers for Medicare & Medicaid Services (CMS) revealed a series of important behavioral health proposals on late Thursday afternoon.  First, in its proposed 2024 Medicare Physician Fee Schedule, the agency pitched changes that would allow marriage and family therapists (MFTs) and mental health counselors (MHCs), including substance use disorder (SUD) counselors, to enroll […]

CMS Unveils New ‘Making Care Primary’ Alternative Payment Model, Gives Behavioral Health Care Key Shoutout

The U.S. Centers for Medicare & Medicaid Services (CMS) unveiled a new primary care alternative payment model on Thursday – giving behavioral health care a key shoutout in the process. The Making Care Primary (MCP) Model will test advanced approaches to primary care in eight initial states: Colorado, Massachusetts, Minnesota, New Jersey, New Mexico, New […]

OIG: Over Half of Medicare’s $1B Spending on Psychotherapy Services Was ‘Improper’

Medicare improperly paid an estimated $580 million for psychotherapy services during the COVID-19 public health emergency (PHE). That’s according to a new audit from the Office of the Inspector General (OIG), which reported that between March 2020 and February 2021, Medicare Part B paid $1 billion for psychotherapy services, including telehealth services. The audit included […]

CMS Proposes 1.9% Medicare Payment Increase to Inpatient Psychiatric Facilities, Floats Plan to Boost Bed Count

The U.S. Centers for Medicare & Medicaid Services (CMS) has released a 2024 proposed rule for prospective payments and policies for Medicare-reimbursed inpatient psychiatric facilities.  On Tuesday, CMS proposed to increase the pool of total payments doled out for all inpatient psychiatric facilities by a net of 1.9%. The agency also said it will pursue […]

Telehealth Combined with OUD Treatment Cut Fatal Overdoses by 33%

Combining telehealth with opioid use disorder (OUD) treatment leads to lower odds of death by overdose. That’s according to a new study from three federal agencies on the expanded use of telehealth and other regulatory flexibilities during the coronavirus public health emergency (PHE) to treat OUD. Telehealth coupled with OUD treatment led to a 33% […]

Which States Have the Most Behavioral Health Medicaid Benefits

The bulk of state Medicaid programs cover services to treat substance use disorders (SUDs) and outpatient services, but few cover crisis care services. That’s according to a new report by the Kaiser Family Foundation (KFF), which included survey responses from 45 states about their health benefits. In the survey, KFF provided state Medicaid officials with […]

CMS Singles Out Behavioral Health in Plan to Streamline Payment Between Primary Care, Speciality Care

The U.S. Centers for Medicare & Medicaid Services (CMS) is looking to streamline primary care-specialist care integration, which could make it easier for behavioral health providers to get paid. Medicaid programs may now directly pay consulting providers for interprofessional consultations, even when a patient is not present.  CMS informed state health officials of the new […]

CMS to Mandate Marketplace Plans Cover Mental Health Facilities, SUD Treatment Centers

The U.S. Centers for Medicare & Medicaid Services (CMS) has announced a new proposal that would require health plans offered through the federal and state-based marketplaces to cover mental health facilities and substance use disorder treatment centers.  The new proposal, announced Monday, would make these two types of facilities essential community providers (ECPs). It would […]

CMS Loosens Telehealth Rules, Provider Supervision Requirements for Behavioral Health

The Centers for Medicare & Medicaid Services (CMS) finalized new rules aimed at expanding access to behavioral health for Medicare beneficiaries. On Tuesday, CMS announced it finalized rules that allow for greater flexibility in billing and supervising certain types of providers as well as permanently covering some telehealth services provided in Medicare beneficiaries’ homes. They […]

One Medical, Upward See ACO REACH as a Catalyst for Behavioral Health Innovation

Providers approved for the U.S. Centers for Medicare & Medicaid Services’ (CMS) new ACO REACH program are seeing an opportunity to further integrate behavioral health into care. Earlier this year, CMS announced it was nixing direct contracting and replacing it with the ACO Realizing Equity, Access and Community Health (REACH) model. Multiple direct-contracting models were […]