CMS Expands Behavioral Health Services
The Centers for Medicare & Medicaid Services (CMS) expands behavioral health services and prioritizes “whole-person” health and behavioral health care in its final physician payment rule for 2024.
“The CMS Behavioral Health Strategy endeavors to support a person’s emotional and mental well-being through their behavioral health care. This rule finalized some of the most important changes to improve access to behavioral health care in the Medicare program’s history,” the CMS said in a news release.
Released on November 2, the new rule allows marriage and family therapists and mental health counselors, including eligible addiction, alcohol, and drug counselors, who meet qualification requirements to enroll in Medicare for the first time and start billing for services starting January 1, 2024.
It also increases payment for crisis care, substance use disorder treatment and psychotherapy.
Based on public comments, the CMS says it’s also finalizing increased payment for psychotherapy performed in conjunction with an office visit and for health behavior assessment and intervention services.
Whole-Person Focus
“The impact of these changes means that people with Medicare will be able to access marriage and family therapists and mental health counselors for behavioral health treatment, access culturally-sensitive care from community health workers, care navigators, and peer support workers, access primary care where the provider is invested in a long-term, trusting relationship, and that caregivers for persons with Medicare will have access to appropriate training,” Meena Seshamani, MD, PhD, CMS deputy administrator and director of the Center for Medicare, said in the release.
“Taken holistically, these are some of the largest changes ever towards a Medicare that recognizes people with Medicare as whole persons, with their own families and unique life stories. After all, people are more than the sum of their ailments and diagnoses,” Seshamani noted.
The CMS is also finalizing separate coding and payment for community health integration services, which include person-centered planning, health system coordination, promoting patient self-advocacy, and facilitating access to community-based resources to address unmet social needs that interfere with the practitioner’s diagnosis and treatment of the patient.
They note that these are the first physician fee schedule services designed to specifically include care involving community health workers who link underserved communities with critical healthcare and social services in the community and expand equitable access to care, thus improving outcomes for the Medicare population.
“The policies announced today aim to strengthen Medicare and advance health equity by expanding access to care and services for people who are part of underserved communities,” Xavier Becerra, US Department of Health and Human Services Secretary, said in the news release.
“In addition, we are bolstering our commitment to Biden-Harris Administration priorities including behavioral health care, supporting family caregivers, promoting value-based care, and advancing the President’s Cancer Moonshot,” Becerra added.
A fact sheet on the 2024 Medicare Physician Fee Schedule final rule is available online.
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