Certified Community Behavioral Health Clinic (CCBHC) Services

State Plan Benefit - Section 1905(a)(31) and 1905(jj) of the Social Security Act

On March 9, 2024, section 209 in Title I of Division G of the Consolidated Appropriations Act (CAA) of 2024 (Pub. L. 118-42) established an optional CCBHC services state plan benefit under Medicaid. This legislation amended section 1905 of the Social Security Act (the Act) to establish a new, optional CCBHC state plan benefit at section 1905(a)(31) of the Social Security Act (the Act), and as defined in section 1905(jj) of the Act. As part of this legislation, state plan CCBHC services will include a similar set of substance use and mental health services as those that are offered as part of the CCBHC Demonstration authorized under section 223 of the 2014 Protecting Access to Medicare Act (PAMA) (P.L. 113-93).

CCBHCs are defined at 1905(jj)(2) as organizations that: 

• have been certified by the State Medicaid agency as meeting the most recent version of the CCBHC Certification Criteria (“the Certification Criteria”); 
• provide the nine service categories, such as crisis mental health services, defined at 1905(jj)(1) and do so in a manner that reflects person-centered care; and 
• submit ongoing data on the provision of services, such as data on service encounters and clinical outcomes, to the State or Secretary. The Certification Criteria that states use to certify CCBHCs establish a basic level of service at which CCBHCs should operate.

CCBHC Categories of Service

The CCBHC nine (9) mandatory categories of service described in 1905(jj)(1) of the Act are:

• Crisis mental health services, including 24-hour mobile crisis teams, emergency crisis intervention services, and crisis stabilization;
• Screening, assessment, and diagnosis, including risk assessment;
• Patient-centered treatment planning or similar processes, including risk assessment and crisis planning;
• Outpatient mental health and substance use services;
• Outpatient clinic primary care screening and monitoring of key health indicators and health risk;
• Intensive case management services;
• Psychiatric rehabilitation services;
• Peer support and counselor services and family supports; and
• Intensive, community-based mental health care for members of the armed forces and veterans who are eligible for medical assistance, particularly such members and veterans located in rural areas, provided the care is consistent with minimum clinical mental health guidelines promulgated by the Veterans Health Administration, including clinical guidelines contained in the Uniform Mental Health Services Handbook of such Administration.

CCBHC in the State Plan

In 2026, CMS released guidance in State Medicaid Director Letter regarding coverage of CCBHCs under the available Medicaid Authorities, including the new optional state plan benefit.  At the same time, CMS created a State Plan Coverage Preprint (see Coverage of 1905(a) Benefits section) for states to complete to authorize the CCBHC benefit in their state plan.

States have long had the option to apply to participate in a CCBHC Demonstration program established in 2014 under Section 223 of the Protecting Access to Medicare Act of 2014 (PAMA) (Pub. L. 113-93) and to use Medicaid authorities to implement the CCBHC model to coordinate comprehensive mental health and substance use disorder treatment and support services. For more information about Medicaid CCBH Demonstrations visit our related demonstration webpage on Medicaid.gov.