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Behavioral Health Services

Medicaid is the single largest payer for mental health services in the United States and is increasingly playing a larger role in the reimbursement of substance use disorder services. Individuals with a behavioral health disorder also utilize significant health care services—nearly 12 million visits made to U.S. hospital emergency departments in 2007 involved individuals with a mental disorder, substance abuse problem, or both.  Congress enacted several laws designed to improve access to mental health and substance use disorder services under health insurance or benefit plans that provide medical/surgical benefits.  The most recent law, the Mental Health Parity and Addiction Equity Act (MHPAEA), impacts the millions of Medicaid beneficiaries participating in Managed Care Organizations, State alternative benefit plans (as described in Section 1937 of the Social Security Act) and the Children’s Health Insurance Program.    

This new and revised section of the Medicaid.gov website that provides information to States, managed care organizations, providers, beneficiaries and others regarding mental health and substance use disorder—referred to as behavioral health services.   This site provides information regarding services and supports to meet the health, behavioral health and long term services and support needs of Medicaid individuals with mental health or substance use disorders.  This website has been organized around several key areas that the Centers for Medicaid and CHIP Services (CMCS) has identified as a priority for the next several years:

  • Effective benefit design for mental health services for children, youth and their families
  • Effective benefit design for substance use disorder services  
  • Mental Health Parity and Addiction Equity Act (MHPAEA) application to Medicaid programs

Each of these areas will contain documents and other reference materials that may be helpful to States and managed care organizations as they consider their behavioral health benefit design and delivery systems.  In addition, each area identifies the technical assistance resources regarding behavioral health that CMCS and our other federal partners will make available to States and CMS grantees.