CCBHC Demonstration Background

The Protecting Access to Medicare Act (PAMA) of 2014, (P.L. 113-93) was passed by Congress in March 2014, and signed into law on April 1, 2014. Section 223 of the PAMA provided for the creation and evaluation of a two-year Demonstration program in up to eight states to implement CCBHCs according to certification and program criteria that emphasize high quality and evidence-based practices. Section 223 authorized the Department of Health and Human Services to:

• Establish criteria that states will use to certify community behavioral health clinics for a two-year Demonstration program;
• Provide guidance on the development of a prospective payment system (PPS) for payment of CCBHC services provided by certified clinics; 
• For a state participating in the Demonstration, provide federal matching funds equivalent to the standard Children’s Health Insurance Program (CHIP) rate for CCBHC services to Medicaid beneficiaries (or the rate available to newly eligible beneficiaries);
• Award grants to states for planning purposes to develop proposals to participate in the Demonstration program;
• Select up to eight states to participate in the Demonstration program; and 
• Evaluate the project and prepare annual reports to Congress.

The CCBHC Demonstration is implemented through a cross-HHS partnership with the Centers for Medicare & Medicaid Services (CMS), the Substance Abuse and Mental Health Services Administration (SAMHSA), and the Assistant Secretary of Planning and Evaluation (ASPE).

CCBHC Demonstration Milestone Events

Since the enactment of the CCBHC Demonstration through the PAMA, there have been multiple temporary extensions to the program over the years. The most recent extension under the BSCA, extends the program timeframe for the originally selected 8 states through September 30, 2025; for the two states added through the CARES Act, these states are authorized for 24 fiscal quarters, and new states added through the BSCA are allowed a total of 16 fiscal quarters as of each state’s selected start date. An additional 10 states added through the BSCA expansion on July 1, 2024, and July 1, 2026 will, comprise a total number of 30 states selected for participation in the CCBHC Demonstration. To support the expansion and extension of the program, HHS has developed and revised the CCBHC Certification Criteria and PPS Guidance, including making updates to the set of quality measures developed to determine clinical outcomes. Finally, through the success of the CCBHC Demonstration, on March 9, 2024, Congress passed and signed into law section 209 of the Consolidated Appropriations Act (CAA) of 2024 which created a permanent State plan option at 1905(a)(31) for Medicaid agencies to implement CCBHCs under Medicaid state plan authority.