Centers for Medicare and Medicaid Services

On January 18, 2024, the Centers for Medicare & Medicaid Services (CMS) announced the Innovation in Behavioral Health (IBH) Model. IBH is focused on improving quality of care and behavioral and physical health outcomes for Medicaid and Medicare populations with moderate to severe mental health conditions and substance use disorder (SUD).

The Centers for Medicare & Medicaid Services (CMS) recently released the Calendar Year (CY) 2023 Physician Fee Schedule. This rule makes policy updates which may increase accessibility of behavioral health services and telehealth services in rural areas. CMS subject matter experts from the Hospital and Ambulatory Policy Group (HAPG) presented on the behavioral health and telehealth updates in the rule during the webinar held on Wednesday, December 14, 2022.

The Federal Office of Rural Health Policy is funding a new resource to assist states in conjunction with the National Conference of State Legislatures (NCSL) as they establish new licensure standards for Rural Emergency Hospitals (REH). 

Last week, the Centers for Medicare & Medicaid Services (CMS) Office of Minority Health released the CMS Framework for Health Equity. Using five priority areas, CMS will use this framework to design, implement, and operationalize policies and programs to support health for all people served by its programs including rural populations.

RCORP-TA is pleased to provide technical assistance resources related to grantee business operations that we have prepared for grantees. RCORP-TA is providing these resources to assist grantees on aspects of their business operations that are continuously impacted and routinely challenged by factors associated with living and working in rural communities. Please see the below linked guidance documents and descriptions as they may be of interest to you.

Participants will be provided an overview on how to appropriately document, code and bill for encounters throughout the SUD/OUD continuum of care following CMS billing rules for FQHCs/RHC. An overview of the opportunities and challenges associated with MAT reimbursement mechanisms including coding and billing for Medicare, managed care, Medicaid, and other third-party payors will also be presented as will a brief description of revenue options for reporting Transitional Care Management, Virtual Communication Services, Telehealth, and other care management services such as Behavioral Health Integration and the Psychiatric Collaborative Care Model.

Documentation, Coding, and Billing for SUD/OUD via Medication-Assisted Treatment (MAT): A Rural and Community Health Focus The presenter will outline the steps needed to effectively document, code, and bill for services including screening for SUD/OUD and providing care during the induction, stabilization, and maintenance phases of MAT. Individual state Medicaid issues are too numerous and will not be specifically referred to on a state-by-state basis.

State policymakers are interested in learning about the most effective treatments to address OUD and avoid unintended consequences such as overdose events, mortality from overdose, and use of illicit and unregulated drugs. This article describes the lack of evidence surrounding the use of Medically Supervised Withdrawal as a standalone “treatment.”

This brief, made possible by the Centers for Medicare & Medicaid Services, highlights key features of approved health home models in Maryland, Rhode Island, and Vermont that are tailored to individuals with opioid dependency.

The Center for Connected Health Policy’s (CCHP) Spring 2020 release of the “State Telehealth Laws and Reimbursement Policies” report highlights the changes that have taken place in state telehealth policy. The report offers policymakers, health advocates, and other interested health care professionals a summary guide of telehealth-related policies, laws, and regulations for all 50 states and the District of Columbia.