Sec. 104. Medicare incentives for behavioral health integration with primary care
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Section 1848(b) of the Social Security Act ( 42 U.S.C. 1395w–4(b) ) is amended by adding at the end the following new paragraph: For services described in subparagraph
(B)that are furnished during 2026, 2027, or 2028, instead of the payment amount that would otherwise be determined under this section for such year, the payment amount shall be equal to the applicable percent (as defined in subparagraph (C)) of such payment amount for such year. The services described in this subparagraph are services identified, as of January 1, 2023, by HCPCS codes 99484, 99492, 99493, 99494, and G2214 (and any successor or similar codes as determined appropriate by the Secretary). In this paragraph, the term applicable percent means, with respect to a service described in subparagraph (A), the following: For services furnished during 2026 , 175 percent. For services furnished during 2027, 150 percent. For services furnished during 2028, 125 percent. . Section 1848(c)(2)(B)(iv) of such Act ( 42 U.S.C. 1395w–4(c)(2)(B)(iv) ) is amended— in subclause (V), by striking and at the end; in subclause (VI), by striking the period at the end and inserting ; and and by adding at the end the following new subclause: the increase in payment amounts as a result of the application of subsection (b)(13) shall not be taken into account in applying clause (ii)(II) for 2026, 2027, or 2028. . Not later than January 1, 2025, the Secretary of Health and Human Services (in this subsection referred to as the Secretary ) shall enter into contracts or agreements with appropriate entities to offer technical assistance to primary care practices that are seeking to adopt behavioral health integration models in such practices. For purposes of paragraph (1), behavioral health integration models include the Collaborative Care Model (with services identified as of January 1, 2023, by HCPCS codes 99492, 99493, 99494, and G2214 (and any successor codes)), the Primary Care Behavioral Health model (with services identified as of January 1, 2023, by HCPCS code 99484 (and any successor code)), and other models identified by the Secretary. Notwithstanding any other provision of law, the Secretary may implement the provisions of this subsection by program instruction or otherwise. In addition to amounts otherwise available, there is appropriated to the Secretary for fiscal year 2024, out of any money in the Treasury not otherwise appropriated, $5,000,000, to remain available until expended, for purposes of carrying out this subsection.
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- 42 USC 1395w–4(b)
- 42 USC 1395w–4(c)(2)(B)(iv)
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Sec. 104
Medicare incentives for behavioral health integration with primary care
Cite42 USC 1395w–4(b)
Cite42 USC 1395w–4(c)(2)(B)(iv)
Cites 2Cited by 0 across 0 sources