Mental Health Services Should Be More Accessible in Primary Care Settings

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Date: 7/23/2008
Media Contact: SAMHSA Press Office
Telephone: 240-276-2130

Mental Health Services Should Be More Accessible in Primary Care Settings

A new report released today by three agencies of the U.S. Department of Health and Human Services proposes strategies to overcome barriers associated with the reimbursement of mental health services provided in primary care settings. Key actions recommended focus on a variety of stakeholders, including primary care providers, state Medicaid officials, and others billing for mental health services in the public sector, working together to promote a greater understanding of mental health reimbursement policy .

“The actions identified in this study are practical as well as achievable,” said Terry Cline, Ph.D., administrator of the Substance Abuse and Mental Health Services Administration (SAMHSA). “Improving access to timely and targeted mental health services in primary care settings can improve patient health and compliance with treatment.”

The report was jointly funded by SAMHSA and the Health Resources and Services Administration (HRSA), with the technical expertise of the Centers for Medicare & Medicaid Services (CMS).

“I am pleased to see the results of HRSA’s collaboration with SAMHSA and CMS on this issue,” said HRSA Administrator Elizabeth M. Duke. “Actions identified in this report can help improve reimbursements for health centers and other safety-net providers that deliver mental health services in primary care settings, such as Community Health Centers, which is important to our grantees.”

Mental health service consumers, practitioners, providers, researchers and government officials identified seven barriers and made suggestions for action aimed at alleviating the barriers to the reimbursement of mental health services in the primary care setting.

The main priorities and actions recommended in the conclusions of the report, Reimbursement of Mental Health Services in Primary Care, include the following:

• Increase leadership collaboration at the federal and state levels among government policymakers in Medicare, Medicaid, primary care, and mental health to ensure clarity in policies, rules, and procedures, and to promote the provision and reimbursement of mental health services in primary care settings;

• Broadly disseminate clarified policies and procedures to patients, payers, practitioners, providers, and managers of care;

• Provide technical assistance and education to states, practitioners, providers, and managed care organizations;

• Encourage flexibility in state Medicaid benefit designs to cover mental health services in primary care settings, modeling changes based on best practices achieved through existing state Medicaid waivers;

• Increase payment for professional services by non-physician practitioners under Medicare and Medicaid, particularly in underserved rural and urban areas;

• Implement policies at the state level for appropriate reimbursement of telemedicine services; and,

• Provide reimbursement for mental health prevention and screening services.

The full report is available on the Web at http://download.ncadi.samhsa.gov/ken/pdf/SMA08-4324/SMA08-4324.pdf . Additional information about billing for mental health services is available at: http://hipaa.samhsa.gov/hipaacodes2.htm.
For related publications and information, visit http://www.samhsa.gov.

SAMHSA is a public health agency within the Department of Health and Human Services. The agency is responsible for improving the accountability, capacity and effectiveness of the nation's substance abuse prevention, addictions treatment, and mental health services delivery system.

Page Last Updated: 7/23/2008