MS SPA 20-0022 Mental Health Services Coverage and Reimbursement submitted to CMS

State Plan Amendment (SPA) 20-0022 is being submitted to include: a) Replacing Intensive Outpatient Psychiatric (IOP) services with Intensive Community Outreach Teams (ICORT), b) Reimbursing ICORT services at the current IOP rate, c) Including reimbursement language for Early and Periodic Screening, Diagnosis and Treatment (EPSDT) mental health services which the rates are not being revised, d) Allowing providers of EPSDT community mental health services to provide services to non-EPSDT beneficiaries and be reimbursed according to the current payment methodology, e) Adding coverage and reimbursement of Acute Partial Hospitalization in the outpatient hospital setting, f) Adding language to ensure that community mental health services are covered for beneficiaries with a substance use disorder, g) Removing annual service limits for Crisis Response Services and Medication Administration, and h) Increasing the rate for Mental Health Assessments by a non-physician to 90% of the Medicaid physician rate for Psychiatric Diagnostic Evaluation, effective September 1, 2020.

For more information, read the submitted SPA pages.