MA H1396

Increases minimum payment rates for behavioral health services by 5% per procedure code, effective January 1, 2027

Requires behavioral health clinic reimbursement rates to be at least 20% higher than rates paid to independent practitioners for comparable services

Applies to both direct Medicaid payments and managed care entities including health insurers, HMOs, and accountable care organizations

Mandates biennial review of behavioral health service rates, incorporating Medicare Economic Index inflation adjustments and comparison to 75th percentile wages from Bureau of Labor Statistics

Covers services for mental health, developmental disorders, and substance use disorder including evaluation, diagnosis, treatment, care coordination, and peer support