MA H4893

Requires all health insurance plans in Massachusetts to cover at least 6 sessions of preventive behavioral health services for members under 21 years old who have a positive behavioral health screening, or for infants whose caregivers have a positive post-partum depression screening

Coverage applies even if the individual does not meet criteria for a formal behavioral health diagnosis, targeting early intervention for symptoms of depression, anxiety, and other social-emotional concerns

Services must be covered without prior authorization and with no patient cost-sharing (except for tax-exempt plans that would lose their status)

Allows services to be provided by licensed behavioral health clinicians or supervised non-licensed clinicians/trainees in pediatric primary care, community-based outpatient, and school settings

Requires insurers to accept Social Determinants of Health Z-codes as primary diagnosis codes for claims, and directs the Division of Insurance to develop implementation guidance in consultation with the Office of Medicaid