MA S874

Minimum payment rates for behavioral health services under Medicaid must increase by 5% per procedure code effective January 1, 2027

Behavioral health clinics must be reimbursed at rates no less than 20% above comparable services delivered by independent practitioners

The Division of Medical Assistance must conduct biennial reviews of behavioral health service rates, including inflationary adjustments tied to the Medicare Economic Index

Rate reviews must compare staff wages to the 75th percentile of Bureau of Labor Statistics wage estimates for Massachusetts and account for costs of government mandates

Requirements apply to both direct Medicaid payments and all managed care entities including health insurers, HMOs, behavioral health management firms, and accountable care organizations