Sponsors (2)
The bill increases Medicare payments and funds technical assistance to expand integrated behavioral health in primary care—likely improving access for beneficiaries and supporting providers—but raises federal costs and risks uneven uptake that could widen disparities or skew service delivery.
Medicare beneficiaries receiving behavioral health integration services will receive higher Medicare payment multipliers (175% in 2027, 150% in 2028, 125% in 2029), increasing provider revenue and likely improving access to integrated behavioral health care.
Primary care practices and health systems will receive technical assistance to adopt certified behavioral health integration models by Jan 1, 2026, helping expand integrated care capacity and clinician capability.
The higher payments for behavioral health integration are excluded from budget-neutrality adjustments for 2027–2029, so the incentive increases won't be offset by reductions elsewhere in the Medicare physician fee schedule and thus are more likely to achieve their intended effect.
Taxpayers will likely face increased Medicare spending because the higher payment multipliers are excluded from budget-neutrality offsets for 2027–2029, increasing federal costs.
Medicare beneficiaries and providers may see shifting service patterns because concentrating higher payments on specific HCPCS codes could incentivize billing for those services over other needed care, potentially skewing service delivery.
Smaller or resource-limited providers—particularly in rural and low-income communities—that cannot adopt certified behavioral health integration models may not benefit from the incentives, risking wider disparities in access to integrated care.
Based on analysis of 2 sections of legislative text.
Temporarily raises Medicare payments for specific behavioral health integration services (2027–2029) and funds technical assistance for primary care to adopt BHI models.
Official title: Amend title XVIII of the Social Security Act to provide incentives for behavioral health integration.
Introduced March 11, 2025 by Catherine Marie Cortez Masto · Last progress March 11, 2025
Increases Medicare payment rates for specified behavioral health integration (BHI) services for calendar years 2027–2029 (175% in 2027, 150% in 2028, 125% in 2029) and exempts those increases from Medicare budget-neutrality adjustments for those years. Requires the HHS Secretary to contract for technical assistance to help primary care practices adopt BHI models (e.g., Collaborative Care Model) by January 1, 2026, and appropriates “such sums as are necessary” for FY2025–FY2029 for that assistance.