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CERTIFIED COMMUNITY BEHAVIORAL HEALTH CLINICS (CCBHCs)
What is a CCBHC?
CCBHCs were created through Section 223 Protecting Access to Medicare Act (PAMA), which established a demonstration program based on the Excellence in Mental Health Act.
The Excellence Act is a two-year, 8-state demonstration to expand Americans’ access to mental health and addiction care in community-based settings. The Excellence Act established a federal definition and criteria for Certified Community Behavioral Health Clinics (CCBHCs) and stipulated that CCBHCs may receive an enhanced Medicaid reimbursement rate based on their anticipated costs of care.
CCBHCs are responsible for directly providing nine required types of services, with an emphasis on the provision of 24-hour crisis care, utilization of evidence-based practices, care coordination, and integration with physical health care. Ultimately, the demonstration program is expected to infuse more than $1.1 billion into community-based services, making it the largest investment in mental health and addiction care in generations.
CCBHCs are paid through a Prospective Payment System like that used by Federally Qualified Health Centers and other types of providers. PPS rates are CCBHC specific, and the same rate is paid regardless of the intensity of services. In establishing PPS rates, CCBHCs must create a cost report that includes the cost of providing all services to all patients in order to establish the cost of serving patients in that clinic.