Payers Reimburse Behavioral Health Hospital Services At 34% Below Costs

Payer reimbursements to hospitals for inpatient behavioral health services in 2023 were about 34% below the actual cost of providing the services. Payments for outpatient behavioral health services were nearly 32% below the cost to provide the services. The shortfall is the average across all payers. Medicare margins for behavioral health services were 39% below hospital costs.

All payer reimbursement shortfalls affect other services as well. The largest shortfalls affect the following inpatient services:

Behavioral health, with payments at 34.3% below costs.

Nephrology, with payments 34.1% below costs.

Burn and wound care, with payments 24.1% below costs . . .