California Medicaid Transitions From Cost-Based Specialty Behavioral Health Reimbursement To Fee-For-Service

On July 20, 2023, the Centers for Medicare & Medicaid Services (CMS) approved a California Medicaid state plan amendment (SPA 23-0015) to transition payment for county-provided specialty behavioral health services from cost-based reimbursement to fee-for-service (FFS). The change will disaggregate data on provision of specialty behavioral health services and relieve counties and provider organizations of the administrative burden imposed by cost reconciliation for interim rates, interim payments, and interim and final settlement. It will also help the state comply with federal requirements to adopt Current Procedural Terminology in lieu of the broader Healthcare Common Procedure . . .