CENTERS FOR MEDICARE AND MEDICAID SERVICES BEHAVIORAL HEALT H SERVICE PROVIDER REPORT OCTOBER 2018 This project was supported by a Cooperative Agreement, Grant No. 1M0CMS331078-04-02, from the U.S. Department of Health & Human Services, Centers for Medicare & Medicaid Services. The contents provided are solely the responsibility of the authors and do not necessarily represent the official views of HHS or any of its agencies. CONTENTS Introduction ................................................................................. 1 CENTERS FOR MEDICARE Alabama ........................................................................................ 3 AND MEDICAID SERVICES Alaska ............................................................................................ 4 Arizona .......................................................................................... 5 BEHAVIORAL California ...................................................................................... 6 Colorado ....................................................................................... 7 HEALTH Connecticut .................................................................................. 8 Florida ........................................................................................... 9 SERVICE Idaho ........................................................................................... 10 PROVIDER Illinois ...........................................................................................11 Indiana ........................................................................................ 12 REPORT Iowa ............................................................................................ 13 Kansas ......................................................................................... 14 OCTOBER 2018 Louisiana ..................................................................................... 15 Maine .......................................................................................... 16 Maryland ..................................................................................... 17 Massachusetts ............................................................................. 18 Michigan ..................................................................................... 19 Minnesota ................................................................................... 20 Mississippi ................................................................................... 21 Montana ..................................................................................... 22 Nebraska ..................................................................................... 23 Nevada ........................................................................................ 24 New Mexico ................................................................................ 25 New York ..................................................................................... 26 North Carolina ............................................................................ 27 North Dakota .............................................................................. 28 Oklahoma .................................................................................... 29 Oregon ........................................................................................ 30 Rhode Island ............................................................................... 31 South Carolina ............................................................................ 32 South Dakota ............................................................................. 33 Texas ........................................................................................... 34 Utah ............................................................................................ 35 Virginia ........................................................................................ 36 Washington ................................................................................ 37 Wisconsin .................................................................................... 38 Wyoming ..................................................................................... 39 Allowable Medicaid Telemedicine Features State-by-State Summary ........................................................... 40 INTRODUCTION The Centers for Medicare and Medicaid Services materials, along with the typical minimum educational (CMS) Behavioral Health Service Provider Report (“the requirement for the position (degree and field of Report”) was created to identify the Medicaid behav- study). The sources of information were mostly state ioral health provider types in the 37 states1 where and Tribal Medicaid or Medicaid behavioral health health programs are operated by the Indian Health plans, billing guides, fee schedules and related state Service (IHS), Tribes and Tribal organizations, and rules and statutes. Urban Indian Health Programs (UIHP), collectively The Affordable Care Act (ACA) allows states the option referred to as ITUs or Indian health care providers. to expand Medicaid eligibility to uninsured adults and Many Indian health care providers offer behavioral children whose incomes are at or below 138% of the health services but currently do not bill Medicaid. federal poverty level (FPL). As of this date, 34 states The Report will help Indian health care providers hire and D.C. have expanded Medicaid. Of the 37 states behavioral health providers that meet Medicaid licen- identified in this Report, 22 have expanded Medicaid. sure and/or certification requirements in order to bill The state summary table indicates which states have Medicaid and receive reimbursement. Indian health expanded Medicaid – those states that have expanded care providers must meet the enrollment requirements Medicaid are in green and states that have not are in of their respective Medicaid agency and that process orange. Medicaid expansion, in conjunction with other varies from state to state. The Report does not address federal laws, increases access to behavioral health state specific enrollment processes. For state specific services and enables Indian health care providers to information, please visit www.medicaid.gov to locate increase Medicaid reimbursement for behavioral health your state Medicaid website and more information and substance use disorder services. about the provider enrollment process. The state specific summaries contain links to primary sources of information located on state specific Medicaid websites. Users of the Report are encouraged REPORT CONTENTS AND ORGANIZATION to access the web-links provided in this document to The Report analyzes the 37 states with Indian health confirm that information presented in the tables is up care providers and identifies Medicaid reimbursable, to date. non-physician providers of behavioral health services. A summary table of reimbursable Medicaid telemedi- Because physicians are uniformly qualified practi- cine services for each state is also included at the end tioners that are eligible to submit claims for reim- of the state tables. This information was obtained bursement in all states, they are not included in the from the Center for Connected Health Policy’s State state summaries. Spring 2018 Telehealth Laws and Reimbursement The 37 state summary tables list Medicaid behav- Policies document. ioral health practitioners identified in state reference 1 Alabama, Alaska, Arizona, California, Colorado, Connecticut, Florida, Idaho, Illinois, Indiana, Iowa, Kansas, Louisiana, Maine, Maryland, Massachusetts, Michigan, Minnesota, Mississippi, Montana, Nebraska, Nevada, New Mexico, New York, North Carolina, North Dakota, Oklahoma, Oregon, Rhode Island, South Carolina, South Dakota, Texas, Utah, Virginia*, Washington, Wisconsin, Wyoming BEHAVIORAL HEALTH REPORT 1 INTRODUCTION CONTINUED TRIBAL SPECIFIC PROVISIONS recognized under the State or local law where the There are several important Tribal specific provisions entity is located to furnish health care services shall related to behavioral health services provided by be deemed to have been met in the case of an entity Indian health care providers. operated by the Service, an Indian tribe, tribal orga- nization, or urban Indian organization if the entity Federal Medical Assistance Percentage (FMAP) meets all the applicable standards for such licensure or Title IV of the Indian Health Care Improvement Act, recognition, regardless of whether the entity obtains Public Law 94-437, amended title XIX of the Social a license or other documentation under such State Security Act to authorize a facility of the Indian or local law. In accordance with section 1621t of this Health Service (including a hospital, nursing facility, or title, the absence of the licensure of a health profes- any other type of facility which provides services of a sional employed by such an entity under the State or type otherwise covered under the State plan), whether local law where the entity is located shall not be taken operated by such Service or by an Indian tribe or tribal into account for purposes of determining whether organization (as those terms are defined in section the entity meets such standards, if the professional is 1603 of title 25), to be eligible for reimbursement licensed in another State. 25 USC 1647a for medical assistance provided under a State plan if Licensing and for so long as it meets all of the conditions and requirements which are applicable