CCBHC Prospective Payment System Demonstration Project
In October, 2015, Missouri was one of 24 states that received a Planning Grant from the federal Substance Abuse Mental Health Services Administration (SAMHSA) to prepare for implementing a federal demonstration project designed to pilot implementation of a Medicaid prospective payment system for community behavioral health services provided by organizations meeting new national standards for community behavioral healthcare.
In December 2016, Missouri was one of only eight (8) states selected by SAMHSA and the Centers for Medicare/Medicare Services (CMS) to actually pilot the prospective payment system.
The Division of Behavioral Health (DBH) currently have 22 community behavioral healthcare organizations serving all of Missouri's 114 counties. The community behavioral health organizations are compliance with the new federal standards for “Certified Community Behavioral Health Clinics" (CCBHCs), and are eligible to participate in the Demonstration Project. CCBHCs are required to provide:
- Crisis Mental Health Services
- Screening, Assessment and Diagnosis
- Patient-centered Treatment Planning
- Outpatient Mental Health and Substance Use Disorder Treatment Services
- Screening and Monitoring of Health Risks and Status
- Targeted Case Management
- Psychiatric Rehabilitation
- Peer and Family Support Services
The populations of focus for the Demonstration Project in Missouri include:
- Adults with serious mental illness
- Children and adolescents with serious emotional disorders
- Children, adolescents and adults with moderate to severe substance use disorders
- Children and adolescents in state custody who have behavioral health issues
- Young adults with mental illness or substance use disorders identified as in need of treatment by the courts, law enforcement, or hospital emergency rooms.
CCBHCs are required to provide services to members of the armed forces and veterans consistent with guidelines set forth by the Veterans Administration.
The Demonstration Project (which began on July 1, 2017, and runs through September 30, 2025) is designed to convert Medicaid reimbursement for community behavioral health services from a fee-for-service reimbursement system to a prospective payment system while improving the availability, accessibility, and quality of community behavioral healthcare.
- General Information
- List of Certified Community Behavioral Health Organizations
- Map of Certified Community Behavioral Health Organizations
- Narrative Section of Missouri’s Application to Participate in the Demonstration
- List of Required Evidence-based Practices
- Populations of Focus
- Progress in Development and Testing of CVS
- SAMHSA CCBHC Demonstration Information
CCBHO Reporting Measures
- DBH Targets for Value Based Payments - FY 2024 & Transition Period
- Metrics and Quality Measures for Behavioral Health Clinics Technical Specifications and Resource Manual vol. 1
- Metrics and Quality Measures for Behavioral Health Clinics Technical Specifications and Resource Manual vol. 2
- SAMHSA Quality Measures
CCBHC Impact Reports
- Information for Managed Care Organizations (MCO)
- Information for Providers
Information
- CCBHC Costs Only Service List 01/2022
- CCBHC Providers & Rates
- CCBHC Providers & Rates for 07/01/2018
- CCBHC Providers & Rates for 07/01/2019
- CCBHC Providers & Rates for 07/1/2020
- CCBHC Providers & Rates for 07/01/2021
- CCBHC Providers & Rates for 07/01/2022
- CCBHC Providers & Rates for 07/01/2023
- CCBHC Providers & Rates for 07/01/2024
- CCBHC Visit Service List 08/2024
- CCBHC Providers & Rates for FY22
- CCBHCs with Provider Numbers
- Clients Screened but Determined Ineligible for Services/Programs
- Service Categories for CCBHC
- Appendix A Crosswalk to CCBHC Services
- CCBHC Provider EDI Billing Guidelines
Regulations
- CCBHO State Plan Amendment approved
- Division 30 - Chapter 6: Certified Community Behavioral Health Organization
- SAMSHA CCBHC Demonstration Information
- In March 2023, SAMHSA released the updated criteria (PDF | 1.3 MB) for certifying community behavioral health clinics in compliance with the statutory requirements outlined under Section 223 of PAMA. Clinics and states are on different schedules to come into compliance with the updated criteria, with most being required to come into compliance by July 1, 2024. See this summary of changes (PDF | 273 KB) and the redline edits (DOC | 181 KB) from the existing criteria to the updated criteria and an implementation timeline for the different CCBHC programs and deadlines from coming into compliance with the updated criteria.
CCBHC New Criteria Implementation
- 2023 CCBHC Criteria ASAM Process
- 2023 SAMSHA CCBHC-O Provider Readiness Checklist
- CCBHC Compliance Attestation
CCBHO Policy and Procedures
Under Construction
CCBHO Bulletins
- CCBHC Health Screen Requirements, Bulletin 040 (effective July 1, 2017, revised October 1, 2018)
- CCBHO Clinical Implications for Community Support, Peer Support, and Family Support Services in CPR and CSTAR Programs, Bulletin 041 (effective July 1, 2017, revised May 15, 2019)
- CCBHC Clinical Implications for Assertive Community Treatment (ACT) and ACT/Transition Age Youth (TAY), Bulletin 042 (effective July 1, 2017)
- CCBHC Clinical Implications for Screening, Assessment and Treatment Planning in CPR, CSTAR, Outpatient Mental Health and Outpatient Substance Use Disorder Programs, Bulletin 044 (effective July 1, 2017, revised January 14, 2019)
- CCBHC Clinical Implications for Outpatient Substance Use Treatment Programs, Bulletin 045 (effective July 1, 2017)
- CCBHC Criteria for Access to Care, Bulletin 050 (effective January 1, 2019)
- CCBHC/O DCO Requirements for Crisis Behavioral Health Services
- CPS CCBHC SUD Services Grid