Regulatory updates that include a 4.5% increase to Medicaid Behavioral Health Reform 1115 Waiver Services have been adopted.
This rate increase is effective for all dates of service (DOS) effective November 8, 2024.
These new rates will be implemented in the Medicaid Management Information System (MMIS). No changes will be made within Optum’s system as all claims processing will occur in the MMIS as of November 1, 2024.
The “Chart of Behavioral Health Reform 1115 Medicaid Services Rates”will be published to the Division of Behavioral Health (DBH) Medicaid Related Information webpage as soon as possible.
DBH provider fee schedules do not include reference to all services reimbursed by Medicaid. If there are questions about services in this chart or services not covered in this chart, controlling regulation should be consulted. Regulatory payment restrictions such as payment limits, coverage limitations, mutually exclusive restrictions, or service authorization requirements are not fully addressed in the fee schedule documents.
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