|
The Department of Human Services (DHS) is sharing Certified Community Behavioral Health Center (CCBHC) updates regarding substance use disorder (SUD) service and billing code changes as outlined in this Behavioral Health Administration (BHA) e-Memo. DHS carefully assessed the effects of state-level legislative changes to the integrated CCBHC model and CMS-approved alternative payment methodology.
The DHS CCBHC Policy Team conducted a comprehensive review of the CCBHC model to ensure that the state-level SUD changes could be implemented without unintentionally affecting the CCBHC model's integrity.
These steps included, but were not limited to:
- Legal review and analysis of the state SUD legislation
- Legal review and analysis of the CCBHC state plan language
- Program review and analysis of the SUD changes
- Fiscal review and analysis of the CCBHC payment methodology
The review concluded that CCBHCs are subject to the state-level SUD changes. Through the analysis, we identified a gap in services for CCBHCs if the effective date for SUD changes is delayed: the ability to provide and bill for the new Recovery Support services. For this reason, we have determined that the effective date for SUD changes for CCBHCs must be Aug. 1, 2026, to align with the non-CCBHC SUD providers. However, the CCBHC daily bundled rate payment methodology takes significantly more time to implement and test in the Medicaid Management Information System (MMIS) than traditional fee-for-service (FFS) code changes. MMIS will not be ready to accept the two SUD treatment codes that are replacing H2035 nor will the code/modifier combination for the new service, Recovery Support, be ready on Aug. 1, 2026.
To align with non-CCBHC SUD providers and the effective date of Aug. 1, 2026, CCBHCs must discontinue use of the Health Care Procedure Code (HCPC) H2035 beginning with claim dates of service on August 1, 2026. DHS will notify CCBHCs when the SUD changes are live in MMIS for CCBHCs. At that time, CCBHCs must bill SUD claims for dates of service beginning Aug. 1, 2026, and beyond.
This delays CCBHCs’ ability to bill and receive payment for SUD services beginning Aug. 1, 2026. This does not delay or affect CCBHCs’ ability to bill and receive payment for all other non-SUD CCBHC services. The SUD changes for CCBHC are estimated to be live in MMIS prior to Oct. 1, 2026. Aligning the effective date with non-CCBHC SUD providers allows CCBHCs the ability to also provide and retroactively bill the new service of Recovery Support for claim dates of service Aug. 1, 2026, and beyond.
The revised CCBHC Scope of Services that will take effect Aug. 1, 2026, is available on the CCBHC webpage. The revised codes and modifiers are in the “Substance Use Disorder Treatment” section.
Refer to the “Information on 2026 Changes” listed under the News and Current Reminders heading on the Substance Use Disorder Reform webpage for information about the upcoming SUD changes. Also, be sure to follow the information shared in the Thursday Connections with SUD at DHS.
Submit questions related to the SUD changes to sud.direct.access.dhs@state.mn.us.
Submit CCBHC-specific questions to mn_dhs_ccbhc@state.mn.us.
|
