Behavioral Health Integration (Medicare)

Current understanding

Federal policy affecting Medicare payment for integrated behavioral health services delivered in primary care settings, including Collaborative Care Model (CoCM) and general behavioral health integration codes. Legislation in this area typically adjusts payment rates or funds technical assistance to help primary care practices adopt integration models.

Evidence log

• 2025-09-17 — 988 LGBTQ+ Youth Access Act of 2025: 2025 — 988 LGBTQ+ Youth Access Act of 2025 (HR5434, introduced; referred to House Energy and Commerce): crisis-line access measure for LGBTQ+ youth, adjacent to (but distinct from) Medicare behavioral health integration payment policy. (novelty: 3)
• 2025-03-28 — Rural Wellness Act: 2025 — Rural Wellness Act (introduced): USDA-based rural development financing prioritization for behavioral, mental health, and SUD treatment through FY2029, adjacent to (but distinct from) Medicare behavioral health integration payment policy. (novelty: 2)
• 2026-07-30 — Increasing Mental Health Options Act of 2026: 2026-07-30 — Increasing Mental Health Options Act of 2026 (HR9990, introduced, referred to Energy and Commerce and Ways and Means): broadly framed proposal to expand mental health care options, adjacent to (but distinct from) Medicare behavioral health integration payment policy; specific mechanisms not yet detailed at referral stage. (novelty: 3)
• 2026-06-11 — Departments of Labor, Health and Human Services, and Education, and Related Agencies Appropriations Act, 2027: 2026-06-11 — Labor-HHS-Education Appropriations FY2027 (HR9260, placed on Union Calendar): would fund FY2027 SAMHSA and HRSA behavioral health programs that support integration efforts, adjacent to (but distinct from) Medicare-specific integration payment policy. (novelty: 2)
• 2026-07-31 — Medicare Program; FY 2027 Inpatient Psychiatric Facilities Prospective Payment System-Rate Update: cross-connection with medicare-inpatient-psychiatric-coverage: IPF PPS payment and quality reporting policy sits alongside Medicare’s broader behavioral health payment framework, though IPF PPS governs facility-level inpatient psychiatric care rather than primary care integration. (novelty: 2)
• 2026-07-22 — C.A.R.E. for Mental Health Professionals Act: 2026 — C.A.R.E. for Mental Health Professionals Act (HR9866, introduced, referred to House Energy and Commerce): a mental health workforce-support measure adjacent to (but distinct from) Medicare behavioral health integration payment policy, addressing clinician availability that constrains integrated care delivery. (novelty: 2)
• 2026-07-22 — Expand the Behavioral Health Workforce Now Act: 2024 — Expand the Behavioral Health Workforce Now Act (HR9867, introduced, referred to House Energy and Commerce): a workforce-supply measure adjacent to (but distinct from) Medicare behavioral health integration payment policy, addressing clinician availability that constrains integrated care delivery. (novelty: 2) (novelty: 2)
• 2025-07-22 — Medicare Mental Health Inpatient Equity Act of 2025: 2025 — Medicare Mental Health Inpatient Equity Act of 2025 (introduced): though focused on inpatient psychiatric coverage rather than integrated primary care, it reflects the broader legislative push to expand Medicare behavioral health access by removing the 190-day lifetime cap. (novelty: 3)
• 2026-05-04 — VA Mental Health Outreach and Engagement Act: 2025 — VA Mental Health Outreach and Engagement Act (introduced): mandates annual VA mental-health consultations and proactive outreach for veterans with service-connected mental-health disabilities — a VA-side outreach expansion adjacent to (but distinct from) Medicare behavioral health integration payment policy. (novelty: 2)
• 2026-07-23 — A bill to amend title XVIII of the Social Security Act to expand access to psychological and behavioral health services.: 2026 — S5120 (introduced): Senate bill to amend Medicare (title XVIII) to expand access to psychological and behavioral health services, adjacent to integration payment policy by broadening the covered behavioral health benefit under Part B. (novelty: 2)
• 2026-05-26 — Minority Fellowship Program Reauthorization Act of 2026: 2026 — Minority Fellowship Program Reauthorization Act of 2026 (HR9044, introduced): would reauthorize SAMHSA’s Minority Fellowship Program, which trains psychiatrists, psychologists, social workers, and other behavioral health clinicians from underrepresented communities — a workforce-diversity lever adjacent to (but distinct from) Medicare behavioral health integration payment policy. (novelty: 2) (novelty: 2)
• 2025-09-08 — Rural Behavioral Health Improvement Act of 2025: 2025-09-08 — Rural Behavioral Health Improvement Act of 2025 (HR5217, introduced): rural-targeted behavioral health services proposal referred to Energy and Commerce and Ways and Means; adjacent to Medicare behavioral health integration insofar as Ways and Means jurisdiction touches Medicare payment for rural behavioral health delivery. (novelty: 3) (novelty: 3)
• 2026-07-16 — To provide funding for programs and activities under the SUPPORT for Patients and Communities Act.: 2026 — HR9759 (introduced): would fund SUPPORT Act programs that encompass substance-use disorder treatment integration, adjacent to (but distinct from) Medicare behavioral health integration payment policy. (novelty: 2)
• 2026-02-03 — To amend title 38, United States Code, to establish qualifications for the appointment of a person as a marriage and family therapist, qualified to provide clinical supervision, in the Veterans Health Administration.: 2025 — HR658 (introduced): would codify credentialing requirements for VHA marriage and family therapists providing clinical supervision; a VA-side workforce credentialing measure adjacent to (but distinct from) Medicare behavioral health integration payment policy. (novelty: 2)
• 2026-06-11 — Take Care of America’s Veterans Act: Take Care of America’s Veterans Act (HR9237, introduced) would expand VA mental health programs — a VA-side expansion adjacent to (but distinct from) Medicare behavioral health integration payment policy. (novelty: 3)
• 2025-02-04 — Parity Enforcement Act of 2025: 2025 — Parity Enforcement Act of 2025 (HR957, introduced, referred to House Education and Workforce Committee): while focused on enforcement of mental health parity in group health plans rather than Medicare integration payment, the bill reflects the broader legislative push to expand behavioral health access by strengthening coverage requirements. (novelty: 2) (novelty: 2)
• 2026-06-11 — Primary and Behavioral Health Care Access Act of 2026: 2026 — Primary and Behavioral Health Care Access Act of 2026 (S4754, introduced in Senate, referred to HELP Committee): broadly framed bill to expand access to primary and behavioral health care; specific mechanisms not yet detailed at referral stage. (novelty: 2)
• 2025-02-20 — Fatal Overdose Reduction Act of 2025: 2025 — Fatal Overdose Reduction Act of 2025 (introduced): while operating through Medicaid rather than Medicare, the bill’s Health Engagement Hub model mirrors integrated behavioral health/primary care delivery concepts by bundling SUD treatment with broader behavioral health services. (novelty: 3)
• 2026-03-12 — Removing Medicare Mental Health Inpatient Limitations Act of 2026: 2026 — Removing Medicare Mental Health Inpatient Limitations Act of 2026 (S4076, introduced): while focused on inpatient psychiatric hospital coverage rather than integrated primary care, the bill reflects the broader legislative push to expand Medicare behavioral health access by removing the 190-day lifetime cap. (novelty: 2)

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