Medicare policy increases payments for integrated mental health services

The Centers for Medicare and Medicaid Services (CMS) updated the CY 2027 Medicare Physician Fee Schedule to increase payments for Collaborative Care services.

This policy change aims to improve access to mental health treatment by making it easier for primary care practices to offer integrated behavioral health services. The new rule raises work RVUs and clinical labor rates for the Collaborative Care model by as much as 73 percent compared to previous Medicare rates.

This model combines a primary care provider, a behavioral health care manager, and a psychiatric consultant to coordinate treatment for patients with conditions like depression and anxiety. By embedding these services into routine medical visits, the model helps patients receive quicker diagnoses and treatment without needing to navigate separate systems. West Health says the previous lack of sufficient reimbursement limited the reach of the model despite its proven effectiveness.

The organization points to its partnership with Northwestern Medicine as a successful example of the model in action. Through the Northwestern Medicine West Health Accelerator, the health system expanded these services to 86 clinics, providing access to more than 500,000 patients. Research from the West Health-Gallup Center on Healthcare in America indicates that many people struggle to find mental health providers.

While 70 percent of Americans want their primary care doctors to address both physical and mental health, nearly one-third of people say they have never been asked about their mental health during an office visit. The CMS policy change intends to make the Collaborative Care model financially sustainable for more practices.