Certified Community Behavioral Health Clinics: A New Type of Prospective Payment System

Jun 9, 2022

Certified Community Behavioral Health Clinics (CCBHCs) are transforming access to addiction and mental illness care. CCBHCs must meet stringent criteria regarding timeliness of access, care coordination, quality reporting, staffing and scope of services. In return, they receive Medicaid payment based on a prospective payment system (PPS). States and the federal government have substantial experience with PPS across many health care programs. PPS in its many variations provides a critical financial foundation across the safety net and deserves continued support from policymakers. As more states consider adopting the CCBHC model, it is important for state officials to understand how CCBHC PPS operates and the levers of state control available to them in the CCBHC PPS model.