Payment Reform

CalMHSA works with the Department of Health Care Services (DHCS) to help counties achieve the behavioral health payment reforms necessary to implement California Advancing and Innovating Medi-Cal (CalAIM) initiatives. This includes collecting fiscal data from all counties to use in the development of new rates tied to Current Procedural Terminology (CPT) codes, as well as hosting payment reform webinars for county leadership and their staff.

CalMHSA analyzed cost surveys from all 58 counties and their contracted providers to help the DHCS develop and evaluate new payment rates. To aid counties in the completion of these cost surveys, CalMHSA created survey instructions and training materials and hosted weekly office hours to answer any questions about the process. In addition to rate review, CalMHSA is helping counties create coding crosswalks, document and material review, and code analysis to support the CPT billing codes that will be required in 2023.

 

Rate Setting: Supplemental Materials (password protected)