Mental health -- Additional resources

CMS resources

• Medicare and Mental Health Coverage

  Medicare-covered behavioral health services, typically known as mental health and substance use services, can affect a patient’s overall well-being. It’s important to understand Medicare’s covered services and who can provide them.  

• Substance Use Screenings and Treatment

  Substance use disorders (SUDs) can develop from using various substances, like alcohol, tobacco, and opioids. SUDs can interfere with physical and mental health. CMS expanded SUD coverage so more people can access the help and care needed for recovery. 

• Opioid Treatment Programs (OTPs): Calendar year (CY) 2025 updates

  CMS updated Opioid Treatment Program (OTP) information for CY 2025, including payment and locality rates. Access the updates here.

• Opioid Treatment Program: Learn how to bill Medicare 

  Opioid Treatment Programs (OTPs) provide medications for people diagnosed with an opioid use disorder (OUD). Medicare pays for OTP services for OUD treatment when eligible. Learn more here.

• Opioid Treatment Program: Bill correctly for opioid use disorder treatment services 

  The Office of the Inspector General reported they found Opioid Treatment Program (OTP) providers didn’t always comply with federal requirements when billing for opioid use disorder (OUD) treatment services, including intake activities. Review the report and OTP billing and payment information here.

• Behavior Health Integration (BHI) services

  BHI is a model of care incorporating behavioral health care into other care, like primary care to improve mental, behavioral, or psychiatric health. We encourage all providers to help improve your patient’s behavioral health.

• Psychotherapy for crisis

  Psychotherapy for crisis services is appropriate for patients in high distress with life-threatening, complex problems requiring immediate attention. These services can help reduce a patient’s mental health crisis (including substance use disorder) through urgent assessment and history of a crisis state, mental status exam and disposition. We encourage all providers to help improve your patient’s behavioral health.

• Opioid use disorder (OUD) screening and treatment

  Medicare covers screenings and treatment for patients with OUD. Services include OUD screenings, office-based treatments, screening, brief intervention, and referral to treatment (SBIRT) and the opioid treatment program. We encourage all providers to explore these services to help improve your patient’s behavioral health.

Professional associations, societies and organizations

• Florida Psychiatric Society
• Florida Psychological Association
• Florida Board of Psychology
• Florida Clinical Social Work Marriage & Family Therapy & Mental Health Counseling
• Academy of Organizational & Occupational Psychiatry
• American Academy of Child and Adolescent Psychiatry
• American Psychiatric Association
• Agency for Health Care Administration CMHC/PHP

Other resources

• Billing compliance: Office of Inspector General report on improper payments for opioid use disorder treatment services (A-09-22-03005)

  The Office of the Inspector General (OIG) reported Medicare made $17.8 million in potentially improper payments for opioid use disorder (OUD) treatment services furnished by opioid treatment programs (OTPs). Review the report here.

• SSA.gov/disability