Mental health services
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Spotlight
- Opioid Treatment Programs (OTPs): Calendar year (CY) 2025 updates
CMS updated Opioid Treatment Program (OTP) information for CY 2025, including payment and locality rates.
LCD / NCD – policy information
LCD
Search for mental health and CHMC PHP-related LCDs using these available tools:
- Interactive LCD index tool
- View First Coast’s active / proposed LCDs / articles on CMS’ Medicare coverage database (MCD)
NCD
Medical documentation
Medical record documentation is used to verify that services were billed correctly and to ensure that payment and processing of Medicare claim(s) are accurate and based on sound policy. Find information, tips, and resources regarding medical documentation.
Targeted probe and educate review topics
Education
Utilize educational information from First Coast and CMS on mental health services.
- View First Coast’s upcoming events
- On-Demand Learning
- Psychiatric and psychotherapy services YouTube
- CMS open door forums -- overview
FAQs
Before you call the First Coast provider contact center, find answers to mental health and CMHC PHP-related FAQs on First Coast’s and/or CMS’ website.
- View our specialty / services FAQs for additional information.
- View CMHC PHP FAQs on CMS.gov
CMS internet-only manual (IOM)
The CMS’ IOMs contain day-to-day operating instructions, policies, and procedures based on statutes, regulations, guidelines, models, and directives.
The following CMS IOMs contain information specific to providers of mental health services:
- CMS IOM Pub 100-01 Medicare General Information, Eligibility, and Entitlement Manual, Chapter 3, Section 30
- CMS IOM Pub. 100-02 Medicare Benefit Policy Manual, Chapter 13
- CMS IOM Pub. 100-02 Medicare Benefit Policy Manual, Chapter 15
- CMS IOM Pub. 100-04 Medicare Claims Processing Manual, Chapter 5
- CMS IOM Pub. 100-04 Medicare Claims Processing Manual, Chapter 9
- CMS IOM Pub. 100-04 Medicare Claims Processing Manual, Chapter 12
- CMS IOM Pub 100-08 Medicare Program Integrity Manual, Chapter 3, Section 3.3.2.6
- CMS IOM Pub 100-08 Medicare Program Integrity Manual, Chapter 13, Section 13.5.4
The following CMS IOMs contain information specific to CMHC PHP providers:
- CMS IOM Pub. 100-02, Medicare Benefit Policy Manual, Chapter 6, Hospital Services Covered under Part B, Section 70, Outpatient Hospital Psychiatric Services
- CMS IOM Pub. 100-02, Medicare Benefit Policy Manual, Chapter 2, Inpatient Psychiatric Hospital Services
- CMS IOM Pub. 100-04, Medicare Benefit Policy Manual, Chapter 4, Inpatient Psychiatric Benefit Days Reduction and Lifetime Limitation
The following CMS IOM contains information specific for enrollment, including providers that are eligible and not eligible to enroll:
Resources
CMS resources
Professional associations, societies and organizations
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