Bill > H5230

This bill mandates that various health insurance providers, including those offering state employee health plans, Medicaid, accident and sickness insurance, hospital service plans, medical service agreements, and health maintenance contracts, must ensure that their minimum payment rates for services provided under the psychiatric collaborative care model are at least as high as the current Medicare Resource-Based Relative Value Scale (RBRVS) physician fee schedule for those specific billing codes, and these rates should be adjusted annually. The psychiatric collaborative care model is a team-based approach to mental health care integrated within primary care settings. The bill also specifies certain Current Procedural Terminology (CPT) billing codes that fall under this model, such as 99492, 99493, 99494, and G2214, and allows for the Division of Insurance to establish additional codes and payment rates. These new payment requirements will apply to contracts that are entered into, renewed, or amended on or after January 1, 2027.

Health and Social Services

Joint Committee on Mental Health, Substance Use and Recovery (Joint)

https://malegislature.gov/Bills/194/H5230