Relative to access to psychiatric collaborative care
Summary
H5230 would require certain Massachusetts health insurance carriers and public coverage programs to pay for psychiatric collaborative care model services at minimum rates tied to the Medicare Resource-Based Relative Value Scale physician fee schedule. The bill specifies that reimbursement for psychiatric collaborative care must include current CPT billing codes 99492, 99493, 99494, and G2214, and it authorizes the Division of Insurance to issue regulations or guidance to add additional codes and set minimum payment rates.
The measure amends multiple sections of the General Laws governing different types of health coverage, including Medicaid-related coverage and commercial insurance products such as hospital service plans, medical service plans, and accident and sickness policies. It applies to contracts entered into, renewed, or amended on or after January 1, 2027, thereby creating a future effective date for implementation across the affected insurance markets.
Impact
The bill would change reimbursement requirements across several Massachusetts insurance statutes by mandating minimum payment levels for psychiatric collaborative care model billing codes, generally at or above Medicare-based rates. It would affect MassHealth-related coverage and multiple chapters of the General Laws governing insurers and health plans, requiring carriers and plans to cover and pay for these services under specified billing codes and allowing regulatory expansion of covered codes by the Division of Insurance.
Sentiment
The available context suggests generally favorable sentiment toward the bill. The committee reported that the bill ought to pass, and there is no recorded opposition, vote tally, or transcript indicating controversy. The bill’s focus on expanding access to mental health care through better reimbursement appears to have been viewed positively by the reporting committee.
Contention
No specific points of contention are documented in the available materials. Potential areas of debate, if any arise later, would likely concern the cost impact on insurers and public programs, the use of Medicare-based payment benchmarks, and the Division of Insurance’s authority to add additional billing codes and set minimum rates. However, the provided record does not show any expressed opposition from legislators, insurers, providers, or advocacy groups.