What is it?
Medicaid is a joint federal and state organized program that provides behavioral health care coverage to those who have low incomes or certain disabilities. It is the single largest payer for individuals with behavioral health conditions. As of 2020, nearly 29% of Medicaid insured individuals were diagnosed with a behavioral health condition, compared to 21% of privately insured and 20% of uninsured people.
Federal law requires Medicaid to cover certain behavioral health services, including specific outpatient and inpatient services. States can choose to include additional services such as case management, peer support, and residential care. With recent federal policy focus on expanding Medicaid coverage, many states have committed to initiatives designed to expanding tele-behavioral health coverage, community-based service access, substance use support, and crisis intervention programs. With several mandating requirements, controlled funding, and a complex patient population, Medicaid programs often generate innovative care models to be able to maximize care services for their patient population. However, the state-based structure of Medicaid leads to significant nationwide variation that can be confusing for health care partners to navigate.