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The Directed Payment Program for Behavioral Health Services is one of four directed payment programs (DPPs) HHSC submitted to the Centers for Medicare and Medicaid Services (CMS) for approval as part of the Delivery System Reform Incentive Payment Transition Plan. CMS approved DPP BHS for state fiscal year (SFY) 2024 (Year [Y] 3) on July 31, 2023.
Background
DPP BHS is a DPP for community mental health centers (CMHCs) to promote and improve access to behavioral health services, care coordination, and successful care transitions for individuals enrolled in the STAR, STAR+PLUS, and STAR Kids Medicaid managed care programs. It also incentivizes continuation of care for these individuals using the Certified Community Behavioral Health Clinic (CCBHC) model of care.
The program includes two components:
- Component 1 is a uniform dollar increase issued in monthly payments to all CMHCs participating in the program. As a condition of participation, providers are required to report progress made toward certification or maintenance of CCBHC status. They are also required to report on the implementation status of activities foundational to quality improvement.
- Component 2 is a uniform percent increase on certain CCBHC services. As a condition of participation, providers are required to report on metrics that align with CCBHC measures and goals. Providers that have CCBHC certification are eligible for a higher rate enhancement.
SFY 2024 (Y3) Measures and Requirements
- Y3 Requirements (PDF) (2/23/2023)
- Y3 Measure Specifications and FAQs (Excel) (9/8/2023)
- Stakeholder Feedback for Y3 (PDF) (2/23/2023)
- Getting Ready for Quality Reporting (PDF) (6/28/23)
- Webinar recording: Getting Ready for Quality Reporting (6/28/23)
- Webinar slide deck: Getting Ready for Quality Reporting (PDF) (6/28/23)
SFY 2023 (Y2) Measures and Requirements
- Y2 Requirements (PDF) (1/13/2022)
- Y2 Measure Specifications (Excel) (3/23/2023)
- Y2 Measure Specifications FAQs (Excel) (3/23/2023)
- Stakeholder Feedback for Y2 (PDF) (3/1/2022)
SFY 2022 (Y1) Measures and Requirements
- Y1 Requirements (PDF) (12/1/2021)
- Y1 Measure Specifications (Excel) (4/8/2022)
- Y1 Measure Specifications FAQs (Excel) (4/8/2022)
- Stakeholder Feedback for Y1 (PDF) (3/13/2021)
- Y1 Provider-Reported Data (Excel) (10/27/2022)
Contact Information
- Visit the HHSC Provider Finance Department website for more enrollment, eligibility and payment information for DPP BHS.
- For program eligibility and financial questions, email the Directed Payment Program for Behavioral Health Services.
- For questions on DPP BHS quality requirements and reporting, email HHSC DPP Quality.
Rules
Reporting Portal Access
If you are participating in the DPP BHS program, you will use the reporting portal to access templates, review technical guidance, and submit your quality reporting. If you need to add a user or change access, submit a contact change form.