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) 2022 (Year [Y] 1) on November 15, 2021. CMS approved DPP BHS for SFY 2023 (Y2) on August 1, 2022.
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.
Proposed SFY 2024 (Y3) Measures and Requirements
The proposed quality requirements and measures are submitted to CMS for annual program review and approval. The final quality measures and reporting requirements will be posted following CMS’ approval.
- Proposed Y3 Requirements (PDF) (2/23/2023)
- Proposed Y3 Measure Specifications (Excel) (2/23/2023)
- Proposed Y3 Measure Specifications FAQs (Excel) (2/23/2023)
- Stakeholder Feedback for Y3 (PDF) (2/23/2023)
SFY 2023 (Y2) Measures, Requirements, and Evaluation
- Y2 Requirements (PDF) (1/13/2022)
- Y2 Measure Specifications (Excel) (9/23/2022)
- Y2 Measure Specifications FAQs (Excel) (9/23/2022)
- Stakeholder Feedback for Y2 (PDF) (3/1/2022)
SFY 2022 (Y1) Measures, Requirements, and Evaluation
- 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 pfd_dppbhs@hhs.texas.gov.
- For questions on DPP BHS quality requirements and reporting, email DPPQuality@hhs.texas.gov.