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 on November 15, 2021.
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 such as telehealth services, collaborative care, integration of physical and behavioral health, and improved data exchange.
- 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 State Fiscal Year (SFY) 2023 (Year [Y]2) Measures, Requirements, and Evaluation
HHSC conducted a public hearing on January 11, 2022 to review proposed measures and reporting requirements for Y2 of the DPP BHS program.
- Proposed Y2 Requirements (PDF) (1/10/2022)
- Proposed Y2 Measure Specifications (Excel) (1/10/2022)
- Y2 Measure Specifications FAQs (Excel) (3/1/2022)
- Stakeholder Feedback for Y2 (PDF) (3/1/2022)
- Y2 Evaluation Plan (3/31/2022)
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 Evaluation Plan (10/31/2022)
- Preliminary Y1 Evaluation Report (3/31/2022)
- Visit the HHSC Provider Finance Department website for more enrollment, eligibility and payment information for DPP BHS.
- For financial questions, email email@example.com.
- For financial questions on DPP BHS quality requirements, email DPPQuality@hhs.texas.gov.