Directed Payment Program for Behavioral Health Services (DPP BHS)

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.

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 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.

SFY 2022 (Y1) Measures, Requirements, and Evaluation

Contact Information

Rules

Forms

DPP Contact Change Form (PDF)