The Iowa Department of Health and Human Services (HHS), pursuant to the requirements outlined in 42 C.F.R. ยง447.205, hereby gives notice of the following proposed action regarding State Plan Amendment (SPA) IA-23-0003. This SPA is being submitted to the Centers for Medicare and Medicaid Services (CMS) to add Multi-Systemic Therapy (MST) and Functional Family Therapy (FFT) as covered Medicaid services under the Early and Periodic Screening, Diagnostic and Treatment (EPSDT) benefit for members under age 21, including setting forth provider types that may assess members for and provide the respective service. SPA IA-23-0003 also implements the following reimbursement rates for MST and FFT provided by Nationally accredited providers meeting the requirements set forth in the SPA:
|
Service |
Service Code |
Modifier |
Rate |
|
MST |
H2033-15 min |
$46.37 |
|
|
FFT |
90846-hourly |
HK |
$164.98 |
|
FFT |
90847-hourly |
HK |
$164.98 |
This SPA is being submitted pursuant to the requirements of 2022 Iowa Acts, House File (HF) 2578, Div. 5, Section 13. 12, item 21.
Pending federal approval, the proposed effective date of this SPA is March 1, 2023.
Estimated Fiscal Impact
The estimated increase in Medicaid fee-for-service (FFS) expenditures for State Fiscal Year (SFY) 2023 related to establishing coverage of Multi-Systemic Therapy (MST) and Functional Family Therapy (FFT) is:
Total Dollars: $ 125,370
Federal Dollars: $ 70,275
State Dollars: $ 55,095
There is no state general fund impact. The state share cost will be funded by increased assessment fees.
Public Review and Comments
A copy of this SPA is posted on the HHS website at the following link: [INSERT LINK]. To reach all stakeholders, the SPA is also available for public review at each local HHS office.
Submission of Comments
Written comments may be sent to Jenny Erdman, Behavioral Health and Substance Use Disorder Policy Specialist, Department of Human Services, Iowa Medicaid, 1305 E. Walnut Street, Des Moines, IA 50319 or may be emailed to jerdman@dhs.state.ia.us. Please indicate SPA IA-23-0003 in the subject line of the email.
Written and emailed comments must be received by March 27, 2023 by 4:30 p.m.
Attachments
Submitted by:
Elizabeth Matney
Medicaid Director
Iowa Medicaid
Iowa Department of Health and Human Services