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 changes to the reimbursement rates for individual mental health therapy provider services provided under the State Plan under Title XIX of the Social Security Act Medical Assistance Program (Medicaid).
Summary of Submission
Pursuant to the authority of 2023 Iowa Acts, Senate File (SF) 561, Section 13, item 21, $7,000,000 shall be used to increase reimbursement rates for individual mental health therapy providers and $3,000,000 to increase substance use disorder (SUD) provider rates.
Medicaid State Plan Amendment (SPA) IA-23-0018 will amend Attachment 4.19-B, page 7, to indicate the fee schedule effective date for psychologist services, social worker services, and behavioral health provider services is July 1, 2023. The increase to the fee schedule rates for certain services provided by individual mental health therapy providers will be 56.57% from the rates in effect on June 30, 2023. In addition, the rates for SUD procedure codes H0015 and H0035, which are covered under Medicaid fee-for-service (FFS) and Medicaid managed care will be increased by 96.47% from the rate in effect on June 30, 2023. The remaining SUD services are covered under Medicaid managed care only.
Estimated Fiscal Impact
The estimated increase in Medicaid fee-for-service (FFS) expenditures for State Fiscal Year (SFY) 2024 related to the individual mental health therapy provider rates is:
Total Dollars: $ 509,630
Federal Dollars: $ 368,792
State Dollars: $ 140,838
Public Review and Comments:
A copy of SPA IA-23-0018 is posted on the HHS website at the following link: https://hhs.iowa.gov/public-notices. To reach all stakeholders, non-electronic copies will be made available for public review at each local HHS office.
Submission of Comments:
Written comments may be sent to Hannah Olson, Department of Health and Human Services, Iowa Medicaid, 1305 E. Walnut Street, Des Moines, IA 50319 or may be emailed to holson1@dhs.state.ia.us. Please indicate SPA IA-23-0018 in the subject line of the email.
All written and emailed comments must be received no later than July 21, 2023, by 4:30 p.m.
Attachments
Submitted by:
Elizabeth Matney
Medicaid Director