Medicare pays doctors 75% more to treat mental health in primary care
S. 931 — COMPLETE Care Act · Filed by Catherine Cortez Masto (D-NV) · 1 cosponsor · Introduced Mar 11, 2025 · Referred to committee
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What it does
This bill creates financial incentives for primary care doctors to integrate behavioral health (mental health and substance abuse) services into their practices over 2027–2029, paying them 175%, 150%, and 125% of normal rates respectively for specific integration codes. It also funds technical assistance to help practices adopt these models and waives budget-neutrality rules so Medicare doesn't have to offset the cost elsewhere.
Why we flagged it
The bill's core function is to increase Medicare reimbursement rates for specific behavioral health integration codes over a three-year window, coupled with technical assistance funding. It is a targeted payment reform, not a broad care-delivery mandate.
What the text implies
- The declining payment percentages (175% → 125%) create a cliff effect in 2030; practices may struggle to sustain integrated models once incentives expire, potentially fragmenting care again.
- Budget-neutrality waiver means the cost is not offset by cuts elsewhere in Medicare, increasing overall federal healthcare spending without explicit appropriation debate.
The full analysis lists 5 implications of this text.
Who stands to gain
primary care practices and federally qualified health centers; behavioral health integration service providers; healthcare IT vendors supporting integration workflows