HR2509-119

What This Bill Does

The COMPLETE Care Act creates Medicare payment incentives for integrating behavioral health with primary care. For HCPCS behavioral health integration and collaborative care codes 99484, 99492, 99493, 99494, G2214, and G0323, Medicare payment would be 175 percent of the otherwise applicable amount for 2027, 150 percent for 2028, and 125 percent for 2029. Those temporary increases are excluded from a budget-neutrality calculation that otherwise could reduce other physician-fee-schedule payments. By January 1, 2026, HHS must contract with appropriate entities to provide technical assistance to primary care practices adopting Collaborative Care, Primary Care Behavioral Health, or other integration models. The bill appropriates such sums as necessary for fiscal years 2025 through 2029 for the technical assistance work.

Who Benefits and How

Primary care practices benefit from higher Medicare payments for behavioral health integration services and technical assistance for adopting integration models. Behavioral health clinicians working in integrated care benefit from stronger reimbursement for collaborative care and primary care behavioral health codes. Medicare beneficiaries with mental health or substance-use needs benefit if more primary care practices add integrated behavioral health services. Technical assistance organizations benefit from HHS contracts or agreements to support practice adoption of integration models.

Who Bears the Burden and How

Medicare Part B bears higher payments for covered behavioral health integration codes in 2027, 2028, and 2029. CMS must implement temporary payment multipliers, identify successor codes, avoid budget-neutrality offsets, and manage technical assistance contracts. Federal taxpayers fund the increased Medicare payments and such sums as necessary for fiscal years 2025 through 2029 technical assistance. Practices adopting integration models must change workflows, staffing, billing, and care coordination to use the incentive effectively.

Key Provisions

• Establishes Medicare payment rates of 175 percent in 2027, 150 percent in 2028, and 125 percent in 2029 for specified behavioral health integration codes.
• Covers Collaborative Care Model and Primary Care Behavioral Health codes including 99484, 99492, 99493, 99494, G2214, and G0323.
• Excludes the temporary payment increases from the physician-fee-schedule budget-neutrality calculation.
• Requires HHS technical assistance contracts by January 1, 2026 and appropriates such sums as necessary for fiscal years 2025 through 2029.