Behavioral Health
Medicaid is the single largest payer for behavioral health services, including mental health and substance use services. All state Medicaid programs must cover certain behavioral health services for adults, including medically necessary inpatient and outpatient hospital services, rural health clinic services, nursing facility services, home health services, and physician services. For adults, many other services used for the treatment of mental health and substance use disorder are optional.
Children and youth under age 21 are entitled to medically necessary behavioral health and other services under Medicaid’s mandatory early and periodic screening, diagnostic, and treatment (EPSDT) benefit. Behavioral health services are a required benefit in separate State Children’s Health Insurance Programs (CHIP).
States can provide behavioral health services under state plans, waivers, demonstrations, and other authorities.
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Behavioral health benefits
Substance use disorder
Featured Publications
Introduction to Work on Residential Services for Youth with Behavioral Health Needs
Access in Brief: Children and Youth with Special Health Care Needs
School-Based Behavioral Health Services for Students Enrolled in Medicaid
Access in Brief: Behavioral Health and Beneficiary Satisfaction by Race and Ethnicity
Access to Medicaid Coverage and Care for Adults Leaving Incarceration
Access to Mental Health Services for Adults Covered by Medicaid
Access to Behavioral Health Services for Children and Adolescents Covered by Medicaid and
CHIP
State Coverage Policies of Mental Health Services for Adults
Encouraging Health Information Technology Adoption in Behavioral Health: Recommendations
for Action
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Featured Publications
Utilization of Medications for Opioid Use Disorder in Medicaid
January 23, 2025
Medicaid plays an important role in facilitating access to treatment for the estimated 1.9 million beneficiaries with opioid use disorder (OUD). Federal law requires state Medicaid programs to cover all three forms of medications for opioid use disorder (MOUD): methadone, buprenorphine, and extended-release injectable naltrexone. These medications are the standard of care for OUD, yet […]
Access in Brief: Postpartum Mental Health in Medicaid
January 15, 2025
Medicaid plays a critical role in providing maternity-related services for pregnant women, financing more than 41 percent of all births in the United States. It is also the single largest payer of behavioral health care. Approximately 20 percent of postpartum women experience mental health conditions, including mood disorders such as postpartum depression, anxiety, and bipolar […]
Transitions of Care for Children and Youth with Special Health Care Needs: Interview and Focus Group Findings
October 31, 2024
Medicaid plays a large role in covering health care services for children and youth with special health care needs (CYSHCN). As CYSHCN reach adulthood, they need to transition from child to adult coverage and health care, which can be challenging for beneficiaries and their families. Our work examined state policy on transitions of care and […]
