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.
Learn More About These Topics
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
Learn More about These Topics
Featured Publications
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 […]
Youth Use of Residential Treatment Services: Federal and State Findings
October 31, 2024
Medicaid supports a wide range of behavioral health services for children including residential treatment programs. Given ongoing concerns regarding access to behavioral health services, MACPAC is examining how Medicaid ensures that children and youth with serious behavioral health conditions appropriately access intensive services in residential settings if needed.
This session provided additional context for the Commission’s […]
Introduction to Work on Residential Services for Youth with Behavioral Health Needs
September 19, 2024
Medicaid supports a wide range of behavioral health services for children including residential treatment programs. In response to the Commission’s continued interest in services for Medicaid-enrolled children and youth, MACPAC has initiated work to examine how Medicaid ensures that children and youth with serious behavioral health conditions appropriately access intensive services in residential settings following […]
