Mental health benefits are provided for most Medicaid members through Prepaid Mental Health Plans (PMHP). An overview of mental health services covered by Medicaid can be found under Medicaid Benefits. Foster care children may get outpatient mental health services from any Medicaid provider that their case worker recommends.
Foster children are enrolled in the PMHP for inpatient hospital mental health care.
Related Resources
Medicaid is the single largest payer for mental health services in the United States and is increasingly playing a larger role in the reimbursement of substance use disorder services. Individuals with a behavioral health disorder also utilize significant health care services—nearly 12 million visits made to U.S. hospital emergency departments in 2007 involved individuals with a mental disorder, substance abuse problem, or both. Congress enacted several laws designed to improve access to mental health and substance use disorder services under health insurance or benefit plans that provide medical/surgical benefits. The most recent law, the Mental Health Parity and Addiction Equity Act (MHPAEA), impacts the millions of Medicaid beneficiaries participating in Managed Care Organizations, State alternative benefit plans (as described in Section 1937 of the Social Security Act) and the Children’s Health Insurance Program.
This new and revised section of the Medicaid.gov website that provides information to States, managed care organizations, providers, beneficiaries and others regarding mental health and substance use disorder—referred to as behavioral health services. This site provides information regarding services and supports to meet the health, behavioral health and long term services and support needs of Medicaid individuals with mental health or substance use disorders. This website has been organized around several key areas that the Centers for Medicaid and CHIP Services (CMCS) has identified as a priority for the next several years:
- Effective benefit design for mental health services for children, youth and their families
- Effective benefit design for substance use disorder services
- Mental Health Parity and Addiction Equity Act (MHPAEA) application to Medicaid programs
Each of these areas will contain documents and other reference materials that may be helpful to States and managed care organizations as they consider their behavioral health benefit design and delivery systems. In addition, each area identifies the technical assistance resources regarding behavioral health that CMCS and our other federal partners will make available to States and CMS grantees.
To find a doctor that accepts Medicare payments, you may want to visit the Centers for Medicare and Medicaid Services' Physician
Compare. You can search by entering a health care professional’s last name or group practice name, a medical specialty, a medical condition, a body part, or an organ system. This tool will provide you with a list of professionals or group practices in the specialty and geographic area you specify, along with detailed profiles, maps and driving directions. Please note that Physician Compare only lists professionals
that accept Medicare. Although some may also accept Medicaid, it does not have information about which professionals do accept Medicaid. Medicaid programs vary by state and each state Medicaid agency maintains their own list of professionals that accept Medicaid. For further assistance, please contact your health plan or state Medicaid agency. For more information about Medicaid, visit the
Medicaid & CHIP page on Healthcare.gov. If you have trouble accessing the Physician Compare website, please call 1-800-MEDICARE and a representative will be able to run the search for you. They can also send you a print version of the search results. There are
other directories on MedlinePlus that will help you find health professionals, services, and facilities, some of which may serve Medicare or Medicaid payments.
Content
created by Digital Communications Division (DCD)
Content last reviewed September 10, 2015