Centers for Medicare & Medicaid Services (CMS) Funding and Resources

Provides state Medicaid agencies with the opportunity to participate in a value-based payment model that will promote integrated behavioral healthcare delivery in outpatient settings for Medicaid, Medicare, and dually eligible beneficiaries with mental health and/or substance use disorders (SUDs). Seeks to align payment between Medicare and Medicaid for integrated services, with the goal of improving behavioral health access, quality, and outcomes for the target population. Tribal and rural providers may be selected to join the model as practice participants.

Offers a dataset with information on Medicare-enrolled Opioid Treatment Program (OTP) providers that is updated weekly. Contains the name, National Provider Identifier (NPI), address, phone number, and the effective enrollment date for each provider. Includes resources for understanding and using the data.

Describes the Centers for Medicare & Medicaid Services (CMS) activities to address the opioid epidemic related to prevention, treatment, and data. Highlights program successes, innovative approaches, and future goals of CMS efforts to address the opioid crisis.

Evaluates 7 states participating in CMS's Maternal Opioid Misuse (MOM) Model, which is designed to support delivery system transformation for pregnant and postpartum people enrolled in Medicaid who have opioid use disorder (OUD). Provides an overview of program activities for implementation year 2 from July 2022 to June 2023, including adoption, implementation, reach, and sustainability of the model, as well as the model's outcomes and effectiveness. Discusses barriers and other factors affecting care in rural areas.

Provides data describing Medicaid and the Children's Health Insurance Program (CHIP) enrollees, ages 12 to 64, who received at least 1 mental health (MH) or substance use disorder (SUD) service paid for by Medicaid or CHIP in 2020. Supports CMS efforts to measure disparities in healthcare access and make targeted, data-informed investments to improve health equity for Medicaid and CHIP populations. Summarizes demographic trends among enrollees receiving SUD/MH services, including analysis by age, sex/gender identity, race/ethnicity, geographic area, primary language spoken, and eligibility category.

Provides a dataset with comparisons of the number and percentage of Medicaid opioid prescriptions from each state. Includes an interactive mapping tool and resources for understanding and using the data.

Describes a benefit that covers opioid use disorder (OUD) treatment services under Medicare Part B medical insurance. Enables the Centers for Medicare & Medicaid Services (CMS) to make bundled payments to certified opioid treatment programs (OTPs) for OUD treatment services for an episode of care provided to Medicare Part B beneficiaries. Covers the following services under the benefit: opioid agonist and antagonist medications for opioid use disorder (MOUD) approved by the U.S. Food and Drug Administration (FDA), substance use counseling, individual and group therapy, toxicology testing, intake activities, periodic assessments, and intensive outpatient services.

Provides a dataset with comparisons of the number and percentage of Medicare Part D opioid prescriptions at the state, county, and ZIP code level. Includes an interactive mapping tool and resources for understanding and using the data.

Offers technical assistance for clinicians in small, underserved, and rural practices to participate in the Centers for Medicare and Medicaid Services (CMS) Quality Payment Program (QPP), which establishes value-based payment systems and models for clinicians serving Medicare patients. Help participants understand QPP requirements, learn about flexible options for small practices, and implement measures to improve quality and efficiency.

Directory of tribal behavioral health service providers that is searchable by state. Shares contact information, affiliation, and details the services available for each provider.