More Behavioral Health Providers Act of 2025
The More Behavioral Health Providers Act of 2025 would expand the Medicare health professional shortage area (HPSA) bonus program to include mental health and substance use disorder (SUD) services. Specifically, it broadens eligibility for the HPSA incentive payments beyond physicians to certain non-physician practitioners who provide mental health or SUD care in designated shortage areas. The bill creates two bonus tracks: a 10% add-on for physicians’ services in standard HPSAs and a 15% add-on for “specified health services” (defined mental health and SUD treatments) furnished in areas designated as mental health professional shortage areas (MHPSAs). These bonuses would be paid from the Federal Supplementary Medical Insurance Trust Fund on a monthly or quarterly basis. The bill also expands who qualifies as an “applicable practitioner” to include physician assistants, nurse practitioners, clinical nurse specialists, clinical social workers, clinical psychologists, marriage and family therapists, and mental health counselors. In short, the act aims to increase Medicare payments to a broader group of providers delivering mental health and SUD care in shortage areas, with a higher bonus for non-physician mental health providers in MHPSAs, in order to incentivize expanded access to behavioral health services.
Key Points
- 1Expands HPSA bonuses to include mental health and SUD services furnished in MHPSAs, not just general physician services.
- 2Two bonus rates: 10% additional payment for physicians’ services in standard HPSAs; 15% additional payment for specified mental health and SUD services furnished in MHPSAs.
- 3Defines “specified health services” as mental health or SUD-related services covered under Medicare Part B, furnished on or after January 1, 2024.
- 4Defines “applicable practitioner” to include: physician assistants, nurse practitioners, clinical nurse specialists, clinical social workers, clinical psychologists, marriage and family therapists, and mental health counselors.
- 5Bonuses are paid from the Federal Supplemental Medical Insurance Trust Fund on a monthly or quarterly basis.
- 6Areas designated as HPSAs or MHPSAs are identified by the Secretary (with the MHPSA designation tying to mental health shortages).