CCBHC Development & Certification Consulting

CCBHC Development & Certification Consulting

A Certified Community Behavioral Health Clinic (CCBHC) is a community-based behavioral health clinic that meets a specific set of federal criteria established by SAMHSA and receives an enhanced Medicaid prospective payment system (PPS) rate that is designed to cover the actual cost of providing a comprehensive array of mental health and substance use disorder services. The CCBHC model was created to address the longstanding underfunding of community behavioral health services — paying for the full cost of care rather than just the clinical encounter.

CCBHCs must provide nine required service areas: crisis services available 24/7, outpatient mental health and SUD services, primary care screening and monitoring, targeted case management, psychiatric rehabilitation services, peer and family support services, intensive community mental health services (including ACT), screening, assessment, and diagnosis, and outpatient SUD services including MAT.

The CCBHC Medicaid demonstration has been expanded nationally, and states are increasingly making CCBHC certification available to qualifying organizations outside of the original demonstration states. The financial impact of CCBHC designation — particularly the PPS rate that covers actual cost of care — is transformative for organizations that achieve it.

CCBHC Requirements We Navigate

• Required Service Array
  Gap analysis of required CCBHC services with support to build services internally or through DCO partnerships.

• Staffing Requirements
  Assessment and planning for crisis staffing, peer support, care coordination, and cultural competency standards.

• Organizational Infrastructure Requirements
  Development of systems for quality reporting, care coordination, HIT, accreditation, and compliance readiness.

• Prospective Payment System Implementation
  Support with PPS methodology, cost accounting systems, and accurate rate optimization.

• Quality Reporting
  Design of data collection and reporting systems to meet CCBHC measure and funding requirements.