Crisis Care Access: Medicare Payment for Hospital Stabilization Services.
This Act aims to improve immediate access to help for individuals experiencing a mental health or substance use crisis by including crisis stabilization services in the Medicare payment system for hospital outpatient departments. This means hospitals will be able to receive payment for providing comprehensive crisis care, including observation, suicide and violence risk assessment, and physical health care, for up to 23 hours. These changes, effective January 1, 2027, are designed to ensure citizens receive faster and more coordinated assistance during behavioral health emergencies.
Key points
Funding for Crisis Care: Medicare will begin paying hospitals for crisis stabilization services provided in outpatient departments, increasing the availability of immediate help.
Definition of Stabilization Services: These services include observation and supervised care for up to 23 consecutive hours, assessment of suicide and violence risk, and care for immediate physical health needs.
Hospital Requirements: To receive payment, hospitals must ensure 24/7 staffing by a multidisciplinary team (including psychiatrists, nurses, peer support specialists) and the capability to accept referrals from mobile crisis response teams.
Peer Support Integration: The Act defines and integrates the role of Peer Support Specialists—individuals in recovery who are certified to provide support services.
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