Summary#
This bill, called the COMPLETE Care Act, would change Medicare payments and fund technical help to encourage behavioral health services inside primary care. It adds a new payment rule to the Medicare physician fee schedule for certain behavioral health services for calendar years 2027–2029. For the listed services, payments would be set at 175% of the normal payment in 2027, 150% in 2028, and 125% in 2029. The services are identified by HCPCS codes 99484, 99492, 99493, 99494, G2214, and G0323 (and successor or similar codes as the Secretary determines).
The bill also says that the increase in those payment amounts must be excluded from certain budget-neutrality calculations for 2027–2029.
The bill requires the Secretary of Health and Human Services to contract with entities to offer technical assistance to primary care practices that want to adopt behavioral health integration models. The Secretary must do this by January 1, 2026. The bill names the Collaborative Care Model and the Primary Care Behavioral Health model as examples and allows the Secretary to identify other models. The bill allows the Secretary to implement this part by program instruction or other means. It also appropriates "such sums as are necessary" for fiscal years 2025 through 2029 to carry out the technical assistance work, available until expended.
What it means for you#
- If you are a Medicare provider offering the listed services, the bill would change how much Medicare would pay for those services in 2027–2029 (175%, 150%, and 125% of the usual amount in each year).
- If you run or work in a primary care practice, the bill requires HHS to offer technical help to adopt behavioral health integration models, with a required start date for contracts by January 1, 2026.
- If you are a Medicare patient, the bill changes how certain behavioral health services are paid for, but the bill text does not say how this would change your out-of-pocket costs or access to care.
Expenses#
- The bill appropriates "such sums as are necessary" for fiscal years 2025 through 2029 to fund the technical assistance contracts. These funds are to remain available until expended.
- The bill also directs that the payment increases for 2027–2029 be excluded from certain budget-neutrality calculations.
- No publicly available information in the bill text gives a total dollar cost or estimate of the budgetary impact.
Proponents' View#
- The bill's short title and text state its purpose is to provide incentives for behavioral health integration and to connect medical providers with links to expand tailored and effective care. Sponsors listed include Representatives Nicole Malliotakis and Lizzie Fletcher, among others.
- No further proponents' statements or detailed arguments are included in the provided text or metadata.
Opponents' View#
No publicly available information.