H.R. 9847: Improving Coordination and Access to Resources Equitably for Youth Act

This bill would require state Medicaid programs to cover certain primary care, mental health, and substance use disorder services when they are provided to the same person on the same day, rather than denying payment just because the services happened during the same visit date.

In practical terms, the bill is aimed at making it easier for a patient to get both physical health care and behavioral health care in one day. For example, if someone sees a doctor for a primary care issue and also receives a mental health or substance use disorder service at the same clinic or facility on that same day, Medicaid would not be allowed to refuse payment for one of those services solely because they were delivered on the same day.

What counts as a “same-day qualifying service”

• Primary care services provided on the same day as a mental health or substance use disorder service.
• Mental health services or substance use disorder services provided on the same day as a primary care service.
• Services can be delivered in person or through telehealth.
• The services must be furnished by a physician or practitioner working for, or under contract with, the same physician’s office, federally qualified health center, rural health clinic, or other outpatient facility.

The bill does not appear to create a new health benefit overall. Instead, it changes Medicaid payment rules so that states cannot block reimbursement for these services just because they occur on the same day.

The main effect would likely be to encourage more coordinated care, since providers could offer different kinds of treatment during one visit without risking Medicaid payment denials based on same-day billing restrictions.

Relevant Companies

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