Behavioral Health
Medicaid is the single largest payer for behavioral health services, including mental health and substance use services. All state Medicaid programs must cover certain behavioral health services for adults, including medically necessary inpatient and outpatient hospital services, rural health clinic services, nursing facility services, home health services, and physician services. For adults, many other services used for the treatment of mental health and substance use disorder are optional.
Children and youth under age 21 are entitled to medically necessary behavioral health and other services under Medicaid’s mandatory early and periodic screening, diagnostic, and treatment (EPSDT) benefit. Behavioral health services are a required benefit in separate State Children’s Health Insurance Programs (CHIP).
States can provide behavioral health services under state plans, waivers, demonstrations, and other authorities.
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Behavioral health benefits
Substance use disorder
Featured Publications
Introduction to Work on Residential Services for Youth with Behavioral Health Needs
Access in Brief: Children and Youth with Special Health Care Needs
School-Based Behavioral Health Services for Students Enrolled in Medicaid
Access in Brief: Behavioral Health and Beneficiary Satisfaction by Race and Ethnicity
Access to Medicaid Coverage and Care for Adults Leaving Incarceration
Access to Mental Health Services for Adults Covered by Medicaid
Access to Behavioral Health Services for Children and Adolescents Covered by Medicaid and
CHIP
State Coverage Policies of Mental Health Services for Adults
Encouraging Health Information Technology Adoption in Behavioral Health: Recommendations
for Action
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Featured Publications
March 2026 Report to Congress on Medicaid and CHIP
March 12, 2026
MACPAC’s March 2026 Report to Congress on Medicaid and CHIP contains four chapters of interest to Congress: (1) a recommendation to help promote the home- and community-based services (HCBS) workforce, (2) behavioral health in Medicaid and the State Children’s Health Insurance Program (CHIP), (3) Medicaid for justice-involved youth, and (4) Medicaid for children in foster care.
Chapter 1 makes […]
Behavioral Health in Medicaid and the State Children’s Health Insurance Program
March 12, 2026
Chapter 2 of the March 2026 report focuses on behavioral health in Medicaid and the State Children’s Health Insurance Program (CHIP). The Commission has had a long-standing interest in examining behavioral health service use and spending in Medicaid, given the program’s role as a major source of coverage for behavioral health services in the United […]
Access to Appropriate Residential Services for Children and Youth with Behavioral Health Needs: Draft Recommendations
March 5, 2026
This work is a continuation of the Commission’s examination of appropriate access to residential treatment services for Medicaid-enrolled youth. MACPAC staff began with an overview of key findings and challenges with access, and highlighted new information on federal efforts to create systems for tracking beds. MACPAC staff reviewed revised draft policy recommendations based on earlier […]