MEDICAID SUD SERVICES RATE ADJUSTMENT ACT.

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View NCGA Bill Details(link is external)2025-2026 Session
Senate Bill 567 (Public) Filed Tuesday, March 25, 2025
AN ACT TO ESTABLISH AND ADJUST MEDICAID REIMBURSEMENT RATES FOR SUBSTANCE USE DISORDER SERVICES.
Intro. by Meyer, Adcock, Batch.

Status: Ref To Com On Rules and Operations of the Senate (Senate action) (Mar 26 2025)
S 567

Bill Summaries:

  • Summary date: Mar 27 2025 - View Summary
     
    Directs the Department of Health and Human Services, Division of Health Benefits to make the following changes to Medicaid substance use disorder payments, each per diem: 
     
    (1) ASAM level 2.1 substance use intensive outpatient program services increased to $255.28. (2) ASAM level 2.5 substance use comprehensive outpatient treatment program services increased to $400.00. (3) Coverage for ASAM level 3.1 clinically managed low-intensity residential treatment services established at a rate of $350.00. (4) Coverage for ASAM level 3.3 clinically managed high-intensity treatment services established at a rate of $250.00. (5) Coverage for ASAM level 3.5 clinically managed residential treatment services established at a rate of $550.00. (6) ASAM level 3.7 substance use medically monitored community residential treatment services increased to $650.00. (7) ASAM level 3.7 non-hospital medical detoxification services increased to $756.65.
     
    Appropriates $15,000,000 to DHB in recurring funds for each year of the 2025-2027 biennium from the General Fund to establish and increase the rates under this act. Also appropriates to DHB the federal recurring funds of $27,400,000 for each year of the 2025-2027 biennium for the same purpose. 
     
    Effective July 1, 2025.