Any provider who participates in the Medicaid program knows that it risks committing fraud if it bills twice for the same service. Unfortunately, Certified Community Behavioral Health Clinics (CCBHCs) that are also Federally Qualified Health Centers (FQHCs) have been incorrectly advised by the Centers for Medicare & Medicaid & Services (CMS) to do just that.
CCBHCs are entities that were created by a Substance Abuse and Mental Health Services Administration (SAMHSA) demonstration project to improve the availability and quality of services provided in community mental health centers. Once certified, the CCBHC is required to offer a specific range of services and meet standards for service. The model is intended to ensure access to coordinated comprehensive behavioral health care. CCBHCs are paid similar to FQHCs using a Prospective Payment System (PPS) rate that is based on certain costs to provide CCBHC services.
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