Directed Payment Program for Behavioral Health Services

The Directed Payment Program for Behavioral Health Services (DPP BHS) is a program for Community Mental Health Centers (CMHCs) and Local Behavioral Health Authorities (LBHAs). Beginning September 1, 2024, all participants must be a Certified Community Behavioral Health Clinic (CCBHC). DPP BHS is not a direct assistance program for Medicaid beneficiaries. However, it encourages provider participation in Medicaid by providing funding to certain mental and behavioral health providers.

Overview

DPP BHS is a value-based payment program for CMHCs and LBHAs to incentivize the continuation of services to Medicaid-enrolled individuals aligned with the CCBHC model of care. The program will continue successful Delivery System Reform Incentive Payment (DSRIP) innovations to promote and improve access to behavioral health services, care coordination, and successful care transitions. DPP BHS payments will be included in Managed Care Organization (MCO) capitation rates and distributed through two components to enrolled CMHCs and LBHAs who meet program requirements throughout the State Fiscal Year (SFY).

Texas Response to CMS Round 1 Questions for SFY 2023 DPP BHS (April 21, 2022) (.pdf)
Texas Response to CMS Round 2 Questions for SFY 2023 DPP BHS (May 16, 2022) (.pdf)
Texas Response to CMS Round 3 Questions for SFY 2023 DPP BHS (June 8, 2022) (.pdf)
Texas Response to CMS Round 4 Questions for SFY 2023 DPP BHS (July 8, 2022) (.pdf)
Texas Response to CMS Round 5 Questions for SFY 2023 DPP BHS (July 28, 2022) (.pdf) 
CMS Renewal Approval Letter for SFY 2023 DPP BHS (August 01, 2022) (.pdf)
CMS Renewal Approval Letter for SFY 2024 DPP BHS (July 31, 2023) (.pdf)
CMS Renewal Approval Letter for SFY 2025 DPP BHS (July 30, 2024) (.pdf)
CMS DPP BHS Amendment Approval Letter (August 10, 2022) (.pdf)
DPP BHS Approval Letter (November 15, 2021) (.pdf) 

Federal Approval

On July 29, 2024, the Texas Health and Human Services Commission (HHSC) received federal approval to renew DPP BHS from the Centers for Medicare and Medicaid Services (CMS) for the period covering September 1, 2024, through August 31, 2025.

Methodology/Rules

HHSC adopted rules, 1 Texas Administrative Code (1 TAC) Section 353.1320, concerning the Directed Payment Program for Behavioral Health Services and (1 TAC) Section 353.1322, concerning Quality Metrics for the Directed Payment Program for Behavioral Health Services. An update to 1 TAC Section 353.1320 was published in the January 19, 2024, issue of the Texas Register (49 TexReg 244) and became effective on January 25, 2024.

The 1 TAC Section 353.1320 adoption preamble and rule text for DPP BHS are effective January 2024.

Pre-Print Packages

Proposed SFY 2022 DPP BHS Pre-Print Package of 7/13/2021 (.zip)
Updated SFY 2022 DPP BHS Pre-Print Package as of 9/15/2021 (.zip)
Reconciliation Visual Applicable to all pre-prints SFY 2022 as of 9/15/2021 (.pdf)
Updated SFY 2022 DPP BHS Pre-Print Package as of 9/29/2021 (.zip)
Updated SFY 2022 DPP BHS Pre-Print Package of 10/15/2021 (.zip)
Proposed SFY 2023 DPP BHS Pre-Print Package of 3/1/2022 (.pdf)
Approved SFY 2022 DPP BHS Pre-Print Package to 4/21/2022 (.zip) (Posted 5/20/2022)
Approved SFY 2023 DPP BHS Pre-Print Package as of 8/1/2022 (.zip)
Proposed SFY 2024 DPP BHS Pre-Print Package as of 6/1/2023 (.zip)
Approved SFY 2024 DPP BHS Pre-Print Package as of 7/31/2023 (.zip)
Proposed SFY 2025 DPP BHS Pre-Print Package as of 2/29/2024 (.zip)
Updated SFY 2025 DPP BHS Pre-Print Package as of 5/30/2024 (.zip)
Updated SFY 2025 DPP BHS Pre-Print Package as of 7/12/2024 (.zip)
Approved SFY 2025 DPP BHS Pre-Print Package as of 7/29/2024 (.zip)
Proposed SFY 2026 DPP BHS Pre-Print Package as of 5/7/2025 (.zip)

DPP BHS Participants

List of SFY 2025 DPP BHS Participants and SFY 2026 DPP BHS Applicants (.xlsx) (Updated 5/9/2025)

State Fiscal Year 2026 (Year 5)

Enrollment

HHSC collected enrollment applications for DPP BHS from February 3, 2025, through February 24, 2025. Enrollment is now closed.

Suggested IGT

Suggested Intergovernmental Transfer (IGT) amounts per provider for the first and second six months of IGT are available here (.pdf), and the Excel file is located here (.xlsx) (Updated 05/09/2025).

The modeling is available here (.pdf) and the Excel file is located here (.xlsx) (Updated 05/09/2025).

The IGT Declaration of Intent form is available here (.xlsx) (Updated 05/09/2025).

When filling out the Declaration of Intent form:

  • Cell A3 for Sponsoring Governmental Entity's (SGE's) Operational Nature should list if you are a Local Mental or Behavioral Health Authority and the county where you are headquartered.
  • Cell A5 (SGE Jurisdiction County Name) should be the primary county where the SGE is headquartered.
  • Only list the primary National Provider Identifier (NPI) for cell A12 (NPI of SGE Eligible for Payment).
  • Fill in the Provider’s Legal Name under cell A21 for Service Delivery Area (SDA) instead of SDA.

State Fiscal Year 2025 (Year 4)

Enrollment

HHSC collected enrollment applications for DPP BHS from February 1, 2024, through February 21, 2024. Enrollment is now closed.

Component 1 Scorecards

Component 1 (100% of the DPP BHS funding) is a uniform dollar increase paid prospectively every month. CMHCs and LBHAs with CCBHC certification are eligible to participate in Component 1. MCOs must make HHSC-calculated payments to DPP BHS providers in accordance with the scorecard.

DPP BHS SFY25 (Year 4) September Component 1 Scorecard (.xlsx) (Updated 9/16/2024)

DPP BHS SFY25 (Year 4) October Component 1 Scorecard (.xlsx) (Updated 10/15/2024)

DPP BHS SFY25 (Year 4) November Component 1 Scorecard (.xlsx) (Updated 11/15/2024)

DPP BHS SFY25 (Year 4) December Component 1 Scorecard (.xlsx) (Updated 12/16/2024)

DPP BHS SFY25 (Year 4) January Component 1 Scorecard  (.xlsx) (Updated 1/15/2025)

DPP BHS SFY25 (Year 4) February Component 1 Scorecard  (.xlsx) (Updated 2/17/2025)

DPP BHS SFY25 (Year 4) March Component 1 Scorecard  (.xlsx) (Updated 3/17/2025)

DPP BHS SFY25 (Year 4) April Component 1 Scorecard   (.xlsx) (Updated 4/15/2025)

DPP BHS SFY25 (Year 4) May Component 1 Scorecard   (.xlsx) (Updated 5/15/2025)

Suggested IGT

Suggested Intergovernmental Transfer (IGT) amounts per provider for the first and second six months of IGT are available here (.pdf), and the Excel file is located here (.xlsx) (Updated 05/31/2024).

The modeling is available here (.pdf) and the Excel file is located here (.xlsx) (Updated 5/15/2024).

The IGT Declaration of Intent form is available here (.xlsx) (Updated 05/07/2024).

When filling out the Declaration of Intent form:

  • Cell A3 for Sponsoring Governmental Entity's (SGE's) Operational Nature should list if you are a Local Mental or Behavioral Health Authority and the county where you are headquartered.
  • Cell A5 (SGE Jurisdiction County Name) should be the primary county where the SGE is headquartered.
  • Only list the primary National Provider Identifier (NPI) for cell A12 (NPI of SGE Eligible for Payment).
  • Fill in the Provider’s Legal Name under cell A21 for Service Delivery Area (SDA) instead of SDA.

State Fiscal Year 2024 (Year 3)

Enrollment

HHSC collected enrollment applications for DPP BHS from February 1, 2023, through February 21, 2023. Enrollment is now closed.

Component 1 Scorecards

Component 1 (65% of the DPP BHS funding) is a uniform dollar increase paid prospectively every month. CMHCs and LBHAs with CCBHC certification and CMHCs and LBHAs without CCBHC certification are eligible to participate in Component 1. MCOs must make HHSC-calculated payments to DPP BHS providers in accordance with the scorecard.

DPP BHS SFY24 (Year 3) September Component 1 Scorecard (.xlsx) (Updated 09/15/2023)

SFY24 (Year 3) October Scorecard (.xlsx) (Updated 10/16/2023)

SFY24 (Year 3) November Scorecard (.xlsx) (Updated 11/15/2023)

SFY24 (Year 3) December Scorecard (.xlsx) (Updated 12/15/2023)

SFY24 (Year 3) January Scorecard (.xlsx) (Updated 01/16/2024)

SFY24 (Year 3) February Scorecard (.xlsx) (Updated 02/15/2024)

SFY24 (Year 3) March Scorecard (.xlsx) (Updated 03/15/2024)

SFY24 (Year 3) April Scorecard (.xlsx) (Updated 04/15/2024)

SFY24 (Year 3) May Scorecard (.xlsx) (Updated 05/15/2024)

SFY24 (Year 3) June Scorecard (.xlsx) (Updated 06/17/2024)

SFY24 (Year 3) July Scorecard (.xlsx) (Updated 07/15/2024)

SFY24 (Year 3) August Scorecard (.xlsx) (Updated 08/15/2024)

Component 2 Rate Increase Percentages

Component 2 (35% of the DPP BHS funding) is a uniform rate increase applied to the following Current Procedural Terminology (CPT) codes: 90791, 90792, 90832, 90834, 90837, 90847, 96372, 99212, 99213, 99214, 99215, H0004, H0005, H0020, H0034, H2011, H2014, H2017, H2035, and T1017. CMHCs and LBHAs with or without CCBHC certification, otherwise eligible to participate in DPP BHS and enrolled with an MCO for the delivery of Medicaid-covered benefits, are eligible to participate in Component 2.

DPP BHS SFY24 (Year 3) Sept – Aug Component 2 Rate Increases Percentages by NPI (.xlsx) (Updated 09/15/2023)

Reconciliation – SFY 2024

As required by 1 TAC Section 353.1320, HHSC has completed the annual reconciliation for Component 1 scorecard payments to actual Medicaid utilization during the program period. All providers met the conditions of participation in SFY 2024 for DPP BHS.

The monthly scorecards issued for the program period required rounding based on caseload when calculating amounts. Consequently, an eligibility adjustment is included in the reconciliation file to account for these remaining funds.

Detailed reconciliation files are available in two formats:

Suggested IGT

Suggested Intergovernmental Transfer (IGT) amounts per SDA and provider for the first and second six months of IGT are available here (.pdf), and the Excel file is located here (.xlsx) (Updated 11/03/2023).

The modeling is available here (.pdf), and the Excel file is located here (.xlsx) (Updated 11/06/2023).

IGT Declaration of Intent form is located here (.xlsx) ( Updated 05/17/2023).

BHS Year 3 First IGT Reconciliation (.xlsx)

State Fiscal Year 2023 (Year 2)

Enrollment

HHSC collected enrollment applications for DPP BHS from March 2, 2022, through March 29, 2022. Enrollment is now closed.

List of Year 2 DPP BHS Provider IDs (.pdf)

Reconciliation – SFY 2023

As required by 1 TAC Section 353.1320, HHSC has completed the annual reconciliation for Component 1 scorecard payments to actual Medicaid utilization during the program period. All providers met the conditions of participation in SFY 2023 for DPP BHS.

The monthly scorecards issued for the program period required rounding based on caseload when calculating amounts. Consequently, an eligibility adjustment is included in the reconciliation file to account for these remaining funds.

Detailed reconciliation files are available in two formats:

Suggested IGT

1st 6 Months Suggested Intergovernmental Transfer (IGT) amounts per SDA and provider is available here (.pdf), and Excel file can be located here (.xlsx). (Updated 06/01/2022)

The modeling is available here (.pdf), and the Excel can be located here (.xlsx) (Updated 06/01/2022)

IGT Declaration of Intent form is available here (.pdf), and the Excel file can be located here (.xlsx).(Updated 05/16/2022)

HHSC also updated the projected payments and IGT amounts to reflect the final actuarial trend factors. Updated modeling is located here (.pdf), and the Excel file can be located here (.xlsx.) (Updated 06/16/2022).

2nd 6 Months Suggested IGT amounts per SDA and provider is available here (.pdf), and the Excel file can be located here (.xlsx). (Updated 11/08/2022)

BHS Year 2 First IGT Reconciliation (.xlsx)

Component 1 Scorecards

Component 1 (65% of the DPP BHS funding) is a uniform dollar increase paid prospectively on a monthly basis. CMHCs and LBHAs with CCBHC certification and CMHCs and LBHAs without CCBHC certification are eligible to participate in Component 1. MCOs must make HHSC-calculated payments to a DPP BHS provider in accordance with the scorecard.

DPP BHS SFY23 (Year 2) September Scorecard (.xlsx) (Updated 09/15/2022)

DPP BHS SFY23 (Year 2) October Scorecard (.xlsx) (Updated 10/17/2022)

DPP BHS SFY23 (Year 2) November Scorecard (.xlsx) (Updated 11/15/2022)

DPP BHS SFY23 (Year 2) December Scorecard (.xlsx) (Updated 12/15/2022)

DPP BHS SFY23 (Year 2) January Scorecard (.xlsx) (Updated 01/17/2023)

DPP BHS SFY23 (Year 2) February Scorecard (.xlsx) (Updated 2/15/2023)

DPP BHS SFY23 (Year 2) March Scorecard (.xlsx) (Updated 3/15/2023)

DPP BHS SFY23 (Year 2) April Scorecard (.xlsx) (Updated 04/17/2023)

DPP BHS SFY23 (Year 2) May Scorecard (.xlsx) (Updated 05/15/2023)

DPP BHS SFY23 (Year 2) June Scorecard (.xlsx) (Updated 06/15/2023)

DPP BHS SFY23 (Year 2) July Scorecard (.xlsx) (Updated 07/15/2023)

DPP BHS SFY23 (Year 2) August Scorecard (.xlsx) (Updated 08/15/2023)

Component 2 Rate Increase Percentages

Component 2 (35% of the DPP BHS funding) is a uniform rate increase applied to the following CPT codes: 90791, 90792, 90834, 90837, 90839, 92507, 92523, 92526, 97110, 97530, 99213, 99214, 99215, H0020, H0034, H2011, H2014, H2017, T1017, and Q3014. CMHCs and LBHAs with CCBHC certification and CMHCs and LBHAs without CCBHC certification, otherwise eligible to participate in DPP BHS and enrolled with an MCO for the delivery of Medicaid-covered benefits, are eligible to participate in Component 2.

DPP BHS SFY23 (Year 2) Sept – Aug Component 2 Rate Increases Percentages by NPI (.xlsx) (Updated 09/15/2022)

State Fiscal Year 2022 (Year 1)

Modeling

To assist potential applicants, HHSC has drafted a model of the potential earnings of each CMHC under the program. Please note that the modeling is only an example and does not reflect the final program values. The program values in the model are subject to change based on the actual enrollment, data changes, and approval issued by CMS. The proposed DPP BHS modeling is available in two formats:

Enrollment

HHSC collected enrollment applications for DPP BHS from March 24, 2021, through April 13, 2021, for the eligibility period from September 01, 2021, to August 31, 2022. The enrollment period is now closed.

Reconciliation – SFY 2022 

As required by 1 TAC Section 353.1320, HHSC has completed the annual reconciliation for Component 1 to actual Medicaid utilization during the program period. All providers met the conditions of participation in SFY 2022 for DPP BHS.

Detailed reconciliation files are available in two formats:

Suggested IGT

Suggested Intergovernmental Transfer (IGT) amounts per SDA and provider is available here (.pdf), and excel file can be located here (.xlsx). (Updated 05/17/2021)

The modeling is available here (.pdf), and the Excel can be located here (.xlsx) (Updated 05/17/2021)

The IGT Commitment form is available here (.pdf), and Excel file can be located here (.xlsx).

BHS Year 1 First IGT Reconciliation

BHS Year 1 Final IGT Reconciliation

Component 1 Scorecards

Component 1 (65% of the DPP BHS funding) is a uniform dollar increase paid prospectively every month. CMHCs with CCBHC certification and CMHCs without CCBHC certification are eligible to participate in Component 1. MCOs must make HHSC-calculated payments to a DPP BHS provider in accordance with the scorecard. 

DPP BHS SFY22 (Year 1) Sept – Jan Scorecard (.xlsx)

DPP BHS SFY22 (Year 1) Feb Scorecard (.xlsx)

DPP BHS SFY22 (Year 1) March Scorecard (.xlsx)

DPP BHS SFY22 (Year 1) April Scorecard (.xlsx)

DPP BHS SFY22 (Year 1) May Scorecard (.xlsx)

DPP BHS SFY22 (Year 1) June Scorecard (.xlsx)

DPP BHS SFY22 (Year 1) July Scorecard (.xlsx)

DPP BHS SFY22 (Year 1) August Scorecard (.xlsx)

Component 2 Rate Increase Percentages

Component 2 (35% of the DPP BHS funding) is a uniform rate increase applied to the following CPT codes: 90791, 90792, 90834, 90837, 96372, 99213, 99214, 99215, H0005, H0020, H0034, H2011, H2014, H2017, and T1017. CMHCs with CCBHC certification and CMHCs without CCBHC certification, otherwise eligible to participate in DPP BHS and enrolled with an MCO for the delivery of Medicaid-covered benefits, are eligible to participate in Component 2.

DPP BHS SFY22 (Year 1) Sept – August Component 2 Rate Increases Percentages by NPI(.xlsx) (Updated 09/15/2022)