May 1, 2025
Rural Health Research: Federal and State Reimbursement for Youth Behavioral Health Services
The prevalence of behavioral health conditions, including depression, suicidal ideation, and substance use continue to increase among young people in the United States (U.S.). Medicaid is an important source of health coverage for youth in the rural U.S., covering 47% of youth. Because Medicaid is jointly funded by states and the federal government and is administered by each state within federal guidelines, reimbursement policies for behavioral health care vary across states.
This brief provides a structured review of the state-level policies and federal and state funding mechanisms that may affect the supply of behavioral health services for children and youth through 24 years of age.
Among the findings:
- Medicaid reimbursement and coverage policies for behavioral health professionals vary across and within states.
- A review of individual state Medicaid manuals indicates that social workers and psychologists are eligible for Medicaid manuals indicates that social workers and psychologists are eligible for Medicaid reimbursement for behavioral health services in all 50 states and the District of Columbia. Marriage and family therapists (MFTs) are eligible for reimbursement by all but two state Medicaid programs.
- All 50 states and the District of Columbia allow reimbursement of social workers and psychologists for behavioral health services provided through school-based Medicaid programs, while approximately one-third of states omit MFTs from the list of providers eligible for reimbursement within school-based Medicaid programs.
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