Audit of Certified Community Behavioral Health Clinics Medicaid Reimbursement and Compliance With Demonstration Requirements

Certified Community Behavioral Health Clinics (CCBHCs) provide whole-person, team-based care addressing both behavioral and physical health needs. They are required to offer a broad range of services, including crisis mental health care, case management, and integrated physical health screening. Section 223 of the Protecting Access to Medicare Act of 2014 authorized the creation of a demonstration program for CCBHCs. States participating in the CCBHC demonstration receive Federal funds at the enhanced Federal medical assistance percentage (FMAP) for qualifying expenditures and are required to implement standardized certification and payment structures for CCBHCs. We will determine whether select States participating in the CCBHC demonstration program claimed expenditures that were eligible for the enhanced FMAP and whether select CCBHCs provided the services required to receive Medicaid payments.

Announced or Revised	Agency	Title	Component	Report Number(s)	Expected Issue Date (FY)
November 2025	CMS	Audit of Certified Community Behavioral Health Clinics Medicaid Reimbursement and Compliance With Demonstration Requirements	Office of Audit Services	OAS-25-06-109	2027