In a bold and historic move, the Centers for Medicare & Medicaid Services (CMS) has finalized its 2024 physician payment rule, signaling a new era for behavioral health care in the United States. The Medicare Behavioral Health Changes 2024 mark a transformative moment, expanding access, increasing provider eligibility, and prioritizing mental health and substance use care for millions of Americans.
For the first time, marriage and family therapists (MFTs) and mental health counselors (MHCs)—including licensed substance use disorder (SUD) counselors—will be able to enroll in Medicare and provide reimbursable care to beneficiaries. This long-overdue change significantly broadens the behavioral health workforce available to older adults and people with disabilities, many of whom have struggled to access timely and affordable mental health care.
The Medicare Behavioral Health Changes 2024 also include increased reimbursement rates for several core services, including crisis care, psychotherapy, and substance use disorder treatment. For providers, this means better support for delivering integrated care, particularly when psychotherapy is offered alongside an office visit or when conducting behavioral health assessments and interventions. These payment boosts are not just administrative tweaks—they are a financial reinforcement of the importance of behavioral health in the overall well-being of Medicare recipients.
Dr. Meena Seshamani, Deputy Administrator at CMS, underscored the profound nature of these changes:
“These are some of the largest changes ever towards a Medicare that recognizes people with Medicare as whole persons, with their own families and unique life stories.”
In practical terms, the Medicare Behavioral Health Changes 2024 mean more than just expanded access to clinicians. They also support culturally responsive care through community health workers, peer support specialists, and care navigators—many of whom are now formally recognized through a new set of Principal Illness Navigation (PIN) codes. These codes allow for billing non-clinical services that help connect high-risk individuals to resources, streamline care coordination, and support chronic condition management, such as cancer or complex mental health diagnoses.
This broader definition of care reflects a growing understanding that healing involves more than prescriptions and procedures. Behavioral health is deeply interconnected with social, cultural, and emotional factors—especially for populations traditionally underserved by the healthcare system.
Despite positive feedback on incorporating digital tools like digital therapeutics and digital cognitive behavioral therapy, CMS ultimately decided not to include them in this year’s rule. However, their consideration signals future openness to modernizing Medicare’s behavioral health offerings even further. Advocates for digital behavioral health should remain optimistic, as these tools may gain traction in upcoming policy cycles.
U.S. Department of Health and Human Services Secretary Xavier Becerra linked the updates to broader goals:
“The policies announced today aim to strengthen Medicare and advance health equity by expanding access to care and services for people who are part of underserved communities.”
The Medicare Behavioral Health Changes 2024 align closely with Biden-Harris Administration priorities such as supporting family caregivers, promoting value-based care, and advancing the President’s Cancer Moonshot. They also align with a larger national movement toward health equity and integrated care models that value mental health on par with physical health.
These changes are especially significant in rural and inner-city areas, where access to behavioral health care has often been limited. By allowing MFTs and MHCs to participate in Medicare, CMS is helping fill care gaps and making it more feasible for individuals to seek care in their communities. In turn, this may reduce emergency room visits, improve chronic disease management, and lower overall healthcare costs.
For providers, the Medicare Behavioral Health Changes 2024 represent an opportunity to revisit workflows, expand staff, and adopt a more integrated model of care. Non-clinical support roles—once considered “extra”—are now recognized as essential parts of the behavioral health ecosystem. Peer support specialists, in particular, bring lived experience and trust that can be vital in helping patients engage and stay in treatment.
As the healthcare system evolves, CMS’s updates serve as both a challenge and an invitation: a challenge to adapt to a more person-centered, community-rooted model, and an invitation to be part of a system that sees each patient as more than a diagnosis.
The Medicare Behavioral Health Changes 2024 are not just policy updates; they are a cultural shift toward recognizing the whole person in every care interaction. For providers, patients, and communities alike, this shift brings hope—and real opportunity—for a more equitable and compassionate healthcare system.
