In a bold move to address the nation’s growing behavioral health needs, the Centers for Medicare & Medicaid Services (CMS) has unveiled new guidance that marks a pivotal moment in the Medicaid behavioral health expansion 2025 initiative. This guidance allows a broader range of behavioral health providers to serve Medicaid beneficiaries and introduces a federally funded nurse advice line—bringing a more person-centered approach to health care access.
This announcement coincides with a $36.9 million funding boost from the Biden-Harris administration, delivered through the Substance Abuse and Mental Health Services Administration (SAMHSA), aimed at tackling the mental health and overdose crises across the country.
Expanding who can provide behavioral health services
At the heart of the Medicaid behavioral health expansion 2025 is a long-awaited policy change: CMS will now allow enhanced federal matching dollars for services provided by more types of behavioral health professionals.
This means that:
- Master’s-level social workers
- Marriage and family therapists
- Other master’s-level behavioral health clinicians
…are now eligible to provide reimbursable care to Medicaid beneficiaries under this expanded rule. This is a significant shift for the Medicaid program, which has long limited which providers could bill for behavioral health services. Now, states have the green light to partner with a broader workforce to close access gaps—especially in rural and underserved communities.
“Expanding access to health professionals in real time to address health issues, including mental health concerns, is a critical component of high-quality, affordable, person-centered health coverage,” said CMS Administrator Chiquita Brooks-LaSure.
The Medicaid behavioral health expansion 2025 recognizes the essential role that non-physician professionals play in mental health and substance use treatment and paves the way for more flexible, community-based care delivery models.
Introducing a federally supported nurse advice line
CMS also announced that states can now use federal funds to create nurse advice lines to support Medicaid enrollees. These advice lines will give people real-time access to licensed nurses who can triage non-emergency health concerns—including mental health issues—and direct them to the most appropriate level of care.
This move is seen as a cost-effective way to increase system efficiency and reduce unnecessary emergency room visits. More importantly, it helps fulfill the goals of the Medicaid behavioral health expansion 2025 by supporting access to behavioral health services even before a patient walks into a clinic.
The advice line is also expected to improve workforce capacity by handling low-acuity interactions, freeing up providers to focus on higher-need patients.
$36.9 million in federal grants to strengthen mental health infrastructure
On the same day the CMS guidance was released, the Biden-Harris administration announced $36.9 million in new behavioral health funding through SAMHSA. These grants support six key initiatives aligned with the priorities of the Medicaid behavioral health expansion 2025:
$10 million for SBIRT programs
SBIRT—Screening, Brief Intervention, and Referral to Treatment—is a model used in primary and community settings to identify risky substance use among youth and adults. This funding will help implement or scale SBIRT programs nationwide.
$5 million for youth psychosis intervention
Grants will support community-based outreach and early treatment programs for young people (up to age 25) at risk for psychosis.
$6.2 million for first responder training and naloxone distribution
This funding will help first responders administer and distribute life-saving opioid reversal drugs while improving care coordination during overdose crises.
$5.4 million for provider training
Provider’s Clinical Support System Universities will use this funding to train future health professionals—including doctors, nurses, and therapists—on how to care for patients with substance use disorders.
$1.1 million for consumer-run mental health organizations
These grants will support peer-run groups that focus on mental health awareness, education, and community advocacy.
$1.1 million for state family network programs
Funding will strengthen partnerships between state mental health systems and families of children with serious emotional disturbances.
These investments will complement the expanded provider base and real-time support tools central to the Medicaid behavioral health expansion 2025. Together, they form a more resilient, responsive mental health system that supports prevention, treatment, and recovery.
What Medicaid behavioral health expansion 2025 means for states and providers
The implications of the Medicaid behavioral health expansion 2025 are far-reaching. States will need to:
- Update Medicaid plans to reflect new provider categories
- Establish or enhance nurse advice line infrastructure
- Partner with training institutions and community organizations to ensure an equipped workforce
Meanwhile, behavioral health providers now have new opportunities to serve Medicaid populations, especially in areas where access was previously limited by restrictive billing rules. From rural clinics to urban outreach programs, the expansion supports more flexible, equitable care delivery.
Organizations receiving SAMHSA grants will need to demonstrate outcomes, collaborate with stakeholders, and continue to innovate as they deploy their funds. The Medicaid behavioral health expansion 2025 provides the foundation for these efforts by legitimizing and reimbursing the work of more professionals across more care settings.
Looking forward: A system on the verge of transformation
With CMS and SAMHSA working in tandem, the Medicaid behavioral health expansion 2025 marks a turning point for the nation’s mental health care landscape. By expanding who can deliver care, supporting real-time triage through advice lines, and investing in prevention and recovery, the federal government is sending a clear message: behavioral health is essential health.
Stakeholders in the public and private sectors alike must now seize the momentum to build systems that are more inclusive, scalable, and rooted in community needs.
Whether you’re a policymaker, provider, advocate, or Medicaid enrollee, the Medicaid behavioral health expansion 2025 is more than just policy—it’s a promise to bridge the gap between coverage and care.
