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Senate committee reviews rule letting crisis stabilization units bill Medicaid for short stays and assessments
Summary
The Senate Public Health, Welfare and Labor Committee reviewed a Department of Health rule allowing crisis stabilization units (CSUs) to bill Medicaid for observation periods shorter than 24 hours and for mental‑health stabilization assessments (telehealth and in person); staff said physician‑assistant payment and broader scope issues will be studied further.
The Senate Public Health, Welfare and Labor Committee on an unrecorded date reviewed a Department of Human Services rule change that would let crisis stabilization units (CSUs) bill Medicaid for observation periods shorter than 24 hours and for mental‑health stabilization assessments.
Amy Webb, deputy director of the Office of Substance Abuse and Mental Health, told the committee the manual language now allows "less than midnight observation" and also an "after midnight" billing code, and clarifies that Medicaid will pay for mental health stabilization assessments both "telehealth and in person." The change is intended to open additional revenue pathways so CSUs can operate more sustainably, Webb said.
Representative Lademan pressed department staff on whether physician assistants (PAs) would be able to work in CSUs and receive payment under the rule. Webb and Mitch Rouse, chief of staff at DHS, said the department did not incorporate PA payment language because they feared unintended consequences across the behavioral‑health system and that the effect on the broader provider network remains unclear; they said they will research the matter and provide a follow‑up to the committee. "We didn't want to make that change, and then it impact the whole behavioral health spectrum," Rouse said.
Committee members asked whether CSU operators and county partners had been consulted. Webb said providers had raised the issue and that the change resulted from conversations and prior funding adjustments intended to stabilize operations; she said some funding was increased earlier and that this regulatory change could be implemented without immediate legislation.
Representative Pilkington asked for an update on the Washington County CSU after UAMS withdrew as a partner; Webb said an interested provider has discussed partnering with the county but no contract or agreement is in place. Committee staff said they will continue to share updates with members.
The committee recorded the rule as reviewed without objection. Next steps include department follow‑up on PA scope and any potential legislative needs, and continued updates on local CSU developments.
