United StatesMedicaid plans would allow payment for covered same-day outpatient care
State Medicaid plans would allow payment when patients receive otherwise covered primary care and mental health or addiction care through the same outpatient facility on the same day.
What it does
Medicaid plans would have to allow payment for otherwise covered primary care and mental health or addiction care delivered on the same day through the same outpatient facility.
Argument forPatients could make fewer trips when Medicaid allows payment for primary care and mental health or addiction care on the same day.
Argument againstStates could have fewer options to control Medicaid spending because they could not deny otherwise covered services solely for sharing a day.
More detail
State Medicaid plans would not bar payment solely because covered services happen on the same day. The rule covers Medicaid patients of any age receiving both types of care from clinicians employed by or contracted with the same outpatient office, center, clinic, or facility. Each service must otherwise qualify for payment under the Medicaid plan. Care may be in person or through telehealth, with the same clinician or different clinicians.
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Where it stands
- Introduced
- Passed House
- Passed Senate
- To President
- Became Law
Looking ahead
No hearings or votes scheduled.
History
- 2026
- Jul 22Introduced in HouseLatest
- Jul 22Referred to the House Committee on Energy and Commerce.Introduced
HealthcareMental Health