Kentucky Certified Community Behavioral Health Clinic (CCBHC) Demonstration
In 2017, Certified Community Behavioral Health Clinics (CCBHCs) were established in eight states through the Section 223 CCBHC Medicaid Demonstration. In 2020, Kentucky was selected to participate in the CCBHC Demonstration. Kentucky’s CCBHC Demonstration began Jan. 1, 2022, and currently ends Dec. 31, 2027.
In March 2023, the Substance Abuse and Mental Health Services Administration (SAMHSA) released an updated 2023 CCBHC Certification Criteria in compliance with the statutory requirements outlined under Section 223 of the Protecting Access to Medicare Act (PAMA). SAMHSA CCBHC criteria establish a basic level of service for a CCBHC to operate at and encompasses six key program areas: Staffing, Availability and Accessibility of Services, Care Coordination, Scope of Services, Quality and Other Reporting, and Organizational Authority and Governance.
CCBHCs must incorporate evidence-based practices and other supports based on a community needs assessment. They must also provide comprehensive care coordination to help people with navigating behavioral health care, physical health care, and any needed social service. CCBHCs must provide (either directly or through formal partnerships):
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Crisis Services,
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Outpatient Mental Health and Substance Use Services,
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Person- and Family-Centered Treatment Planning,
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Community-Based Mental Health Care for Veterans,
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Peer Family Support and Counselor Services,
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Targeted Care Management,
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Outpatient Primary Care Screening and Monitoring,
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Psychiatric Rehabilitation Services, and
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Screening, Diagnosis and Risk Assessment.
In addition to the above service requirements, CCBHCs must have the ability to report data on quality measures, as required by the CCBHC authorizing statute and as outlined in the SAMHSA CCBHC Criteria (updated March 2023). Data on quality measures are reported to the state annually, nine months after the end of each demonstration year.
Clinics entering the Kentucky CCBHC Demonstration are certified by Kentucky’s Department for Medicaid Services (DMS). Clinics are to be compliant with CCBHC Certification Criteria and are reimbursed via a Prospective Payment System (PPS) for the required services. The PPS provides cost-based reimbursement for the nine required CCBHC services. Kentucky’s Demonstration uses the PPS-1 rate methodology for CCBHC reimbursement.
DMS has established a new Medicaid Provider Type (PT) of CCBHC- PT (16) to support the Kentucky CCBHC Demonstration. All clinics certified for entry into the demonstration must enroll with DMS as a CCBHC- PT (16) provider. This provider type is separate from other provider types, including CMHC-PT (30). It is expected that all outpatient services will be billed by the CCBHC under their PT (16) Medicaid number.
CCBHC Quality Measures
Agencies participating in the Kentucky CCBHC Demonstration are required to provide data on quality measures calculations to DMS for annual reporting of quality measures to SAMHSA. Quality measures are reported at both the clinic and state level for all years of the demonstration. CCBHCs will calculate and provide outcomes of clinic-level quality measures to DMS, which will calculate state-level quality measures for annual reporting to SAMHSA. All CCBHCs are required to complete a Kentucky CCBHC Quality Measures Checklist, submit raw data, and have a Data Use Agreement with DMS.
To assist CCBHCs in understanding the requirements of quality measures, DMS provides manuals, documentation, and guidance necessary to complete reporting for quality measures. This can be found in the Kentucky CCBHC Documents and Information section of this page.
Kentucky DMS Section 223 Waiver Demonstration CCBHC Quality Measures Manual
DMS guidance for the submission of data for quality measures is outlined within the DMS Section 223 Waiver Demonstration CCBHC Quality Measures Manual. The manual includes state-specific guidance, modifications, and processes not covered in federal-level guidance. The information contained in this manual covers the quality measures technical specifications, calculation workflows, and data submission processes, which include the process for reviewing and responding to data submissions.
SAMHSA Quality Measures Guidance
At the Federal level, SAMHSA has provided technical specifications, data reporting templates, guidance, and technical assistance for all parts of the CCBHC quality measures program. We encourage all potential and certified CCBHCs to review and become familiar with these resources.
Prospective CCBHCs
The Kentucky Demonstration started in 2022 with four pilot CCBHCs. In 2023, Kentucky was approved for demonstration expansion. New demonstration agencies identified by DMS are expected to be certified in late 2025. Additional expansion opportunities may be announced in 2026.
Prospective CCBHCs must complete and submit the following for demonstration consideration:
Note: Prospective CCBHCs must complete the CCBHC Cost Report training and CCBHC Quality Measures training before the CCBHC application submission. After you complete both trainings, fill out the appropriate training attestation forms and submit them with your application. You may find all attestation forms and training links under CCBHC New Provider Training on this webpage.
Agencies will be notified of approval of the application. Once the approval is received, you may move forward with the KY CCBHC certification process. Relevant agency staff must complete the following training:
- CCBHC Community Needs Assessment Training
- CCBHC Program Criteria 1 & 2 Training
- CCBHC Program Criteria 3 and Designated Collaborating Organization (DCO) Agreements
- CCBHC Program Criteria 4 Training
- CCBHC Program Criteria 5 & 6 Training
After all the above trainings are completed, please fill out the appropriate training attestation forms and submit them to CCBHC@ky.gov. You may find all attestation forms and training links under CCBHC New Provider Training on this webpage.
CCBHC New Provider Training
Relevant staff at all prospective CCBHC agencies must complete the below trainings. When the trainings have been completed, agencies should complete the appropriate attestation form and email it to CCBHC@ky.gov.
Before submitting your application, the following trainings must be completed along with the appropriate attestation form:
CCBHC Cost Report Training:
CCBHC Quality Measures Training:
Before CCBHC demonstration certification, the following new provider training and appropriate attestation form must be submitted:
If a community needs assessment has been completed within one year of initial CCBHC certification, the CCBHC may augment or build upon the information to ensure that the required components of the community needs assessment are collected. DMS may require an update to the community needs assessment during a CCBHC’s initial certification period. CCBHCs must use the KY CCBHC Needs Assessment template for any required updates.
Submit application documents to:
CCBHC@ky.gov.
Kentucky CCBHC Documents and Information
This section includes DMS documents and information for the use of potential and current CCBHCs:
CCBHC Billing Information
CCBHC Community Needs Assessment
CCBHC Provider Enrollment
CCBHC Quality Measures
CCBHC SharePoint
CCBHC Evidence-Based Practices
SAMHSA CCBHC Documents and Information
SAMHSA CCBHC Cost Reporting
SAMHSA CCBHC Quality Measures Documents and Information
Contact the CCBHC Team-
CCBHC@ky.gov