Crosswalk

Crosswalk for the implementation of the Demonstration Programs to Improve Community Mental Health Services and additional
Revisions for the Certification (CMS-64) MBES/CBES Section 223 on the current CMS-64, starting Quarter beginning 1/1/2017

Quarter Beginning 1/1/2017

Type of Change

Rationale for the Change

CMS 64.9 Series Forms: CMS is adding the line “Certified
Community Behavioral Health Clinic Payments” to various
MBES worksheets. CMS Regional MBES contacts will
support states in properly reporting demonstration
expenditures

The forms contains payments for Certified
Community Health Clinic for MCO, MCO PAHP
and MCO PIHP.

To comply with the PAMA Section 223(d)(5) matching rates for
Demonstration expenditures beginning January 1, 2017.

As a result of these new lines, the following Forms have
updated: CMS 64 64.9, CMS 64.9P, CMS 64.9 Waiver,
CMS 64.9P Waiver, CMS 64.9VIII, CMS 64.9VIIIP, CMS
64.9VIII Waiver, CMS 64.9VIIIP Waiver, CMS 64.9T and
64.9TP to update expenditures of CCBHCP.

The forms contains payments for Certified
Community Health Clinic for MCO, MCO
PAHP and MCO PIHP.

To comply with the PAMA Section 223(d)(5) matching rates
for Demonstration expenditures beginning January 1, 2017.

Line 2C and Line 18A5 - Certified Community Behavioral
Health Clinic Payments

Are Line Items added to Forms CMS 64.9, CMS
64.9P, CMS 64.9WAIV, CMS 64.9PWAIV, CMS
64.9VIII, CMS 64.9PVIII, CMS 64.9VIIIWAIV, CMS
64.9VIIIPWAIV, CMS 64.9T and CMS 64.9TP for
Certified Community Behavioral Health Clinics
Payment expenditures.

To comply with the PAMA Section 223(d)(5) matching rates
for Demonstration expenditures beginning January 1, 2017.

Line 18B1e - MCO PAHP - Certified Community Behavioral
Health Clinic Payments
Line 18B2e - MCO PIHP - Certified Community Behavioral
Health Clinic Payments
As a result of these new lines, the following MCHIP Forms have
updated: CMS 64.21, CMS 64.21P, and CMS 64.21UP.

The MCHIP Forms contains payments for Certified
Community Health Clinic for MCO, MCO PAHP and
MCO PIHP.

Line 3B - Certified Community Behavioral Health Clinic
Payments 65.62%

Are Line Items added to Forms CMS 64.21, CMS
64.21P and CMS 64.21UP for Certified Community
Behavioral Health Clinics Payment expenditures.

To comply with the PAMA Section 223(d)(5) matching rates for
Demonstration expenditures beginning January 1, 2017.

Crosswalk for the implementation of the Demonstration Programs to Improve Community Mental Health Services and additional Revisions for the
Certification (CMS-37.3) MBES/CBES Started on 8/15/2016
Line #s on Current CMS-37.3 (Starting
Submission on
8/15/2016

Type of Change

Rational for
Change

It is a Line Item added to CMS 37.3, for Certified Community
Behavioral Health Clinics Payment estimates. In Column (a)
and Column (c) is the Total Computable amount of estimates
for the Certified Community Behavioral Health Clinics
Payment. MBES will allow entry entered in column (b) and
Column (d) their Federal Share of Column (a) and Column (c)
estimates.

To comply with PAMA Section 223(d)(5)
matching rates.

Line 18A5- Medicaid MCO - Certified
Community Behavioral Health Clinic Payment.

It is a Line Item added to CMS 37.3, for Certified Community
Behavioral Health Clinics Payment estimates. In Column (a)
and Column (c) is the Total Computable amount of
estimates for the Certified Community Behavioral Health
Clinics Payment. MBES will allow entry entered in column
(b) and Column (d) their Federal Share of Column (a) and
Column (c) estimates.

To comply with PAMA Section 223(d)(5)
matching rates.

Line 18B1e- Medicaid PAHP - Certified Community
Behavioral Health Clinic Payment.

It is a Line Item added to CMS 37.3, for Certified
Community Behavioral Health Clinics Payment estimates. In
Column (a) and Column (c) is the Total Computable amount
of estimates for the Certified Community Behavioral Health
Clinics Payment. MBES will allow entry entered in column
(b) and Column (d) their Federal Share of Column (a) and
Column (c) estimates.

To comply with PAMA Section 223(d)(5)
matching rates.

Beginning with the 8/15/2016 Submission, 4
Certified Community Behavioral Health Clinics
Payment Lines were added to CMS-37.3 Series
Line 2C- Certified Community Behavioral Health
Clinic Payments

Line 18B2e- Medicaid PIHP - Certified
Community Behavioral Health Clinic Payment.

No Changes for 21 and 21B.

It is a Line Item added to CMS 37.3, for Certified
Community Behavioral Health Clinics Payment estimates.
In Column (a) and Column (c) is the Total Computable
amount of estimates for the Certified Community
Behavioral Health Clinics Payment. MBES will allow entry
entered in column (b) and Column (d) their Federal Share
of Column (a) and Column (c) estimates.

To comply with PAMA Section 223(d)(5)
matching rates.