HCPF and the Behavioral Health Administration (BHA) are partnering to strengthen the Colorado crisis continuum of services through the American Rescue Plan Act section 9813. This collaboration involves expanding and improving the community-based mobile crisis intervention service under Health First Colorado (Colorado’s Medicaid program) for individuals experiencing a behavioral health crisis, which can include both mental health and substance use related issues. In addition to federal requirements, this policy has been informed by robust stakeholder engagement, national best practices, and state policy. ARPA 9817 funds are used to support providers in meeting the new standards and are administered via the BHA through Administrative Service Organization (ASO) provider contracts.
The MCR service definition outlines the components that comprise the MCR benefit, which offers de-escalation and stabilization to people in a self-defined behavioral health crisis. This service is provided by a two-person multidisciplinary MCR team with federally required training and expertise. MCR teams must be able to respond 24 hours a day, 365 days a year to individuals in crisis, at their community-based location.
The definition details the following elements of the MCR benefit:
- Engagement with community
- Service activities
- Provider/agency requirements, enrollment, and billing
- Staffing requirements
- 24/7/365 availability, timeliness, and location of service standards, and
- Use of telehealth and other technology
MCR Program Goals
- Improve the quality and consistency of mobile crisis services for people in Colorado experiencing a mental health or substance use disorder crisis.
- Reduce unnecessary emergency department visits, inpatient hospitalizations, and arrests of people experiencing a behavioral health crisis.
- Enhance efforts to connect people, who have experienced a crisis, to ongoing community-based mental health services.
- Strengthen provider capacity and expertise to ensure mobile crisis response services work effectively, including for members of priority populations.
- Align reimbursement with the Colorado Crisis System managed by the BHA.
- MCR is not a replacement for ongoing behavioral health services, and does not replace or stop other crisis response services.
For Members
Members can call 988 or Colorado Crisis Services if they need help during a behavioral health crisis. The MCR team dispatched depends on the situation and resource availability. Generally, members may notice that MCR providers are not police. They may also notice that MCR providers do not always respond with medical or other emergency services personnel.
For Providers
Enrollment
To enroll with HCPF, MCR providers must enroll as:
Provider Type: 95 Behavioral Health Crisis Services
Specialty: 772 Mobile Crisis Response
Please see Find Your Provider Type to view all enrollment requirements and begin your enrollment application. Support is also available for our providers by contacting HCPF's fiscal agent, Gainwell Technologies.
Reimbursement
The MCR benefit is paid through the Managed Care Program, also known as capitation payment model through Regional Accountable Entities (RAEs). MCR Providers use 90839 ET for the first 60 minutes of contact + H2011 ET for each additional 15 mins of service. Provider rates are negotiated with individual RAE contracts. Because MCR services may be delivered anywhere, anytime, to anyone, HCPF encourages MCR providers to maintain contracts with all RAEs. Please see the State Behavioral Health Services Billing Manual July 2023 for additional guidance.
MCR teams are required to enroll with HCPF for Health First Colorado member coverage and BHA for coverage of non-Health First Colorado members. This allows MCR providers to deliver crisis services to all people in Colorado regardless of insurance, age, location, prior use, or residency status.
Due to the close collaboration of HCPF and BHA, the MCR service definition applies to MCR services regardless of funding source. It may be used as a companion to the HCPF Sate Behavioral Health Services Billing Manual July 2023, and any BHA crisis contracts.
Legislative Requirements and Reports
- American Rescue Plan Act section 9813 - Federal requirements for the enhanced Mobile Crisis Response service to be eligible for enhanced Federal Medical Assistance Percentage.
- 2022 Colorado House Bill 22-1278 BHA - officially established the duties of the BHA and directs the BHA to ensure mobile crisis services are available and enhanced, directing the MCR standards
- 2022 Colorado House Bill 22-1214 Behavioral Health Crisis Response System - sets standard for approval including required services.
- 2022 Behavioral Health Transformational Task Force Report - Provides recommendations for ARPA fund usage towards service development in the Colorado Behavioral Health System, including allocations for MCR.
- 2021 State Health Official Letter RE: Medicaid Guidance on the Scope of and Payments for Qualifying Community-Based Mobile Crisis Intervention Services.
- 2021 Colorado Senate Bill 21-137 Behavioral Health Recovery Act of 2021 - Directs ARPA funding to services including crisis response.
- 2017 Colorado Senate Bill 17-207 Strengthen Colorado Behavioral Health Crisis System - sets standards for MCR availability.
Resources
- HCPF MCR Rule 10 CCR 2505-10 8.020
- Policy Memo PM 23-002, "Joint Policy Memo on Facility-Based Mobile Crisis Response in Colorado
- Policy Memo PM 23-004 "Joint Agency policy Memo on Law Enforcement in Mobile Crisis Response
- Benefit Design Stakeholder Engagement Information: Visit this BHA webpage to review prior stakeholder information including presentation slides and recordings.
- SAMHSA National Guidelines for Crisis Toolkit
- Crisis Professional Scope of Practice
- MCR Informational Flier
Stay Informed
Sign up for the monthly Crisis Services Newsletter or attend a crisis services forum.
Contact hcpf_bhbenefits@state.co.us for more information.