H 5230

HOUSE . . . . . . . . No. 5230
   The Commonwealth of Massachusetts
  ________________________________________
  HOUSE OF REPRESENTATIVES, March 12, 2026.
    The committee on Mental Health, Substance Use and Recovery, to
whom was referred the petition (accompanied by bill, House, No. 2220) of
Kathleen R. LaNatra, Michael D. Brady and Bud L. Williams relative to
healthcare coverage for psychiatric collaborative care, reports
recommending that the accompanying bill (House, No. 5230) ought to
pass.
  For the committee,
  MINDY DOMB.
  FILED ON: 3/6/2026
 HOUSE . . . . . . . . . . . . . . . No. 5230
  The Commonwealth of Massachusetts
  _______________
  In the One Hundred and Ninety-Fourth General Court
  (2025-2026)
  _______________
An Act relative to access to psychiatric collaborative care.
  Be it enacted by the Senate and House of Representatives in General Court assembled, and by the authority
of the same, as follows:
1SECTION 1. Section 22A of chapter 32A of the General Laws, as appearing in the 2024
2 Official Edition, is hereby amended by inserting after subsection (b) the following subsection:-
3(c) The commission shall ensure minimum payment rates for psychiatric collaborative
4 care model billing codes are equal to or greater than the current Medicare Resource-Based
5 Relative Value Scale physician fee schedule for such codes and adjusted annually, if applicable.
6SECTION 2. Section 10P of chapter 118E of the General Laws, as so appearing, is
7 hereby amended by inserting after subsection (b) the following subsection:-
8(c) The division shall, subject to federal approval of the Massachusetts Medicaid State
9 Plan and the availability of federal financial participation, ensure minimum payment rates for
10 psychiatric collaborative care model billing codes are equal to or greater than the current
11 Medicare Resource-Based Relative Value Scale physician fee schedule for such codes and
12 adjusted in accordance with section 13D, if applicable.
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13SECTION 3. Section 47QQ of chapter 175 of the General Laws, as so appearing, is
14 hereby amended by inserting after subsection (b) the following subsection:-
15(c) An individual policy of accident and sickness insurance issued pursuant to section 108
16 that provides hospital expense and surgical expense insurance or a group blanket or general
17 policy of accident and sickness insurance issued pursuant to section 110 that provides hospital
18 expense and surgical expense insurance that is issued or renewed within or without the
19 commonwealth shall ensure minimum payment rates for psychiatric collaborative care model
20 billing codes are equal to or greater than the current Medicare Resource-Based Relative Value
21 Scale physician fee schedule for such codes and adjusted annually, if applicable.
22SECTION 4. Section 8RR of chapter 176A of the General Laws, as so appearing, is
23 hereby amended by inserting after subsection (b) the following subsection:-
24(c) A contract between a subscriber and the corporation under an individual or group
25 hospital service plan which is delivered, issued or renewed within the commonwealth shall
26 ensure minimum payment rates for psychiatric collaborative care model billing codes are equal
27 to or greater than the current Medicare Resource-Based Relative Value Scale physician fee
28 schedule for such codes and adjusted annually, if applicable.
29SECTION 5. Section 4RR of chapter 176B of the General Laws, as so appearing, is
30 hereby amended by inserting after subsection (b) the following subsection:-
31(c) A subscription certificate under an individual or group medical service agreement that
32 is issued or renewed within the commonwealth shall ensure minimum payment rates for
33 psychiatric collaborative care model billing codes are equal to or greater than the current
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34 Medicare Resource-Based Relative Value Scale physician fee schedule for such codes and
35 adjusted annually, if applicable.
36SECTION 6. Section 4JJ of chapter 176G of the General Laws, as so appearing, is hereby
37 amended by inserting after subsection (b) the following subsection:-
38(c) Any individual or group health maintenance contract that is issued or renewed within
39 the commonwealth shall ensure minimum payment rates for psychiatric collaborative care model
40 billing codes are equal to or greater than the current Medicare Resource-Based Relative Value
41 Scale physician fee schedule for such codes and adjusted annually, if applicable.
42SECTION 7. Chapter 177 of the acts of 2022 is hereby amended by striking out section
43 84 and inserting in place thereof the following section:-
44Section 84. For the purposes of section 22A of chapter 32A of the General Laws, section
45 10P of chapter 118E of the General Laws, section 47QQ of chapter 175 of the General Laws,
46 section 8RR of chapter 176A of the General Laws, section 4RR of chapter 176B of the General
47 Laws and section 4JJ of chapter 176G of the General Laws, reimbursement for the psychiatric
48 collaborative care model shall include, but shall not be limited to, the following current
49 procedural terminology billing codes: (i) 99492; (ii) 99493; (iii) 99494; and (iv) G2214;
50 provided, that the division of insurance may promulgate regulations or issue further guidance
51 establishing additional psychiatric collaborative care model billing codes and minimum payment
52 rates for such codes.
53SECTION 8. Subsection (c) of section 22A of chapter 32A of the General Laws,
54 subsection (c) of section 10P of chapter 118E of the General Laws, subsection (c) of section
55 47QQ of chapter 175 of the General Laws, subsection (c) of section 8RR of chapter 176A of the
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56 General Laws, subsection (c) of section 4RR of chapter 176B of the General Laws and
57 subsection (c) of section 4JJ of chapter 176G of the General Laws shall apply to all contracts
58 entered into, renewed or amended on or after January 1, 2027.
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