HB 382 – Hospital ED Care/Medicaid Behavioral Health Services

Primary House Sponsors: Rep. Donny Lambeth (R-Forsyth); Rep. Donna White (R-Johnston); Rep. Larry Potts (R-Davidson); Rep. Wayne Sasser (R-Cabarrus, Rowan, Stanly)


This bill specifies that it is the intent of the General Assembly to provide funding to hospitals for behavioral health services provided to Medicaid beneficiaries while those beneficiaries await discharge to a more appropriate setting.

This bill also:

  • Directs the Division of Health Benefits to develop a clinical coverage policy, assign a CPT code, and develop billing instructions for Medicaid coverage of certain specified services provided to a beneficiary who: 1) no longer meets criteria for observation under the specified Medicaid Clinical Coverage Policy; 2) is not currently receiving inpatient behavioral health services covered under Medicaid Clinical Coverage Policy 8B: Inpatient Behavioral Health Services; and 3) a physician, PA, or NP has determined that it would be appropriate for the beneficiary to be admitted to an inpatient psychiatric or behavioral health facility, admitted to a facility for care for psychiatric or behavioral needs, or requires community-based services or supports to be safely discharged to the beneficiary’s home.
  • Specifies the services to be covered by the Medicaid Clinical Coverage Policy, including crisis stabilization and support, development of a safety plan, and reasonable and appropriate efforts to maintain patient safety.
  • Requires DHHS to submit any State Plan amendments necessary to establish new Medicaid reimbursement or rates for these services to CMS for approval.


Filed – 3/24/2021