A federal proposal to broaden access to behavioral health services could be a boon for rural nursing homes and for facilities to “reimagine” how to use unoccupied beds, says one expert who also cautioned that opportunities may take time to develop.

The Centers for Medicare & Medicaid Services proposed a rule last week that would allow mental health counselors, among others, to enroll in Medicare for billing purposes. The proposal also includes substance use disorder counselors. 

These expanded therapists would allow for greater access to coverage for intensive outpatient services, which are less costly than inpatient services. Medicare, however, currently pays for inpatient psychiatric hospitalizations, partial hospitalizations services and outpatient therapeutic services, leaving a gap when patients need treatment between inpatient and outpatient programs. 

The Biden Administration has signaled a need for better mental health services through a national strategy to strengthen system capacity and create a continuum of support through health and social services. 

“It seems like a timely idea to expand access to mental health and behavioral health service by expanding the type of practitioners who can be reimbursed for providing these services,” Melissa Brown, the chief operating officer of Gravity Healthcare Consulting, told McKnight’s Long-Term Care News on Wednesday. “This may create more opportunities for rural locations, who cannot get a psychiatrist or psychologist physically onsite to treat patients in SNFs and senior living, to be able to get access to these much-needed behavioral health services.”

Brown cautioned, however, that providers should not count on these services becoming immediately available. Marriage and family therapists and mental health counselors won’t be able to start billing under Medicare until at least Jan. 1, 2024, and only after receiving a Medicare number. 

“These new providers should complement existing services where they are available and provide additional support to residents, rather than being a replacement for them,” Brown added.

The federal government is generally pushing to have long-term care facilities provide treatment for more patients with substance use and opioid use disorders. McKnight’s reported in September, though, that many nursing home staff feel unprepared to handle such patients and have criticized an overall lack of resources. 

Brown said the new rule could present fresh opportunities for facilities to “reimagine” how they could use unoccupied beds.

“We know the need for substance abuse support is great, and almost every SNF needs to increase census, so this could make a lot of sense for some providers that want to diversify and specialize,” she explained.