Issued: May 11, 2026
Partners comprehensively reviews our rates for services on a regular basis. As part of that comprehensive review, Partners will adjust rates for the following services with dates of service beginning July 1, 2026.
What is happening?
Partners conducts regular, comprehensive reviews of service utilization, cost trends, and reimbursement rates to ensure alignment with Medicaid requirements and long-term sustainability of the behavioral health system. Partners published a provider alert on April 6, 2026 communicating these rate adjustments Important Rate Information Effective July 1, 2026 – Partners Health Management – Provider Knowledge Base.
As part of this review, we identified several service lines where current rates exceed prevailing Medicaid benchmarks and where utilization has increased significantly over time. To ensure consistency across plans, responsible stewardship of public funding, and continued access to services for members, Partners is adjusting select Medicaid rates effective July 1, 2026.
Partners received feedback from several providers, the Provider Council and several other stakeholders. While the intent of these changes was to bring reimbursement into closer alignment with current Medicaid rates and broader market standards, while supporting the stability and sustainability of the system overall, Partners took the opportunity to relook at the information and have made the following adjustments.
What do providers need to know?
Rates for the following will be adjusted effective with dates of service July 1, 2026.
| Service Code | Service Description | Fund Source | Partners’ Current Rate | New Rate | Effective Date |
| T2034 | Out of Home Crisis | Medicaid Direct/TP-BH-I/DD | $266.86 | $249.69 | 7/1/2026 |
| H0035 | Mental Health Partial Hospitalization | Medicaid Direct/TP-BH-I/DD | $194.40 | $171.01 | 7/1/2026 |
| H0046 | Level I Family Type | Medicaid Direct/TP-BH-I/DD | $94.88 | $86.25 | 7/1/2026 |
| T2021 | Day Supports Individual | Medicaid Direct/TP-BH-I/DD | $33.21 | $32.56 | 7/1/2026 |
| H0038 | Peer Support Individual | Medicaid Direct/TP-BH-I/DD | $17.04 | $16.50 | 7/1/2026 |
| H2015 | Community Networking | Medicaid Direct/TP-BH-I/DD | $7.46 | $7.46 | 7/1/2026 |
| S5150 | Respite: Individual | Medicaid Direct/TP-BH-I/DD | $6.02 | $6.02 | 7/1/2026 |
| H2017 | Psychosocial Rehabilitation | Medicaid Direct/TP-BH-I/DD | $3.92 | $3.92 | 7/1/2026 |
| H2015 GT | Community Networking Telehealth | Medicaid Direct/TP-BH-I/DD | $7.46 | $7.46 | 7/1/2026 |
| Service Code | Service Description | Fund Source | Partners’ Current Rate | New Rate | Effective Date |
| T2021 GT | Day Supports Individual Telehealth | Medicaid Direct/TP-BH-I/DD | $33.21 | $32.56 | 7/1/2026 |
| H0045 U4 HA | 1915(i) Respite Individual Child | Medicaid Direct/TP-BH-I/DD | $6.67 | $6.42 | 7/1/2026 |
| H0045 U4 HB | 1915(i) Respite Individual Adult | Medicaid Direct/TP-BH-I/DD | $6.67 | $6.42 | 7/1/2026 |
| S5170 | S5170 – Meal Delivery | Medicaid Direct/TP-BH-I/DD | 8.99 | $7.99 | 7/1/2026 |
The following Service will change from a monthly rate to a per 15-minute unit rate:
| Service Code | Service Description | Fund Source | New Rate per 15-minute unit |
| T2025 | Specialized Consultative Services (SCS)* | Medicaid Direct/TP-BH-I/DD | $38.00 |
*Partners Utilization Management (UM) will transition current SCS authorizations to 15-minute units effective 7/1/2026. 1 monthly unit = 7 units for the prorated period through the end of the current authorization.
What do providers need to do?
- Providers should bill the new rate with dates of service beginning July 1, 2026.
- Requests for Enhanced Provider Rates are not available at this time.
- If Specialized Consultative Services (SCS) units beyond 7 units/month are needed, the treatment team should meet and submit an ISP update with justification.
- Plan Based Innovations Tailored Care Management (TCM) and External TCM providers serving Innovations members will not be required to submit updates to ISPs or corrected budgets unless providers of Specialized Consultative Services (SCS) indicate a need for more than 7 units of services per month effective 7/1/26 forward.
What is not impacted?
Partners will not be reducing rates for procedure codes listed that are billable to State Benefit. Please note that if members receive retroactive Medicaid coverage, claims will be processed at the Medicaid rate.
Who can providers contact if they have questions?
Partners recognizes the critical role providers play in delivering high-quality care to our members. We remain committed to maintaining a strong provider network and will continue to monitor system impacts closely.
If providers have questions, they can:
- Email Rates@PartnersBHM.org for rate-related questions.
- Email ClaimsDepartment@PartnersBHM.org for claims questions.
- Email Provider Relations at PNRelations@partnersbhm.org