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S 1390

Relates to consecutive sentencing for certain convictions for sex crimes

2025 Regular Session Introduced by Patricia Canzoneri-Fitzpatrick

The bill requires payers to reimburse the psychiatric collaborative care model at parity with Medicare rates for specific codes (99492, 99493, 99494, G2214) and to adjust these min

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Bill Summary · S 1390

Summary — S.1390: An Act Relative to Access to Psychiatric Collaborative Care

Note on documents: The bill text filed as Senate No. 1390 (presented by Sen. Julian Cyr) concerns access to and reimbursement for the psychiatric collaborative care model. Some header metadata provided to me (an alternate title about sentencing, a list of mostly federal sponsors, and certain legislative-action dates) appear inconsistent with the bill text; this summary relies on the bill language filed 1/16/2025.

Purpose / Intent

To expand access to the evidence‑based psychiatric collaborative care model by (1) explicitly recognizing and reimbursing the model’s billing codes and (2) requiring state purchasers, insurers, managed‑care entities and accountable care organizations (ACOs) to pay minimum rates for those codes at parity with Medicare’s physician fee schedule (RBRVS), adjusted annually.

Key provisions

  • Section 1: Adds explicit statutory recognition that reimbursement for the psychiatric collaborative care model must include the following billing codes: CPT 99492, 99493, 99494 and G2214.
  • Definitions (Section 13M, Chapter 118E): Defines “psychiatric collaborative care model,” “managed care entity,” and “minimum payment rates.”
  • Payment parity: Directs the relevant state division/agency to increase minimum payment rates for psychiatric collaborative care model billing codes so they are equal to or greater than the current Medicare Resource‑Based Relative Value Scale (RBRVS) physician fee schedule for those codes, and to adjust those rates annually.
  • Applies payment parity obligation to:
    • State purchasers (via amendments to Chapter 32A — the Group Insurance/commission language),
    • Medicaid/Medicare managed care contractors and primary care plans (Chapter 118E),
    • Commercial insurers and group policies (Ch. 175 §47QQ; Ch. 176A §8RR; Ch. 176B §4RR; Ch. 176G §4JJ).
  • ACO/Capitation restriction: Requires that psychiatric collaborative care billing codes be removed from the set of billing codes included in the division’s ACO primary care sub‑capitation per‑member‑per‑month rate and instead be paid on a fee‑for‑service basis.

Who is affected

  • Providers: primary care teams (primary care providers and care managers) and psychiatric consultants who deliver collaborative care — they would receive higher and predictable fees for collaborative care services.
  • Payers: state purchaser programs, Medicaid managed care plans, commercial insurers, HMOs, ACOs and third‑party administrators — required to adopt the higher minimum rates and change payment arrangements.
  • Patients: beneficiaries who receive integrated psychiatric collaborative care, as increased reimbursement may incentivize broader availability of these services.

Implementation and timeline

  • Requires annual adjustments to minimum payment rates tied to the current Medicare RBRVS schedule.
  • Directs the responsible state division/commission to effect rate increases and to modify ACO sub‑capitation arrangements; administrative rulemaking or plan‑contract changes may be required.
  • Current status (per provided actions): filed 1/16/2025; introduced in the Senate and referred to relevant committees; a public hearing was scheduled for 11/03/2025 (check official legislature site for up‑to‑date status).

Potential impacts

  • Likely increases provider revenue for collaborative care services and may encourage wider adoption of the model in primary care.
  • Could raise payer expenditures (commercial insurers, Medicaid managed care and ACOs) relative to current sub‑capitation models because codes must be paid fee‑for‑service and at Medicare‑parity minimums.
  • Administrative/contracting changes required for payers and ACOs (revising capitation bundles, claims systems, and contracts).

Related/technical notes

  • Explicit CPT/G‑code list: 99492, 99493, 99494, G2214.
  • Several statutory sections across insurance, Medicaid and state employee health law are amended to impose the payment parity requirement.
  • Related bills and references provided in the file: HR 2191 (companion), SD 1467 (replaces), and several prior‑session bills (S‑1358, S‑3840, S‑8604, S‑6066).

If you want, I can produce a brief fiscal estimate checklist (likely affected budget lines, payers, and providers) or draft plain‑language talking points for providers or patient advocates.

Compiled from official sources — confirm details with the bill’s official record.

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