Community-based organizations (CBOs) play a critical role in expanding access to behavioral health services and supports for Medicaid members, as well as strengthening clinical and community care coordination. In recent years, states have expanded Medicaid coverage pathways for community-based services — such as peer recovery support and community health worker services — creating opportunities for CBOs to receive Medicaid reimbursement. While these opportunities can support greater sustainability for CBOs, navigating Medicaid enrollment and billing requirements can be complex and resource-intensive.

This tool, developed by the Center for Health Care Strategies in partnership with The McSilver Institute for Poverty Policy and Research at New York University, offers practical guidance to help CBOs assess, prepare for, and build Medicaid billing capacity. It draws on lessons from technical assistance provided to CBOs in Wisconsin and Michigan seeking to build their capacity to bill Medicaid for reimbursable services.While informed by the experiences of organizations focused on mental health and substance use disorder, the strategies are broadly relevant to CBOs interested in billing Medicaid directly. The resource was developed through support from Vital Strategies.