Medicare Boosts Mental Health Integration: Primary Care Doctors Get Up to 175% Bonus for Behavioral Services Starting 2027

The COMPLETE Care Act is trying to tackle a big problem: getting access to mental health support shouldn't require three separate appointments across town. This legislation, officially called the Connecting Our Medical Providers with Links to Expand Tailored and Effective Care Act, is focused on weaving behavioral health services right into your regular Medicare primary care doctor’s office. It does this by offering a significant, temporary financial incentive to providers.

The Incentive: Paying Doctors to Talk About More Than Just Your Blood Pressure

Starting in 2027, Medicare primary care providers who offer specific integrated behavioral health services will get a serious pay bump. Instead of the usual payment, they will receive a bonus percentage: 175 percent of the normal rate in 2027, 150 percent in 2028, and 125 percent in 2029. This applies to services identified by codes like 99492 (Collaborative Care Model) and 99484 (Primary Care Behavioral Health model). Think of this as Medicare putting its money where its mouth is, essentially paying doctors extra to hire the staff or build the systems needed to offer mental health support under one roof, making it much easier for patients to get help.

Crucially, the bill includes a provision that makes sure these increased payments won’t trigger cuts elsewhere in the Medicare system to balance the budget during those three years (SEC. 2). Normally, if Medicare increases payments for one area, it has to find savings in others. By exempting these bonuses, the bill aims to stabilize payments for other providers while encouraging this specific integration. This is important because it means the push for better mental healthcare shouldn't come at the expense of, say, physical therapy or lab services.

Hands-On Help for Practices

It’s one thing to offer a bonus, but it’s another thing entirely to help a busy doctor’s office figure out how to actually integrate a social worker or therapist into their workflow. Recognizing this challenge, the COMPLETE Care Act requires the Secretary of Health and Human Services to set up a system to provide technical assistance—basically, hands-on consulting and support—to help primary care offices adopt these integrated care models (SEC. 2). This assistance must be available by January 1, 2026, and Congress is setting aside funding for it through fiscal year 2029.

For a small practice, this support is vital. It means they don't have to spend months trying to figure out the billing, staffing, and regulatory hurdles on their own; they get expert help. This support is explicitly targeted at proven models like the Collaborative Care Model. However, the Secretary is also given the authority to include “any other models the Secretary determines appropriate” for this assistance, which is a detail worth watching. While this flexibility could allow for the adoption of new, effective approaches, it also gives the Secretary significant, undefined discretion in deciding who gets this valuable, funded support.

Real-World Impact: Less Running Around

For the Medicare beneficiary—say, a retired construction worker dealing with chronic pain and the depression that often comes with it—this bill could be a game-changer. Instead of getting a referral from their primary care doctor and waiting months for a separate appointment with a specialist who doesn't know their history, they could potentially see a behavioral health specialist right there in the same office, often on the same day. This dramatically lowers the logistical barriers that often prevent people from seeking mental health care.

For primary care providers, the financial incentives are strong, but they are temporary, phasing down over three years. This suggests the goal is to provide a significant jumpstart—a hefty initial investment—to get practices set up and integrated, with the expectation that the new models will become sustainable once established. The combination of high payments and dedicated, funded technical assistance offers a strong path for practices to make this necessary transition.