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Section 223 Medicaid CCBHC Demonstration and State Programs


Starting in 2017, 67 CCBHCs were established in eight states through the Section 223 CCBHC Medicaid Demonstration (Demonstration). These CCBHCs are certified by their states as being in compliance with the CCBHC Certification Criteria and are reimbursed via a prospective payment system (PPS) for 9 required services defined in the criteria. The prospective payment system provides cost-based reimbursement for the nine required CCBHC services. You can learn more about the CCBHC PPS on the Centers for Medicare & Medicare Services website. CCBHCs in state Demonstration programs may also receive SAMHSA expansion grants. In 2019, Pennsylvania withdrew from the Demonstration and in 2023 Nevada moved their CCBHC program out of the Demonstration in made it a permanent part of their state Medicaid program.

In order for states to join the demonstration, they must first complete a SAMHSA planning grant. The CCBHC planning phase assists states in certifying clinics as CCBHCs, establish prospective payment systems for Medicaid reimbursable services, and prepare an application to participate in a four-year demonstration program. The first round of 24 SAMHSA state planning grants was awarded in 2015. Another round of 15 grants was funded in 2023, and SAMHSA anticipates funding an additional round of planning grants in 2025.

Independent State Programs

Independent state programs are CCBHCs funded through state Medicaid programs which are separate from the Section 223 CCBHC Demonstration. These states use a Medicaid state plan or section 1115 demonstration authority, not the Section 223 CCBHC Demonstration, to define the CCBHC array of services and payments for CCBHC services. These CCBHCs are subject to state oversight through their Medicaid programs and may also receive SAMHSA expansion grants.

Map of CCBHCs Across the United States*

*Current as of March 6, 2023.

Currently, there are over 500 CCBHCs operating across the country, as either CCBHC-E grantees, as clinics participating in their states’ Medicaid demonstration, or as a part of independent state CCBHC programs.


States with no CCBHCs are Delaware, North Dakota, South Dakota, South Carolina, and Washington, D.C. States participating in CCBHC Medicaid Demonstration and SAMHSA expansion grants are Kentucky, Missouri, Minnesota, Michigan, New Jersey, New York, Oklahoma, and Oregon. States with at least one local CCBHC grantee are Alabama, Alaska, Arizona, Arkansas, California, Colorado, Connecticut, Florida, Georgia, Hawaii, Idaho, Illinois, Indiana, Iowa, Kansas, Louisiana, Maine, Maryland, Mississippi, Montana, Nebraska, New Hampshire, New Mexico, Nevada, North Carolina, Ohio, Pennsylvania, Rhode Island, Tennessee, Texas, Utah, Vermont, Virginia, Washington, West Virginia, Wisconsin, and Wyoming. States that are CMS-approved payment method for CCBHCs via S P A or 1115 waiver are Kansas, Minnesota, Missouri, Nevada, Oklahoma, and Texas.

Key Pt1

stripe iconFederal CCBHC Medicaid Demonstration (And SAMHSA Expansion Grants)

purple iconState contains at least one local SAMHSA expansion grantee

Key Pt2

check iconCMS-approved payment method for CCBHCs via a SPA or 1115 waiver separate from Demonstration


CCBHC Compliance Checklist (PDF | 848 KB): The CCBHC Compliance Checklist helps states to ensure CCBHCs meet the required criteria and is used when states apply for additional CCBHCs to Section 223 Demonstration programs.

Guidance on Addition of CCBHCs to Section 223 State Demonstration Programs (PDF | 300 KB): States participating in the Section 223 Protecting Access to Medicare Act of 2014 CCBHC Demonstration Program are permitted as of February 21, 2023 to add new CCBHCs to their demonstration programs.

CCBHC Demonstration Application (PDF | 477 KB): The CCBHC Demonstration Application is used by eligible states to apply for participation in the CCBHC Demonstration. Applications are due on March 20, 2024.

Last Updated
Last Updated: 02/13/2024
Last Updated