someone signing a bill with an American flag in the foreground

How The Mental Health Access Improvement Act Impacts Behavioral Health Providers

It is well-documented that the social isolation we felt as a result of the COVID-19 lockdowns and restrictions increased the prevalence of mental health diagnoses. 

In a 2021 study, 22.8 percent of Americans reported experiencing a mental illness of some kind, compared to 20.6 percent in a pre-COVID report. According to the National Alliance on Mental Health (NAMI), the most common mental illnesses are anxiety disorders (19.1 percent), followed by depression (8.3 percent). 

Even though such a large percentage of Americans struggle with mental illness, accessing appropriate care can still be difficult for many of them. A study from Mental Health America published in 2023 found that 28.2 percent of adults with a mental illness were not able to receive the necessary treatment, with 42 percent citing they were unable to afford treatment.

The cost of mental health treatment can be prohibitively expensive, with some therapists charging $200-300 an hour, and some psychiatrists charging upwards of $500 an hour. The average cost of a therapy session in the U.S. is between $100-200 an hour. Many Americans – 38 million, in fact – live below the poverty line, but this group is also far more likely to experience mental illness. When someone struggles to put food on the table, the last priority on their mind is finding a good therapist.

But cost isn’t the only thing precluding people from accessing treatment. People who live in rural or underserved areas are more likely to have difficulty finding mental health care, largely because there are few or no mental health professionals nearby. In fact, 25 million Americans live in a Mental Health Professional Shortage Area – a geographic location with too few providers to meet regional demand. 

The problem is clear: there are just not enough resources to go around.

The Mental Health Access Improvement Act

But we are seeing some steps towards improvement. Since 2019, the U.S. Congress has taken steps to address this widespread issue. In December 2022, President Biden signed into law S.28/H.R.432, or the Mental Health Access Improvement Act (MHAIA). The MHAIA has the potential to benefit the 18.7 percent of Americans currently enrolled in Medicare Part B

MHAIA aims to ease the burden of mental health issues on individuals by expanding the network of covered professionals for those on Medicare to include more types of providers, such as licensed marriage and family therapists (LMFTs). It also expands access to care via telehealth, which will help those living in a Mental Health Professional Shortage Area. 

Many therapists choose to only accept private pay – where the patient pays out of pocket without billing their insurance – but those who do join the network will be subject to new rules and regulations in order to be reimbursed by Medicare. More details can be found here

The Impact on Providers

This new law will go into effect Jan. 1, 2024, and it features specific reimbursement rates for in-network counselors and therapists, as well as requirements for care. For example, all “mental health providers who currently participate in Part B must accept assignment.”

Overcoming Bureaucratic Challenges

While the benefits of MHAIA appear to outweigh the challenges it will present for providers, complying with the new rules and regulations as well as balancing new caseloads poses two major potential problems.


With all these new changes comes the demand for more documentation. Providers will need to show proof of treatment in order to receive reimbursement. This may necessitate new ways of checking clients in and storing their signatures and session notes, as well as their case files. 


Since many more Medicare participants will now have access to mental health care, there is the hope that they will utilize those services. Participating providers will likely see an increase in their caseloads. In-network mental health professionals will need to find ways to balance this increase while maintaining high standards of care.

Lean on Tech

One way to overcome both of these challenges lies in technology and digital tools. The Receptionist for iPad allows your clients to check in for a session effortlessly while simultaneously collecting their signatures. These signatures and visit records can be later used when it comes to reimbursement, as Medicare will require proof of session attendance in order to disperse funds to the provider. 

With an increase in the number of patients in your care, you will need to find ways to maintain high productivity. The Receptionist for iPad helps you stay focused on your current client by discreetly notifying you that your next client has arrived. The system can also instruct the client to wait in a certain area while assuring them that you are aware of their arrival and will be with them shortly. This allows you to stay present in the moment for vital tasks, such as increased documentation requirements.

The MHAIA is new and it will take time to fully understand its impact. But the mental health care professionals who participate in Medicare Part B are providing an invaluable service not just to their own patients, but to society as a whole in our endeavor to improve the nation’s mental health crisis. 

Share this Post