Blue Cross Blue Shield of Massachusetts will begin offering coverage for an annual mental health wellness exam starting March 31, 2024. This examination can be conducted as part of the annual preventive visit with your primary care provider (PCP) or as a standalone appointment with a PCP or licensed mental health professional.

Importantly, as the mental health wellness exam is considered preventive care, members in most plans will not incur any out-of-pocket costs. This coverage is in line with the Act Addressing Barriers to Care (ABC Act), a Massachusetts legislation passed in 2022 with the support of stakeholders, including BCBSMA, aimed at enhancing mental health care across the state.

Background:

The ABC Act, focusing on removing barriers to behavioral health care, mandates the coverage of an annual Mental Health Wellness Examination without any cost sharing. While Massachusetts is an early adopter of this progressive change, it is anticipated that other states may follow suit, given the increasing emphasis on mental health as an integral component of overall well-being. Currently, the state of Colorado also requires a similar mental health wellness exam.

What is the mental health wellness exam?

The mental health wellness exam encompasses taking the patient's mental health history, a thorough mental health examination, relevant screening tests, shared decision-making (including lifestyle education and counseling), and a discussion about potential next steps. This could involve referrals for treatments and medication options. It is important to note that the exam may or may not result in a formal diagnosis. The examination can be administered by a primary care provider, including OB/GYNs, either as part of the annual wellness visit or as a separate examination. Licensed mental health professionals are also authorized to conduct the exam.

For more detailed information about the exam, please refer to the official website: https://www.mass.gov/info-details/annual-mental-health-wellness-exams

To provide further insights, BCBSMA will be hosting an informational webinar on March 20, 2024, from 10:00 AM to 11:00 AM.

The session will be led by Dr. Greg Harris, MD, MPH, DFAPA, Senior Medical Director, Mental Health, and Paul Jones, Senior Manager of Public Policy, Government & Regulatory Affairs.