Unmet need for behavioral health care remains high. Behavioral health provider shortages and associated maldistribution of practitioners across the country may contribute to suboptimal behavioral healthcare availability, with an estimated 59.8% of the 5,035 mental health provider shortage areas in the US located in rural and partially rural areas. In addition, lack of access to mental health professionals is a growing problem for those relying on Medicaid and/or Medicare for health needs. Medicare limits coverage to treatment provided by psychiatrists, clinical psychologists, clinical social workers, and psychiatric mental health nurses, effectively tightening the pool of eligible providers for those seeking behavioral health services and potentially exacerbating access to care issues.

This cross-sectional study examines the relationship between reimbursement and behavioral health provider geographic distribution and seeks to understand how Medicare and Medicaid reimbursement for behavioral health providers may limit service delivery.