Table 138Medicare fee-for-service mental health, substance abuse, and all health expenditures among behavioral health claimants, by treatment modality: expenditures and percentage distribution, United States, 2011

[Data are based on Medicare claims data]

Treatment modalityExpenditures by modality among mental health claimants1Percentage distribution of expenditures by modality among mental health claimants1Expenditures by modality among substance abuse claimants2Percentage distribution of expenditures by modality among substance abuse claimants2
Mental health expenditures (millions of dollars)All health expenditures (millions of dollars)Mental health expendituresAll health expendituresSubstance abuse expenditures (millions of dollars)All health expenditures (millions of dollars)Substance abuse expendituresAll health expenditures
All services in expenditure category$6,798$83,849100.0%100.0%$739$9,811100.0%100.0%
 Inpatient$4,01937,56959.144.84995,13467.552.3
 Outpatient3$85210,01412.511.9841,28711.413.1
 Physician/supplier4$1,52217,64122.421.01242,16516.722.1
 Home health agency/hospice/skilled nursing facility$40618,6246.022.2331,2264.412.5
1

Beneficiaries were considered to be using a mental health service if they had a claim for a mental health service as the primary diagnosis. Mental health diagnoses included International Classification of Diseases, Ninth Revision, Clinical Modification (ICD-9-CM) codes 295–302 and 306–314.

2

Beneficiaries were considered to be using a substance abuse service if they had a claim with a substance abuse diagnosis as the primary diagnosis. Substance abuse diagnoses included ICD-9-CM codes 291–292 and 303–305.

3

Outpatient services refer to services rendered in outpatient facilities, such as hospital outpatient departments, rural health clinics, renal dialysis facilities, outpatient rehabilitation facilities, and community mental health centers.

4

Physician or supplier services refers to services provided by noninstitutional providers, such as physicians, physician assistants, psychologists, clinical social workers, and nurse practitioners, that are submitted on a standard Medicare claim form.

NOTES: Estimates do not include expenditures on prescription medications. Estimates of inpatient, home health, hospice, and skilled nursing facilities used 100 Percent Standard Analytical Files, and estimates of outpatient services and physician/supplier services used 5 Percent Standard Analytical Files. Data include all 50 states and U.S. territories.

Expenditure estimates were adjusted from 2011 to 2012 dollars using the GDP Price Index. The index is compiled by the U.S. Department of Commerce's Bureau of Economic Analysis.

As an example of how to interpret the estimates in the table, in 2011, expenditures on mental health services among Medicare beneficiaries with a mental health claim who received inpatient services totaled $4,019 million.

SOURCE: Medicare Standard Analytical Files. Centers for Medicare & Medicaid Services; 2011. .

Beneficiaries were considered to be using a mental health service if they had a claim for a mental health service as the primary diagnosis. Mental health diagnoses included International Classification of Diseases, Ninth Revision, Clinical Modification (ICD-9-CM) codes 295–302 and 306–314.

Beneficiaries were considered to be using a substance abuse service if they had a claim with a substance abuse diagnosis as the primary diagnosis. Substance abuse diagnoses included ICD-9-CM codes 291–292 and 303–305.

Outpatient services refer to services rendered in outpatient facilities, such as hospital outpatient departments, rural health clinics, renal dialysis facilities, outpatient rehabilitation facilities, and community mental health centers.

Physician or supplier services refers to services provided by noninstitutional providers, such as physicians, physician assistants, psychologists, clinical social workers, and nurse practitioners, that are submitted on a standard Medicare claim form.

From: 5, TABLES

Cover of Behavioral Health, United States, 2012
Behavioral Health, United States, 2012.

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