Despite the growing number of people served by certified community behavioral health clinics (CCBHCs), the clinics face possible financial strain amid policy headwinds.
Nearly 13% more people, about 3.4 million, received care across CCBHCs in 2025 compared to the year prior, per the 2026 CCBHC Impact Report, published by the National Council for Mental Wellbeing. Over half of those served were people with serious mental illness or serious emotional disturbance. The number of CCBHCs also grew 9% between 2024 and 2025.
CCBHCs provide behavioral healthcare to all, regardless of age or their ability to pay. Their work includes 24-hour crisis care and coordination with local providers and other partners to ease the pressure on EDs and law enforcement. There are 539 clinics across the U.S. Two types of CCBHCs exist: those that participate in Medicaid and qualify for enhanced payment rates, and expansion grantees that rely on federal funding to operate.
Half of CCBHCs saw increases in uninsured patients, per the report. Though CCBHCs must serve all patients, they can’t recieve Medicaid prospective payment system (PPS) reimbursement for services delivered to the uninsured. Thus, more uninsured people due to the One Big Beautiful Bill Act (OBBBA) Medicaid cuts, predicted to lead to millions losing Medicaid coverage, could increase uncompensated care costs and strain CCBHCs.
“Further attention is needed to understand how coverage losses and rising uninsured rates may affect CCBHC operations and what supplemental funding strategies (e.g., federal grants, state investments and other financing mechanisms) may be needed to support continued access to care for uninsured individuals,” the report noted.
The CCBHC model will continue to expand, with 10 new states selected for the federal Medicaid demonstration program and more CCBHC state planning grants expected. At the same time, CCBHC-Expansion clinics, which rely on Substance Abuse and Mental Health Services Administration (SAMHSA) grants, may decline in number this year as COVID-era funding comes to an end. Some may receive renewed awards or transition into state Medicaid demonstration programs.
“These funding changes should not be interpreted as an indication that the CCBHC model is contracting,” Rebecca Farley David, principal advisor for policy and advocacy at the National Council for Mental Wellbeing, told Fierce Healthcare in emailed comments. “The broader model continues to expand as more states adopt Medicaid CCBHC programs and existing CCBHCs continue to grow the number of people they serve.”
Partnerships with primary care providers are core to the CCBHC model, per Farley David. They ensure that people receive coordinated, whole-person care that spans physical, mental and social needs. Over a quarter of CCBHCs are comprehensive providers of primary care, and a fifth offer primary care through a partner organization. Some have informal referral relationships, while others have formal partnerships, which may entail care coordination, shared treatment planning, bidirectional referrals, data sharing, co-location of services or integrated care teams.
For organizations interested in developing these partnerships, the National Council for Mental Wellbeing and the National Association for Community Health Centers have digital resources here.
Clinics created over 32,000 new staff positions after implementing the CCBHC model. Hiring was greatest among Medicaid CCBHCs, with an average of 81 new positions per clinic, and they saw greater increases in service capacity compared to CCBHC-Expansion grantees.
Half a million people received care for substance use disorder (SUD) in 2025 through a CCBHC. Among those with opioid use disorder, half received medications for opioid use disorder (MOUD), more than triple the national average, according to the report.
More than three-quarters of CCBHCs reported positive justice system outcomes, including diversion from arrest to treatment, increased joint response and reduced law enforcement time spent responding to behavioral health clinics. Research shows people with mental health needs are disproportionately killed during interactions with law enforcement. Fewer than half of law enforcement agencies have responses for mental health crises, a recent analysis found.
Three-quarters of CCBHCs also reported positive housing outcomes, such as reduced homelessness and increased housing retention, and 65% reported positive employment outcomes, such as increased employment and job retention.
On average, clinics reported a 42% increase in the number of clients served since becoming a CCBHC, with expansions most commonly reported being among kids and youth, the uninsured or those without a prior source of outpatient care.