Annual mental health wellness exams

Effective January 1, 2024, Massachusetts law requires certain health plans to provide coverage for an annual mental health wellness exam, which consists of a screen or assessment that seeks to identify any behavioral or mental health needs and appropriate resources for treatment. For most plans, the mental health wellness examination is covered with no out-of-pocket costs for members when performed by a network licensed mental health professional or primary care provider. Some plans, such as those governed by the Federal Internal Revenue Code (Health Savings Accounts) may require copayments, coinsurance or deductible be applied.

The exam may be provided by the primary care provider as part of an annual preventive visit, with systems in place to charge for both.  Based on the mental health wellness examination, there may be follow-up services necessary.