Philadelphia's CBH Raised Rates 5% and 3%. IBHS and ABA Got Neither.

Philadelphia's Community Behavioral Health (CBH) gave most of its network a raise this year: 5% on July 1 for standard-rate levels of care, and 3% on October 1 for negotiated ones. Provider Bulletin 26-09 lists who's left out. The first two lines are “Intensive Behavioral Health Services (IBHS) – Regionalized” and “Intensive Behavioral Health Services (IBHS) – Applied Behavioral Analysis (ABA).”

The same bulletin closed the usual route around it: CBH “will not accept individual provider-initiated requests for increases during the September 2026 request cycle.” The next cycle is March 2027.

The turn: the bonus shrank too

When CBH set up the Regionalized IBHS value-based arrangement, it paired two 25% rate increases, July 2023 and January 2024 (56.25% compounded), with incentives of “up to 15%.” An August 6 notice changes that: “Effective with the Q1 2026 IBHS incentive payments, scheduled for distribution in November 2026, the maximum potential incentive payment will change from ≤15% to ≤10%.” It adds that incentives “are subject to the availability of funds and are not guaranteed.”

So the one lever left for IBHS revenue this year is smaller, and it's paid on 2026 performance that's already been delivered.

What gets measured from January 1

A September 29 notice sets the measurement year 2027 list, which CBH calls “the complete list,” for services from January 1, 2027. Under the “IBHS” model:

• ADHD medication follow-up, initiation rate: goal 60.65%, 2 points (new)
• ADHD medication follow-up, maintenance rate: goal 69.23%, 2 points (new)
• Depression screening: pass/fail on submitting claims in HL7 format, 1 point (new)
• Median days from written order to start of assessment: 23, 1 point. The 2024 measure used the average.

The two concurrent-services measures from 2024, crisis and acute inpatient or partial hospital, aren't on the list. Under the 2024 bulletin, three measures were worth one point each. Now four are worth six, and two-thirds of the points sit on ADHD medication follow-up.

The limits

The August notice is about the Regionalized IBHS arrangement. The September notice labels the model only “IBHS” and doesn't say whether IBHS-ABA programs are scored under it, and Bulletin 26-09 treats the two as separate levels of care. The ADHD measures depend on follow-up with a prescriber, and CBH doesn't say how IBHS providers are expected to move them. Separately, a federal audit found none of 100 sampled CBH denials met all requirements.

What you must know or do

• Finance: re-forecast the November Q1 2026 incentive at no more than 10%, and model zero, since CBH says it isn't guaranteed. Budget 2026–27 IBHS revenue with no rate increase.
• Operations: calculate your 2026 median days from written order to start of assessment now. The 23-day goal applies to the median from January.
• Owners: email cbh.vbp@phila.gov to ask whether your IBHS-ABA program is scored under the MY2027 “IBHS” model, and how IBHS claims count toward the ADHD follow-up measures. Get the answer in writing before you build a plan around those 4 points.
• Contracting: prepare cost data for the March 2027 rate-request cycle.