Certified Community Behavioral Health Clinics (CCBHCs) are available in eight pilot states through 2018 and will go to full release in January 2019. These CCBHCs can complete submissions under two prospective payment systems based on their state. However, there are key differences between the two. CC PPS-1 is a cost-based, per clinic rate that applies uniformly to all CCBHC services rendered by a certified clinic, including those delivered by qualified satellite facilities established prior to April 1, 2014. This system pays CCBHCs a fixed daily rate for all services provided on any given day to a Medicaid beneficiary. In demonstration year one (DY1), the state uses cost and visit data from the demonstration planning phase, updated by the Medicare Economic Index (MEI) to create the rate for DY1. The DY1 rate will be updated again for DY2 by the MEI or by rebasing the PPS rate. The Centers for Medicare and Medicaid Services (CMS) requires one full year of cost data and visit data, unless a state can justify a shorter time period. The CC PPS-1 rate is based on total annual allowable CCBHC costs divided by the total annual number of CCBHC daily visits and results in a uniform payment amount per day, regardless of the intensity of services or individual needs of clinic users. In developing the rates, states may include estimated costs related to services or items not incurred during the planning phase but projected to be incurred during the demonstration. States also should include the cost of care associated with Designated Collaborating Organizations (DCOs). A DCO is an entity that is not under the direct supervision of the CCBHC but is engaged in a formal relationship with the CCBHC and delivers services under the same requirements. Payment for DCO services is included within the scope of the CCBHC PPS, and DCO encounters will be treated as CCBHC encounters for purposes of the PPS. DCO services are distinct from referred services in that the CCBHC is not financially and clinically responsible for referred services.