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Office of Mental Health

Mainstream/Health and Recovery Plan (HARP) Billing Guidance

Medicaid BH Rate Updates and Requirements

Medicaid Billing Guidance

Medicaid Provider Enrollment

Medicaid Advantage Plus (MAP) Billing Guidance

General Medicaid/Medicare Duals Billing Guidance

Commercial BH Billing Guidance

    CPT Revenue Calculator: This tool enables users to calculate the projected revenue for CPT procedures based on current service weights and peer group base rates.

  1. 1. CPT Revenue Calculator: Illustrated
  2. 2. CPT Revenue Calculator: Blank

  3. Department of Health (DOH) Ambulatory Patient Group (APG) Rates This page houses provider-specific base rates for APGs.

  4. School-Based Mental Health Clinic Program Site List (October 6, 2023) – A resource for Commercial Plans listing school-based mental health clinic sites with provider IDs, NPIs, rate codes, and rates.

  5. School-Based Mental Health Clinic Fee Schedule (October 6, 2023) – A resource for Commercial Plans listing possible combinations of procedures, modifiers, and other elements to determine the final weight. The final weight can be used with the base rate identified in the School-Based Mental Health Clinic Program Site List (above) to calculate reimbursement for school-based mental health clinic services.

* If you are having accessibility issues with the previous documents, please contact Office of Diversity Management, or call (518) 473-4144.

Please contact OMH Managed Care with any questions, comments, or problems you may be experiencing with this site. If you would like to file a complaint about behavioral health managed care, please visit the Information on Filing a Complaint page. Providers, if you have any questions about the managed care implementation, please complete and send a question form.