CORE Services are person-centered, recovery-oriented mobile behavioral health supports. They build skills and assist in community participation and independence.

CORE Services allow eligible adult Medicaid beneficiaries with serious mental illness and/or addiction disorders to receive services in their own home or community.

Designated CORE providers work together with:

• individuals and their managed care (insurance) plan
• other service providers
• family
• government partners

CORE SERVICES:

1. Community Psychiatric Support and Treatment (CPST)

• Goal-directed supports and solution-focused interventions with the intent to achieve person-centered goals.
• Multi-component service that consists of therapeutic interventions.

2. Psychosocial Rehabilitation (PSR)

• Assists individuals in improving their functional abilities to the greatest degree possible in settings where they live, work, learn, and socialize.
• Rehabilitation counseling, skill building, and psychoeducational interventions.

3. Family Support and Training (FST)

• Offers instruction, emotional support, and skill building necessary to facilitate engagement and active participation of the family.
• FST partners with families through a person-centered or person-directed, recovery oriented, trauma-informed approach.

4. Empowerment Services – Peer Support

• Non-clinical, peer-delivered services with focus on rehabilitation, recovery, and resilience.
• Promotes skills for coping with and managing behavioral health symptoms while facilitating the use of natural supports and community resources.

WHO IS ELIGIBLE?

Eligibility for CORE Services is based on the following criteria for individuals in a Medicaid Health and Recovery Plan (HARP), HIV-Special Needs Plan (HIV-SNP), or Medicaid Advantage Plus (MAP) Plan:

1. The individual must be enrolled in a HARP, HIV-SNP, or MAP Plan
2. The individual must meet the NYS Behavioral Health (BH) High-Risk Criteria (commonly referred to as the HARP Eligibility Algorithm), indicated by one of the following codes:
• H1: Enrolled in a HARP and has met the NYS BH High-Risk Criteria
• H4: Enrolled in a HIV-SNP and has met the NYS BH High-Risk Criteria
• H9: Has met the NYS BH High-Risk Criteria
3. The CORE Service(s) must be recommended by a Licensed Practitioner of the Healing Arts (LPHA)

There are additional restrictions to ensure there is no duplication of services. For more information on these restrictions, please see the CORE Benefit & Billing Guidance.

Adults 21+ can find out more about CORE Services and their eligibility by contacting their HARP, HIV-SNP, or MAP Plan; their current behavioral health service provider(s); or NY Medicaid Choice (1-800-505-5678) for more information.

RESOURCES & GUIDANCE

Educational Materials for Individuals and Families

• Core Brochure (ى | বাঙালি | 中文 | 繁體字 | Kreyòl Ayisyen | Italiano | 한국어 | Polski | PyCCКИЙ | Español | אידיש)
• CORE Member FAQ (ى | বাঙালি | 中文 | 繁體字 | Kreyòl Ayisyen | Italiano |
  한국어 | Polski | PyCCКИЙ | Español | אידיש)
• CORE Palm Card (ى | বাঙালি | 中文 | 繁體字 | Kreyòl Ayisyen | Italiano | 한국어 | Polski | PyCCКИЙ | Español | אידיש)

Managed Care Policy, Guidance, and Forms:

• CORE Benefit & Billing Guidance (Updated April 1, 2024)
  • Archived CORE Benefit & Billing Guidance (Transitional Information - October 2021/April 2022)
• CORE Services and CCBHC Allowable Service Combinations
• MCO Notification Letter
• CORE Provider Service Initiation Template (updated April 1, 2024)

Program Policy, Guidance, and Forms:

• CORE Operations Manual
• LPHA Memo and Recommendation Form | Fillable LPHA Recommendation Form
• CORE FAQ (revised 11/15/2022)
• Staff Training Memo