Office of Mental Health (OMH) Clinic Rates Codes
OMH Clinic Rate Codes
| Description | Non hospital* | Hospital | Federally Qualified Health Center (FQHC) |
|---|---|---|---|
| Base Rate | 1504 | 1516 | 4301 |
| Off-site Base Rate (available for select children’s services and crisis-brief for both adults and children.) | 1507 | 1519 | Not applicable |
| Seriously Emotionally Disturbed (SED) Child Base Rate (Medicaid managed care SED children only) | 1510 | 1522 | 4601 |
| SED Child Off-site Base Rate (Medicaid managed care SED children only) | 1513 | 1525 | Not applicable |
| Health Services (e.g., Health Monitoring, Health Physicals) | 1474 | 1588 | Not applicable |
| SED Child Health Services (e.g., Health Monitoring, Health Physicals) (Medicaid managed care SED children only) | 1477 | 1591 | Not applicable |
| Crisis Intervention | 1579 | 1576 | Not applicable |
| SED Child Crisis Intervention (Medicaid managed care SED children only.) | 1585 | 1582 | Not applicable |
| Intensive Outpatient Program (IOP) | 1042 | 1048 | Not applicable |
| Intensive Outpatient Program (IOP) SED | 1045 | 1051 | Not applicable |
| Delivery System Reform Incentive Payment (DSRIP) | 1106 | 1110 | Not applicable |
| Delivery System Reform Incentive Payment (DSRIP) SED | 1108 | 1112 | Not applicable |
| Integrated Outpatient Services (IOS) | 1480 | 1122 | Not applicable |
| Integrated Outpatient Services (IOS) SED | 1483 | 1124 | Not applicable |
*Non hospital includes Diagnostic & Treatment Center (D&TCs), Local Governmental Unit (LGUs), freestanding Art 31s, and state operated injections may be claimed using either the Health Services rate codes or the Clinic rate codes.
OMH Clinic Rate Codes Exempt from Utilization Threshold Counts
| Description | Non Hospital* | Hospital |
|---|---|---|
| Off-site Base Rate (available for select children’s services and crisis-brief for both adults and children.) | 1507 | 1519 |
| SED Child Off-site Base Rate (Medicaid managed care SED children only) | 1513 | 1525 |
| Health Services (e.g., Health Monitoring, Health Physicals) | 1474 | 1588 |
| SED Child Health Services (e.g., Health Monitoring, Health Physicals) (Medicaid managed care SED children only) | 1477 | 1591 |
| Crisis Intervention | 1579 | 1576 |
| SED Child Crisis Intervention (Medicaid managed care SED children only) | 1585 | 1582 |
| Intensive Outpatient Program (IOP) | 1042 | 1048 |
| Intensive Outpatient Program (IOP) SED | 1045 | 1051 |
Comments or questions about the information on this page can be directed to the Bureau of Financial Planning.