Mental Health Outpatient Treatment and Rehabilitative Services (MHOTRS) Rate Codes
MHOTRS Rate Codes
| Description | Non Hospital* | Hospital |
|---|---|---|
| Base Rate | 1504 | 1516 |
| Off-site Base Rate | 1507 | 1519 |
| Health Services (e.g., Health Monitoring, Health Physicals) / Peer Support Services | 1474 | 1588 |
| Crisis Intervention | 1579 | 1576 |
| Intensive Outpatient Program (IOP) | 1042 | 1048 |
| Delivery System Reform Incentive Payment (DSRIP) | 1106 | 1110 |
| Integrated Outpatient Services (IOS) | 1480 | 1122 |
| Integrated Outpatient Services with Intensive Outpatient Services – Off-site | 1084 | 1086 |
| Integrated Outpatient Services (IOS) Off-site | 1092 | 1094 |
| Utilization Threshold Exempt (Court Order / AOT / SIST) | 1136 | 1140 |
| School Based Satellite Location | 1030 | 1033 |
*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.
MHOTRS Rate Codes Exempt from Utilization Threshold Counts
| Description | Non Hospital* | Hospital |
|---|---|---|
| Off-site Base Rate | 1507 | 1519 |
| Health Services (e.g., Health Monitoring, Health Physicals) / Peer Support Services | 1474 | 1588 |
| Crisis Intervention | 1579 | 1576 |
| Intensive Outpatient Program (IOP) | 1042 | 1048 |
| Delivery System Reform Incentive Payment (DSRIP) | 1106 | 1110 |
| Integrated Outpatient Services (IOS) | 1480 | 1122 |
| Utilization Threshold Exempt (Court Order / AOT / SIST) | 1136 | 1140 |
| Integrated Outpatient Services with Intensive Outpatient Services – Off-site | 1084 | 1086 |
| Integrated Outpatient Services (IOS) Off-site | 1092 | 1094 |
| School Based Satellite Location | 1030 | 1033 |
OMH Federally Qualified Health Center (FQHC) Rate Codes
| Description | Rate Code |
|---|---|
| OMH – FQHC | 4301 |
| OMH – FQHC Group | 4303 |
| OMH – FQHC Offsite | 4306 |
| FQHC GROUP PSYCHOTHERAPY - COURT MANDATED | 4026 |
| FQHC OFF-SITE SERVICES (INDIV) - COURT ORDERED | 4027 |
| FQHC INDIVIDUAL THRESHOLD VISIT - COURT ORDERED | 4028 |
Comments or questions about the information on this page can be directed to medicaidffsbillinghelp@omh.ny.gov.