Office of Mental Health (OMH) Clinic Rates Codes
OMH Clinic Rate Codes
| Description | Non Hospital* | Hospital |
|---|---|---|
| Base Rate | 1504 | 1516 |
| Off-site Base Rate (available for select children’s services and crisis-brief for both adults and children.) | 1507 | 1519 |
| Health Services (e.g., Health Monitoring, Health Physicals) | 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 |
*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 |
| Health Services (e.g., Health Monitoring, Health Physicals) | 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 |
OMH Federally Qualified Health Center (FQHC) Rate Codes
| Description | Rate Code |
|---|---|
| Clinic – FQHC | 4301 |
| Clinic – FQHC Group | 4303 |
| Clinic – FQHC Offsite | 4306 |
Comments or questions about the information on this page can be directed to the Bureau of Financial Planning.