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Office of Mental Health

Medicaid Managed Care (MMC)
APG "Government" Rates

According to NYS law of 2019, Medicaid Managed Care (MMC) mental health clinic reimbursement “shall be in the form of fees…which are equivalent to the payments established for such services under the ambulatory patient group (APG) rate-setting methodology”. The fees are referred to as “government rates.” This mandate is effective until March 31, 2023, unless further extended.

Medicaid Reimbursement Rates

OMH Required Services Chart - this chart lists all the Medicaid Managed Care Organization (MCO) reimbursable services for both OMH-licensed clinics and non-OMH hospital-based outpatient departments and diagnostic and treatment centers (05/17/2016)

OMH Clinic Staffing List – List of staff that must be reimbursed by MCOs when services are provided in an OMH-licensed clinic (10/10/2012)

Foreign Licensure Standards Leaving OMH site – New York State Education Department Regulations of the Commissioner, Part 60: Medicine, Physician Assistant, Specialist Assistant and Acupuncture, Section 60.5

OMH Behavioral Health Managed Care

Comments or questions about the information on this page can be directed to the Managed Care Division.