Medicaid Reimbursement Rates
Approved Medicaid fee-for-service rates for all OMH programs.
Assertive Community Treatment (ACT) - Regional Rate - File updated 10/19/21
Certified Community Behavioral Health Clinics (CCBHC) - File updated 10/25/2019
Children and Family Treatment and Support Services (CFTSS)
- Other Licensed Practitioner (OLP), Community Psychiatric Support and Treatment (CPST), and Psychosocial Rehabilitation (PSR)
- Family Peer Support Services (FPSS) and Youth Peer Support and Training (YPST)
- Crisis Intervention
Children's Home and Community Based Services (HCBS)
Clinic
- APG Peer Group Base Rates - File updated 4/15/21
- APG Peer Group Base Rates - Provider-Specific - File updated 10/20/21
- Clinic APG Payment Modifiers
- OMH Clinic Rates Codes
- Blend Rates -- Provider-Specific - Phased out for claims with dates of service on or after 10/1/13. This spreadsheet is being provided for informational purposes only.
Collaborative Care - Statewide Rate
Continuing Day Treatment (CDT) - Adult - Regional Rates - File updated 4/15/21
Community Residence - Adult - Provider-Specific Rates
Community Residence and Teaching Family Home - Children - Provider-Specific Rates - New rates effective 4/1/2015 to reflect 2% COLA increase
Children’s Case Management - Regional Rates
Comprehensive Psychiatric Emergency Program (CPEP) - Statewide Rates - File updated 4/15/21
Day Treatment Services for Children - Regional Rates - File updated 4/15/21
Federally Qualified Health Center (FQHC) - Provider-Specific Rates
Intensive Psychiatric Rehabilitation Treatment (IPRT) - Statewide Rates - New rates effective 4/1/2015 to reflect 2% COLA increase
Partial Hospitalization - Regional Rates - File updated 4/15/21
Personalized Recovery Oriented Services (PROS) - Regional Rates - Updated 10/19/21
Private Psychiatric Hospitals - Rates - Updated 2/24/2021
State Operated Community Residence - Updated 8/24/21
State Operated Inpatient Psychiatric Hospital - Updated 8/24/21
Reimbursement Rates only available through Medicaid Managed Care Organizations (MMCOs)
Mobile/Telephonic Crisis Intervention - 9/30/2020
Rate codes are only available through Medicaid Managed Care Organizations (MMCOs) to individuals 21 and older.
Crisis Intervention - Residential - 9/30/2020
Rate codes are only available through Medicaid Managed Care Organizations (MMCOs) to individuals 21 and older.
Health and Recovery Plans (HARP) Behavioral Health Home and Community Based Services (BH HCBS) Fee Schedule – Codes that HARP plans and HIV-SNPs will be using to bill Medicaid for HCBS services that are provided to HARP enrollees (or HIV-SNP enrolled HARP-eligible).
- HARP BH HCBS Fee Schedule - Updated 6-1-2021
Comments or questions about the information on this page can be directed to Adult Clinic or Children’s Clinic.