Medicaid Reimbursement Rates

This page contains approved Medicaid fee-for-service rates for all OMH programs.

Assertive Community Treatment (ACT) - Regional Rate - New Rates Effective 1/1/2019

Certified Community Behavioral Health Clinics (CCBHC)

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)
• Youth Peer Support and Training (YPS) and Crisis Intervention

Children's Home and Community Based Services (HCBS)

Clinic

• APG Peer Group Base Rates - New Rates Effective 1/1/2019
• APG Peer Group Base Rates - Provider-Specific - New Rates Effective 1/1/2019
• 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 – New Rates Effective 1/1/2019

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 – New Rates Effective 1/1/2019

Day Treatment Services for Children - Regional Rates - New Rates Effective 1/1/2019

Federally Qualified Health Center (FQHC) - Provider-Specific Rates

Health and Recovery Plans (HARP) Behavioral Health Home and Community Based Services (BH HCBS) Fee Schedule – These are the codes that the 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-eligibles).

• Upstate HARP BH HCBS Fee Schedule – Updated 3-1-2018
• Downstate HARP BH HCBS Fee Schedule – Updated 3-1-2018

Intensive Psychiatric Rehabilitation Treatment (IPRT) - Statewide Rates – New rates effective 4/1/2015 to reflect 2% COLA increase

Partial Hospitalization - Regional Rates – New Rates Effective 1/1/2019

Personalized Recovery Oriented Services (PROS) - Regional Rates – New Rates Effective 1/1/2019

Private Psychiatric Hospitals - Rates – Updated 2/12/2019

State Operated Community Residence – New Rates Effective 4/1/18

State Operated Inpatient Psychiatric Hospital - New Rates Effective 4/1/18

 

Comments or questions about the information on this page can be directed to the Bureau of Financial Planning.