NYAPRS Note: See below for more information about the rates for behavioral health services in managed care, including a billing manual for HCBS and “mainstream” (State Plan service) providers.
Dear Behavioral Health Provider –
Click on these three files for your information:
1. Final Draft Behavioral Health Billing Guidance – The first section of the document called “New York State HARP Mainstream BH Billing and Coding Manual” provides billing mechanics for all the Medicaid fee-for-service “government rate” services (including OMH licensed and OASAS certified services). This should be reviewed in conjunction with attachments 2 and 3. The second section of the manual gives detailed information on OASAS services. There are numerous links in this document, provided for your convenience.
2. Coding Taxonomy – This Excel file provides the required coding construct for billing the government rates services. All OMH licensed and OASAS certified providers must submit claims to Managed Care Plans using the coding contained herein.
3. HCBS fee schedule – This shows the required coding combinations to bill the Managed Care Plan for the provision of these services. The rate codes that you will use to bill Plans, in conjunction with procedure and modifier codes, will be provided in the near future and are subject to CMS and NYS DOB approval. Only HCBS designated providers are eligible to be reimbursed for these services.
Please keep in mind the transition is upon us. Announcement letters for the New York City adult behavioral health managed care transition will be mailed mid-April through mid-June.
Please call (518) 474-6911 or e-mail bho@omh.ny.gov with questions.
Thank you,
Gary Weiskopf
Associate Commissioner for Managed Care
NYS Office of Mental Health
Patricia Lincourt
Director, Practice Innovation and Care Management
New York State Office of Alcoholism and Substance Abuse Treatment