Reminder*** UPL Schedule due June 1, 2019

The email below comes to us from OMH for providers that operate certain programs listed in the notice – not residential.

Dear Provider:

A new schedule, the CFR Addendum – Upper Payment Limit (UPL) Schedule, has been created to gather revenue and threshold visits for select OMH programs.  The Centers for Medicare and Medicaid Services (CMS) require that the UPL data be presented in an approved cost report. The approved UPL Schedule, instructions and certifications can be found below.

Providers that operated one or more of the following OMH programs during the calendar 2018 CFR reporting period that did not provide outpatient hospital services under 42 CFR § 440.20, are required to complete the UPL Schedule:

  • 0200 – Day Treatment
  • 1310 – Continuing Day Treatment
  • 2100 – Clinic Treatment
  • 2200 – Partial Hospitalization
  • 2320 – Intensive Psychiatric Rehabilitation Treatment (IPRT)

The deadlines for completing the UPL schedule(s) and certifications are as follows:

CFR Reporting Period UPL Schedule Filing Due Date
Calendar Year 2018 June 1, 2019

A complete list of your Agency’s OMH programs is available in the Mental Health Provider Data Exchange (MHPD).  If after reviewing MHPD there are still questions, please don’t hesitate to contact the OMH CFR Unit for assistance.

Hospitals, Federally Qualified Health Centers and clinic programs that did not bill Medicaid are not required to complete the UPL schedule.

Providers that operated a Certified Community Behavioral Health Clinic will need to complete the UPL Schedule.   (Note: This is a change from our original instructions sent last year.)

The completed UPL schedules and signed certifications should be submitted by email to  A signed CPA certification is required for each UPL schedule that is completed and a signed CEO certification is required for each Agency.

Please don’t hesitate to contact OMH if you have questions regarding the completion of the UPL schedule.

Attachments can be downloaded below: 
CFR Addendum – Upper Payment Limit (UPL) Schedule

UPL Schedule Instructions

CEO Certification

CPA Certification


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