Good afternoon,
We have been getting inquiries from a number of people in regards to the new Health Home High Medium and Low rates effect July 1, 2015 and the TCM legacy rate extension. Please see the notice below that was sent out March 25th, 2015 in case it was missed.
Please be advised that the Centers for Medicare and Medicaid Services (CMS) has approved the State Plan Amendment to extend the legacy Health Home rates for the former OMH and COBRA Targeted Case Management (TCM) agencies as well as the OASAS Managed Addiction Treatment Services (MATS Agencies) until the implementation of the initial carve-in of the behavioral health care benefit into Managed Care. The current target date for the initial carve-in of the behavioral health care benefit into Managed Care is July 1, 2015. Based on this target date, legacy providers will continue to bill directly for dates of service up to and including June 30, 2015.
Guidance reflecting additional changes to billing practices effective July 1, 2015, including implementation of a tiered rate structure, uniform rate for outreach and engagement, and transitional billing during the HARP enrollment period, has also been released.
Click here for a summary of these changes. This information has also been posted to the Health Home website at the following links:
http://www.health.ny.gov/health_care/medicaid/program/medicaid_health_homes/hh_tcm_legacy_rates_extended.htm
http://www.health.ny.gov/health_care/medicaid/program/medicaid_health_homes/hh_billing_practices.htm
Thank you,
NYSDOH Health Home Program