This site is intended to be a quick reference guide for all stakeholders looking for information on clinic services.
- Integrated Services Effective January 1, 2015, New York State authorizes the licensure category “Integrated Outpatient Services” for OMH-licensed providers (14 NYCRR Part 598), OASAS-licensed providers (14 NYCRR Part 825), and DOH-licensed providers (10 NYCRR Part 404). The new regulations further the integration of physical and behavioral health services in clinic settings under a single license.
- Vital Access Provider (VAP) Program Funding for Mental Health Clinics (November 20, 2014) – The 2014-15 Budget includes VAP funding to preserve the stability and geographic distribution of mental health clinic services. OMH is seeking initial proposals from clinic providers who have documented fiscal losses that threaten the continued viability of their agency and/or clinic programs. Information on the mini-bid application, VAP background and regulations can be found here.
- Medicaid Claims Readjudication Update (February 28, 2014) – Claims reprocessing for dates of service 10/1/10-12/31/11 was completed on 1/13/14. This update includes information regarding the possible need for adjusting a reprocessed claim and the OMH process of setting the pre-APG rate codes to zero, effective 10/1/10.
- Sample Clinic Encounter Form (June 6, 2013) – This sample form was revised to include the 2013 CPT codes. This form is not required. It was developed for clinics to use if they so choose.
- Medicaid Fee-for-Service (FFS) and Medicaid Managed Care rate sheets have been updated (May 30, 2013)
- Medicaid FFS Rates – These rates have been revised to reflect Medication Treatment and Foster Care Adjustments to the Medicaid Fee-for-Service Legacy/Blend Rate Calculations Effective October 1, 2010.
- Medicaid Managed Care Rates – These charts were revised to include new clinics and any clinics that may have been erroneously omitted from the last chart.
- Medicaid Claims Readjudication Update for All Article 31 Mental Health Clinics (May 23, 2013) (448Kb) – Please read the attached notice in its entirety. It contains extremely important and time sensitive information for Article 31 clinic providers regarding the long-awaited readjudication of Medicaid fee-for-service claims with dates of service 10/1/10-12/31/11. The process will begin with eMedNY cycle #1867.
- OMH is planning to hold a webinar for providers in June to discuss any issues that may arise after the process begins. Information on registration for the webinar will be posted here soon.
- Clinic Projection Tools have been updated (May 28, 2013)
- OMH Clinic Rates Codes
These codes must be used for all services provided on or after January 1, 2012.
- Letter to the Office of Medicaid Inspector General (OMIG) - Co-signed by OMH and New York State Department of Health (DOH) to OMIG
- This letter in part temporarily waives the 90 days claims submission requirement and gives clinics 3 months from the date of federal Medicaid State Plan approval to adjust all claims and make any corrections as appropriate. The letter also requests that OMIG allow a time-limited moratorium on Article 31 clinic audits and disallowances.
- Please note: When submitting claims more than 90 days from date of service during the period the waiver is in effect, clinics must enter reason code 3 (Authorized Delays - Delays previously approved). In addition, you should keep a copy of the attached letter in your files.
Comments or questions about the information on this page can be directed to the Bureau of Financial Planning.