The Office of Mental Health (OMH) has implemented new regulations, rates and services for all OMH licensed mental health clinics. This site is intended to be a quick reference guide for all stakeholders looking for information on clinic services.
- Medicaid Claims Readjudication Update (February 28, 2014) (164Kb) – 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) (164Kb) – 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.