Clinic Reimbursement & Policy Guidance
This site is intended to be a quick reference guide for all stakeholders looking for information on clinic services.
- Part 599 Guidance Document has been updated (June 17, 2015) – Revised to reflect rule changes to Complex Care Management (CPT 90882), the definition of a 45 min. psychotherapy service (CPT 90834), allowance for a 20-minute visit and the creation of utilization threshold exemption rate codes for court-mandated services.
- Clinic rate sheets have been updated (June 11, 2015) – Revised to reflect the increase to the APG peer group base rates effective January 1, 2015.
- CPT procedure rate and weight schedule (October 22, 2015) – Revised to reflect the 2% COLA increase.
- 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.
Comments or questions about the information on this page can be directed to the Bureau of Financial Planning.