Clinic Reimbursement & Policy Guidance
This site is intended to be a quick reference guide for all stakeholders looking for information on clinic services.
- Clinic IOP Guidance (February 1, 2017) - OMH has issued guidance for the creation of a new intensive level of outpatient service that will increase clinic-based treatment options for people with psychiatric disabilities and help them to avoid inpatient admissions to psychiatric centers. The new Intensive Outpatient Program (IOP) level of service will provide a concentrated treatment option for community-based services across New York State.
- Part 599 Guidance Document has been updated (June 1, 2016) – Revised to update reference from “Physician Add-on” to “Physician Modifier”. Also added clarifying language regarding documentation of the Physician Modifier.
- 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 (March 14, 2016) – 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.