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Office of Mental Health

Medicaid Managed Care (MMC)
APG "Government" Rates

NYS statute mandates that Medicaid Managed Care (MMC) mental health clinic reimbursement “shall be in the form of fees…which are equivalent to the payments established for such services under the ambulatory patient group (APG) rate-setting methodology”. The fees are referred to as “government rates.” This mandate became effective September, 2012.

Medicaid Managed Care Government APG Rates (May 17, 2016)

OMH Required Services Chart PDF Document - this chart lists all the Medicaid Managed Care Organization (MCO) reimbursable services for both OMH-licensed clinics and non-OMH hospital-based outpatient departments and diagnostic and treatment centers (May 17, 2016)

OMH Clinic Staffing List PDF Document – List of staff that must be reimbursed by MCOs when services are provided in an OMH-licensed clinic (October 10, 2012)

Foreign Licensure Standards Leaving OMH site – New York State Education Department Regulations of the Commissioner, Part 60: Medicine, Physician Assistant, Specialist Assistant and Acupuncture, Section 60.5 (July 23, 2012)

Comments or questions about the information on this page can be directed to the Bureau of Financial Planning.