Consumer Directed Personal Assistance Program (CDPAP) Rates

2026 Statewide Fiscal Intermediary Rates
2025 Statewide Fiscal Intermediary Rates
Statewide Fiscal Intermediary Billing Update

This change applies to Fiscal Intermediaries (FI) performing administrative services under the Consumer Directed Personal Assistance Program (CDPAP). The State Fiscal Year 2024-25 Enacted Budget authorized the Commissioner of Health to contract with a single Statewide Fiscal Intermediary (SFI) to provide fiscal intermediary services to CDPAP consumers.

Public Partnerships LLC. (PPL) was selected as the SFI vendor and effective April 1, 2025, is the only entity authorized to provide fiscal intermediary services for CDPAP.

PPL will bill the Department a single negotiated Per Member Per Month (PMPM) rate for reimbursement of the administrative component for CDPAPs established during the procurement process.

Between now and March 28th, 2025, CDPAP members will transition from their current FI to PPL. During the transitional period, for services incurred prior to April 1, 2025, FIs may continue to bill an administrative fee for members from whom they are providing fiscal intermediary services. FIs should ensure they are following Medicaid claims timely filing rules to ensure they are able to be reimbursed for administrative services for when the member was under their responsibility.

Q1: The Service Descriptions included on the posted Consumer Directed Personal Assistance Program Rates include a reference to "Hard-to-Serve". What does this mean?

A: The "Hard-to-Serve" designation is synonymous with the Enhanced description commonly used by Health Plans.

Q2: The posted rates do not include any service descriptions that include two clients or mutual descriptions. Are these services still available?

A: Yes, the two client/mutual services still exist. The two client and/or mutual services are paid at 50% of the applicable posted rate.

Q3: The Service Descriptions and Rates do not align with the Procedure Code and Modifier combinations that are used by Health Plans. How do we know which align to each of the possible combinations?

A: The table below includes a crosswalk of the Procedure Code and Modifiers that align with the Service Descriptions on the posted CDPAP rates.

Service Description Region Procedure Code/Modifier Description
CDPAS: Basic New York City T1019 U6 1 Client – Basic
T1019 U7 2 Client – Basic*
CDPAS: Hard to Serve New York City T1019 U8 1 Client – Enhanced
T1019 U9 2 Client – Enhanced*
CDPAS: Live-In New York City T1020 U6 1 Client Live-In
T1020 U7 2 Client Live-In*
CDPAS: Basic Nassau, Suffolk, Westchester T1019 U6 1 Client – Basic
T1019 U7 2 Client – Basic*
CDPAS: Hard to Serve Nassau, Suffolk, Westchester T1019 U8 1 Client Enhanced
T1019 U9 2 Client Enhanced*
CDPAS: Live-In Nassau, Suffolk, Westchester T1020 U6 1 Client Live-In
T1020 U7 2 Client Live-In*
CDPAS: Basic Rest of State T1019 U6 1 Client – Basic
T1019 U7 2 Client – Basic*
CDPAS: Hard to Serve Rest of State T1019 U8 1 Client Enhanced
T1019 U9 2 Client Enhanced*
CDPAS: Live-In Rest of State T1020 U6 1 Client Live-In
T1020 U7 2 Client Live-In*

*2-client services are reimbursed at 50% of the posted rate