Current Health Home Rate Codes
- Rate Codes are also available in Portable Document Format (PDF)
| Health Home Rate Codes in Effect for Health Home Services | ||||||||||
|---|---|---|---|---|---|---|---|---|---|---|
| On/after April 1, 2024 (5) pending CMS approval (Rate changes are highlighted in blue) | ||||||||||
| Rate Code |
Rate Description | Rates Apply to | Rates Effective October 1, 2022 | Rates Effective April 1, 2023 (3) | Rates Effective January 1, 2024 (4) | Rates Effective April 1, 2024 (5) | ||||
| Upstate (1) | Downstate(1) | Upstate (1) | Downstate(1) | Upstate (1) | Downstate(1) | Upstate (1) | Downstate(1) | |||
| 1853 | Health Home Plus/Care Management | Health Homes Serving Adults | $790.50 | $843.20 | $822.12 | $876.93 | $822.12 | $876.93 | $845.47 | $901.83 |
| Rate Code to be assigned | Health Home Plus/AOT | Health Homes Serving Adults | $1,020.12 | $1,086.93 | ||||||
| 1860 | Health Home Services - Adult Home Transition (2) | HHs Serving Adult Home Class Members | $800.00 | $800 | $800 | |||||
| 1861 | Adult Home Assessment and Management Fee (2) | HHs Serving Adult Home Class Members | $200 | $200 | $200 | |||||
| 1864 | Health Home Services - Children (Low) | Health Homes Serving Children | $227.25 | $242.40 | $227.25 | $242.40 | $243.00 | $276.00 | $243.00 | $276.00 |
| 1865 | Health Home Services - Children (Medium) | Health Homes Serving Children | $454.50 | $483.79 | $454.50 | $483.79 | $485.00 | $553.00 | $485.00 | $553.00 |
| 1866 | Health Home Services - Children (High) | Health Homes Serving Children | $757.50 | $806.99 | $757.50 | $806.99 | $809.00 | $921.00 | $809.00 | $921.00 |
| 1867 | High Fidelity Wrap (HFW) | Health Homes Serving Children | $1,228.00 | $1,399.00 | $1,228.00 | $1,399.00 | ||||
| 1868 | Health Home-CANS Assessment (Children) | Health Homes Serving Children | $186.85 | $186.85 | $186.85 | $186.85 | $186.85 | $186.85 | $186.85 | $186.85 |
| 1869 | Health Home Services - Children (Low) (Inc FFP) | Health Homes Serving Children | $227.25 | $242.40 | $227.25 | $242.40 | $243.00 | $276.00 | $243.00 | $276.00 |
| 1870 | Health Home Services - Children (Medium) (Inc FFP) | Health Homes Serving Children | $454.50 | $483.79 | $454.50 | $483.79 | $485.00 | $553.00 | $485.00 | $553.00 |
| 1871 | Health Home Services - Children (High) (Inc FFP) | Health Homes Serving Children | $757.50 | $806.99 | $757.50 | $806.99 | $809.00 | $921.00 | $809.00 | $921.00 |
| 1873 | Health Home Care Management | Health Homes Serving Adults | $202.00 | $215.13 | $202.00 | $215.13 | $202.00 | $215.13 | $202.00 | $215.13 |
| 1874 | Health Home High Risk/Need Care Management | Health Homes Serving Adults | $363.60 | $386.83 | $363.60 | $386.83 | $363.60 | $386.83 | $363.60 | $386.83 |
| 1875 | Home and Community Based Services Assessment Fee | Health Homes Serving Children | $200.00 | $200.00 | $200.00 | $200.00 | $200.00 | $200.00 | $200.00 | $200.00 |
| Notes: | ||||||||||
| (1) Downstate includes NYC, Dutchess, Nassau, Orange, Putnam, Rockland, Suffolk and Westchester Counties. Upstate includes all other counties | ||||||||||
| (2) Rates only apply to impacted Adult Home class members | ||||||||||
| (3) Rates Effective April 1, 2023 | ||||||||||
| (4) Rates Effective January 1, 2024 | ||||||||||
| (5) Rates Effective April 1, 2024 -pending CMS approval | ||||||||||
| The HARP BH HCBS Services Matrix and Fee Schedule can be found on the Office of Mental Health (OMH)'s Billing Behavioral Health (BH) Medicaid Services Under Managed Care, under: BH Rate Updates and Requirements (see: Medicaid Reimbursement Rates - Approved Medicaid fee-for-service rates for all OMH programs) | ||||||||||
Corrected: August 2024
