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 2022 (Rate changes highlighted in yellow)
Rate Code Rate Code Description Rates Apply to Rates Effective July 1, 2020 Rates Effective April 1, 2022***
Upstate * Downstate* Upstate * Downstate*
1853 Health Home Plus/Care Management Health Homes Serving Adults $750.00 $800.00 $790.50 $843.20
1860 Health Home Services - Adult Home Transition ** HHs Serving Adult Home Class Members N/A $800.00 N/A $800.00
1861 Adult Home Assessment and Management Fee ** HHs Serving Adult Home Class Members N/A $200.00 N/A $200.00
1864 Health Home Services - Children (Low) Health Homes Serving Children $225.00 $240.00 $227.25 $242.40
1865 Health Home Services - Children (Med) Health Homes Serving Children $450.00 $479.00 $454.50 $483.79
1866 Health Home Services - Children (High) Health Homes Serving Children $750.00 $799.00 $757.50 $806.99
1868 Health Home-CANS Assessment (Children) Health Homes Serving Children $185.00 $185.00 $186.85 $186.85
1869 Health Home Services - Children (Low) (Inc FFP) Health Homes Serving Children $225.00 $240.00 $227.25 $242.40
1870 Health Home Services - Children (Med) (Inc FFP) Health Homes Serving Children $450.00 $479.00 $454.50 $483.79
1871 Health Home Services - Children (High) (Inc FFP) Health Homes Serving Children $750.00 $799.00 $757.50 $806.99
1873 Health Home Care Management Health Homes Serving Adults $200.00 $213.00 $202.00 $215.13
1874 Health Home High Risk/Need Care Management Health Homes Serving Adults $360.00 $383.00 $363.60 $386.83

Notes:
* Downstate includes NYC, Dutchess, Nassau, Orange, Putnam, Rockland, Suffolk and Westchester Counties. Upstate includes all other counties.
** Rates only apply to impacted Adult Home class members.
***Updated May 2022