Current Health Home Rate Codes
ARCHIVED May 2024
- Rate Codes are also available in Portable Document Format (PDF)
| Health Home Rate Codes in Effect for Health Home Services on/after January 1, 2024 **** pending CMS approval (Rate changes highlighted in yellow) | ||||||||||
|---|---|---|---|---|---|---|---|---|---|---|
| Rate Code |
Rate Description | Rates Apply to | Rates Effective April 1, 2022 | Rates Effective October 1, 2022 | Rates Effective April 1, 2024*** | Rates Effective January 1, 2024**** | ||||
| Upstate * | Downstate* | Upstate * | Downstate* | Upstate * | Downstate* | Upstate * | Downstate* | |||
| 1853 | Health Home Plus/Care Management | Health Homes Serving Adults | $790.50 | $843.20 | $790.50 | $843.20 | $822.12 | $876.93 | $822.12 | $876.93 |
| 1860 | Health Home Services - Adult Home Transition ** | HHs Serving Adult Home Class Members | $800.00 | $800.00 | ||||||
| 1861 | Adult Home Assessment and Management Fee ** | HHs Serving Adult Home Class Members | $200.00 | $200.00 | ||||||
| 1864 | Health Home Services - Children (Low) | Health Homes Serving Children | $227.25 | $242.40 | $227.25 | $242.40 | $227.25 | $242.40 | $243.00 | $276.00 |
| 1865 | Health Home Services - Children (Medium) | Health Homes Serving Children | $454.50 | $483.79 | $454.50 | $483.79 | $454.50 | $483.79 | $485.00 | $553.00 |
| 1866 | Health Home Services - Children (High) | Health Homes Serving Children | $757.50 | $806.99 | $757.50 | $806.99 | $757.50 | $806.99 | $809.00 | $921.00 |
| 1867 | High Fidelity Wrap (HFW) | Health Homes Serving Children | $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 | $227.25 | $242.40 | $243.00 | $276.00 |
| 1870 | Health Home Services - Children (Medium) (Inc FFP) | Health Homes Serving Children | $454.50 | $483.79 | $454.50 | $483.79 | $454.50 | $483.79 | $485.00 | $553.00 |
| 1871 | Health Home Services - Children (High) (Inc FFP) | Health Homes Serving Children | $757.50 | $806.99 | $757.50 | $806.99 | $757.50 | $806.99 | $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 | ||
| 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. ***Rates Effective April 1, 2024 ****Rates Effective January 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) |
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