• Appropriateness Criteria Codes - (Web) - (PDF) - Updated September 2024 - Archived February 2025
  • Guide to Edits - Appropriateness Codes and Criteria - (PDF) - Updated September 2024 - Archived February 2025
• Questions and Answers - Fair Hearings - (Web) - (XLSX) - November 2024 - Archived January 2025

Health Homes & Home and Community Based Services (HCBS) Notices and Fair Hearings Policy HH0004 - (Web) - (PDF) - Updated November 2024 - Archived December 2024

• Guide to Edits - Health Homes & Home and Community Based Services (HCBS) Notices and Fair Hearings Policy HH0004 - (PDF) - Updated November 2024 - Archived December 2024

Health Home Plan of Care Policy #HH0008 - (Web) - (PDF) - Updated May 1, 2022 - Archived December 2024

Health Home Notices of Determination and Fair Hearing Policy #HH0004 - (Web) - (PDF) - Updated April 2022 - Archived November 2024

Restriction Exception (R/E) Code Compatibility with the Health Home Program - (Web) - (PDF) - July 2024 ARCHIVED September 2024

Appropriateness Criteria Codes - (Web) - (PDF) - Updated August 2024 - Archived September 2024

• Guide to Edits - Appropriateness Codes and Criteria - (PDF) - Updated August 2024 - Archived September 2024

Guidance for Use of the Continued Eligibility for Services (CES) Tool - (Web) - (PDF) - Updated August 2024 - Archived September 2024

• Guide to Edits for Guidance for Use of the Continued Eligibility for Services (CES) Tool and Continued Eligibility for Services (CES) Tool - (PDF) - Updated August 2024 - Archived September 2024
• DOH - Health Home Continued Eligibility for Services (CES) Tool - (PDF) - Updated August 2024 - Archived September 2024
• DOH - Health Home Continued Eligibility for Services (CES) Tool - (PDF) - Updated September 2024 Archived October 2024

Eligibility Requirements for Health Home Services and Continued Eligibility in the Health Home Program HH0016 - (PDF) - February 2024, Archived August 2024

• Guide to Edits for the Eligibility Requirements for Health Home Services and Continued Eligibility in the Health Home Program HH0016 - (PDF) - February 2024, Archived August 2024

Guidance for Use of the Continued Eligibility for Services (CES) Tool - (Web) - (PDF) - February 2024, Archived August 2024

• Guide to Edits for Guidance for Use of the Continued Eligibility for Services (CES) Tool - (PDF) - February 2024 Archived August 2024
• DOH - Health Home Continued Eligibility for Services (CES) Tool - (PDF) - Updated December 2023 Archived August 2024
• Appropriateness Criteria Codes HHSA & HHSC - (Web) - (PDF) - Updated February 2024, Archived August 2024
• DOH - Health Home Continued Eligibility for Services (CES) Review Tool - (XLSM) - Updated December 2023 Archived August 2024

Restriction Exception (R/E) Code Compatibility with the Health Home Program - (Web) - (PDF) - November 2023 Archived July 2024

Coverage Code Compatibility with the Health Home Program - (Web) - (PDF)

Eligibility Requirements for Health Home Services and Continued Eligibility in the Health Home Program HH0016 - (Web) - (PDF) - October 2023 Archived February 2024

Appropriateness Criteria Codes HHSA & HHSC - (Web) - (PDF) Archived February 2024

Guidance for Use of the Continued Eligibility for Services (CES) Tool - (Web) - (PDF) - October 2023 Archived February 2024

DOH - Health Home Continued Eligibility for Services (CES) Tool - (PDF) - Updated November Archived December 2023

DOH - Health Home Continued Eligibility for Services (CES) Review Tool - (XLSM) - November Archived December 2023

NYS DOH Initial Appropriateness and Continued Eligibility for Services (CES) Tool training slides - (PDF) - Updated November 9, 2023 Archived December 2023

Health Home Initial Appropriateness and Continued Eligibility for Services (CES) Tool: Frequently Asked Questions (FAQ) - (PDF) - November 2023

Restriction Exception (R/E) Code Compatibility with the Health Home Program - (PDF) - July 2023

Appropriateness Criteria Codes HHSA & HHSC - (Protected Excel) Archived November 2023

Health Home Eligibility Policy - (PDF) - Updated March 2022 Archived October 2023

• Eligibility Requirements: Identifying Potential Members for Health Home Services Appropriateness Criteria (HHSA Only) - (PDF) - September 2020 Archived October 2023
• NYS DOH Initial Appropriateness and Continued Eligibility for Services (CES) Tool training slides - (PDF) - November 2023
• NYS DOH Initial Appropriateness and Continued Eligibility for Services (CES) Tool training slides - (PDF) - October 2023
• DOH - Health Home Continued Eligibility for Services (CES) Tool - (PDF) - Sept 2023
• DOH - Health Home Continued Eligibility for Services (CES) Review Tool - (XLSM) - Sept 2023

Comprehensive Assessment Policy #HH0002 - (PDF) - May 2022

Restriction Exception (R/E) Code Compatibility with the Health Home Program - (PDF) - April 1, 2022

Member Disenrollment From the Health Home Program Policy #HH0007 - (PDF) - December 17, 2021

Restriction Exception (R/E) Code Compatibility with the Health Home Program - (PDF) - February 2021

Transfer Process Between Health Homes and Waiver Programs for Care Management Services - (PDF) -

Conflict Free Care Management Policy #HH0012 (HHSC Only) - (PDF) - February 2020

Health Home Plan of Care Policy #HH0008(PDF) - (PDF)

Health Home Monitoring: Reportable Incidents Policies and Procedures #HH0005 - (PDF) - Revised October 2019

Access to/Sharing of Personal Health Information (PHI) and the Use of Health Home Consents #HH0009 - (PDF) - June 2019

Comprehensive Assessment Policy #HH0002 - (PDF) - Updated June 30, 2019

Eligibility Requirements: Identifying Potential Members for Health Home Services - (PDF) - April 2019

Member Disenrollment From the Health Home Program Policy #HH0007(PDF) - (PDF) - March 4, 2019

HHSC Eligibility, Appropriateness, Prioritization and 6 Core Services - (PDF) - February 2019

Eligibility Requirements: Identifying Potential Members for Health Home Services - (PDF) - February 2019

Comprehensive Assessment Policy #HH0002 - (PDF)

Billing and Documentation Standards for Health Home: High, Medium, and Low (HML) Rates with Clinical and Functional Adjustments(PDF) - (PDF)

Eligibility Requirements: Identifying Potential Members for Health Home Services - (PDF) - November 30, 2018

Member Disenrollment From the Health Home Program Policy #HH0007 - (PDF) - November 1, 2018

MAPP Segment End Date Reason Codes Crosswalk - (PDF) - Effective: October 31, 2018

MAPP Segment End Date Reason Codes Guidance Chart - (PDF) - Effective: October 31, 2018

Eligibility Requirements: Identifying Potential Members for Health Home Services - (PDF) - August 31, 2018

Continuity of Care and Re-engagement for Enrolled Health Home Members #HH0006 - (PDF) - Updated August 22, 2018

Background Check Requirements for Health Homes and Care Managers #HH0010 - (PDF) - April, 1, 2018 (PDF)

CHRC Extension Announcement - (PDF) - April 2019

Background Check Guidance for HCBS Providers - (PDF) - November 2018

Health Home Notices of Determination and Fair Hearing Policy #HH0004 - (PDF) - November 2017

Continuity of Care and Re-engagement for Enrolled Health Home Members #HH0006 - (PDF) and FAQs - (PDF) - Both updated November 15, 2017

Continuity of Care and Re-engagement for Enrolled Health Home Members #HH0006 - (PDF) - Updated October 25, 2017, and FAQs - (PDF)

Continuity of Care and Re-engagement for Enrolled Health Home Members #HH0006 - (PDF) - October 1, 2017

Adult Behavioral Health and Community Based Services (BH HCBS) - (PDF) - October 1, 2017

Health Home Monitoring: Reportable Incidents Policies and Procedures #HH0005 - (PDF) - July 2017

Health Home Monitoring: Reportable Incidents Policies and Procedures and Reporting Timeframes #HH0001 - (PDF) - Superseded by policy #HH0005

Reportable Incident Reporting Guidance for Health Homes - (PDF)

Eligibility Requirements: Identifying Potential Members for Health Home Services - (PDF) - March 3, 2017

Monitoring Surveys - (PDF)

Eligibility Requirements: Identifying Potential Members for Health Home Services - (PDF) - April 23, 2014