The current Health Homes Provider Manual - Policy and Billing can be accessed at the following link. This manual will remain "in effect" until otherwise noted.

• Health Home Provider Manual - Policy and Billing (version 2019-2) (PDF)

Archived Manuals

• Health Home Provider Manual - Policy and Billing (version 2019-1) - (PDF)
• Health Home Provider Manual - Billing Policy and Guidance (version 2014-01) - (PDF)

This section contains ALL Health Home policies and guidance documents.

• Health Home Policy and Updates

The Health Home Standards and Requirements explains and clarifies the roles and responsibilities of Lead Health Homes, downstream Care Management providers, and Managed Care Organizations (MCOs) for the provision of Health Home services.

Click here for the Standards and Requirements for Health Homes, Care Management Providers and Managed Care Organizations - Updated May 2022 (PDF)

This document contains the following sections:

1. State Plan Standards and Requirements for Health Homes
2. Additional Health Home Standards and Requirements
3. Additional Health Home Standards and Requirements for Assisted Outpatient Treatment (AOT) enrollees
4. Additional Health Home Standards and Requirements Related to the Provision of Home and Community Based Services to HARP Enrollees and HARP-eligible HIV SNP Enrollees.
5. Additional Health Home Standards and Requirements for Health Homes Serving Adult Home Class Members Pursuant to a Stipulated Order and Settlement
6. Additional Health Home Standards and Requirements for Health Homes Serving Children
7. Standards and Requirements for MCOs Related to the Provision of Health Home Care Management Services

Medicaid Health Homes State Plan Amendments: The Health Home Program´s State plan amendments are official documents that describe the nature and scope of a state´s Medicaid program that has been approved by the Federal Department of Health & Human Services (DHHS).

In order to assist Health Homes in achieving the goals of increased quality of care as well as reduction in the cost of treatment, the New York State Office of Health Insurance Programs, Medicaid, partnered with the New York State Office of Quality and Patient Safety (OQPS) in an effort to leverage HIT. HIT can provide the tools for providers to better coordinate care for Medicaid patients at highest risk for severe medical outcomes. Visit the Health Information Technology Standards page.

To access the following and other versions of Department of Health Medicaid Update newsletters, please visit the DOH Medicaid Update main page

Regular Editions

December 2023

• Expanded Eligibility for Community Health Worker Services, pages 10-12 (PDF)

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September 2023

• Community Health Worker Services for Pregnant and Postpartum People, pages 9-10 (PDF)

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December 2022

• Reminder: Health Home Consent Forms, pages 4-5 (PDF)

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May 2022

• Sickle Cell Disease Now a Single Qualifying Condition for the Medicaid Health Home Program, page 3 (PDF)

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August 2018

• Health Home Restriction/Exception Codes, page 5 (PDF)

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December 2012

• Health Home Consent Process, page 4 (PDF)

Special Editions

November 2012

• Health Home Implementation Update (PDF)

April 2012

• Introducing Health Homes - Improving Care for Medicaid Recipients with Chronic Conditions (PDF)

Health Home Standards and Requirements for Health Homes, Care Management Agencies, and Managed Care Organizations:

• May 2022
• May 2022
• November 2017