Announcement Expansion of Additional Rural Counties for Children's Waiver Home and Community Based Services (HCBS)

May 1, 2026

TO: Children's HCBS Providers and Medicaid Managed Care Plans (MMCPs) including Mainstream Managed Care and HIV Special Needs Plans

The New York State Department of Health (the Department) investigated stakeholder feedback to add additional rural counties and has since received approval for HCBS Rural Rates expansion.

As previously announced, effective December 1, 2023 HCBS provided in St. Lawrence, Hamilton, Franklin, Essex, Delaware, Clinton, and Alleghany counties are reimbursed at Rural Rates, which are separate from Upstate and Downstate Rates.

Effective July 1, 2026, the list of New York State Counties eligible for Rural Rates has been expanded. In addition to the 7 counties listed above, another 21: Cattaraugus, Cayuga, Chautauqua, Chenango, Columbia, Cortland, Fulton, Genesee, Greene, Lewis, Livingston, Montgomery, Orleans, Otsego, Schoharie, Schuyler, Seneca, Steuben, Sullivan, Wyoming, and Yates are now eligible for Rural Rates as well. Information on these rates can be found in the HCBS Rate Sheet where the additional counties will be added.

MMCPs must configure their systems no later than August 1, 2026 with the updated rates and issue retroactive payment adjustments to providers for Rural Rate claims with dates of service on or after July 1, 2026.

Questions related to HCBS Rural Rates can be directed to BH.Transition@health.ny.gov.