Changes Regarding Children's CFTSS Rates and Health Homes Serving Children (HHSC) Rate Correction

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TO: Children and Family Treatment and Support Services (CFTSS) Providers, Children´s Health Homes and, Mainstream Medicaid Managed Care Plans (MMCP) and HIV Special Needs Plans (HIV SNP)

RE: Changes Regarding Children´s CFTSS Rates and Health Homes Serving Children (HHSC) Rate Correction

Date: December 1, 2020

In accordance with the FY21 Enacted Budget, the enclosed rate amendments for Children and Family Treatment and Support Services (CFTSS) have been approved by New York State. These rate changes implement an MRT II initiative extending transitional rates for CFTSS for two years. Providers will be able to claim the adjusted rate for the indicated periods for services delivered to children enrolled in Medicaid Fee- for-Service and Medicaid Managed Care.

Effective April 1, 2020, rates for the following services are adjusted by 11% through March 31, 2022:

  • Community Psychiatric Support and Treatment (CPST)
  • Other Licensed Practitioner (OLP)
  • Psychosocial Rehabilitation (PSR)

Additionally, the following services will now be paid at the 11% adjusted rate effective July 1, 2020 through March 31, 2022:

  • Youth Peer Support
  • Crisis Intervention

FPSS rates were adjusted to reflect 11% increase on January 1, 2020 as part of the original adjustment schedule; this 11% adjustment will now extend through March 31, 2022.

Medicaid Managed Care Plans are mandated to pay State rates for these services. By February 1, 2021, MMCPs and HIV SNPs should complete any changes to plan claims systems, and adjustments to paid claims as necessary, to pay correct rates for dates of service on or after April 1, 2020 through March 31, 2022 for OLP, PSR, CPST; pay correct rates for dates of service on or after July 1, 2020 through March 31, 2022 for YPS and CI; and pay correct rates for dates of service January 1, 2020 through March 31, 2022 for FPSS. Encounter reports should also be adjusted, as appropriate.

Dates of Service for which the CFTSS Rates Adjustment and Base Rates Apply
Service 25% rate adjustment 11% rate adjustment Base rate Link to Rates
Other Licensed Practitioner (OLP) Community Psychiatric Supports and Treatment (CPST) Psychosocial Rehabilitation (PSR) 1/1/19 – 6/30/19 7/1/19 – 12/31/19 and 4/1/20 – 3/31/22 1/1/20 – 3/31/20 and 4/1/22 and beyond OLP, CPST, PSR Link
Family Peer Support Services (FPSS) 7/1/19 – 12/31/19 1/1/20 – 3/31/22 4/1/22 and beyond FPSS Link
Youth Peer Support (YPS) Crisis Intervention (CI) 1/1/20 – 6/30/20 7/1/20 – 3/31/22 4/1/22 and beyond YPS Link
CI Link

HHSC Rates – Correction to August notice

The August 2020 notification to providers regarding HHSC FFS payments incorrectly indicated that HHSC rates were subject to the Across the Board (ATB) Medicaid Payment Reductions of 1% effective for dates of service between January 1, 2020 through March 31, 2020 and a 1.5% reduction effective for an April 1, 2020 date of service.

Effective January 1, 2020 HHSC FFS payments are exempt from the ATB Medicaid Payment Reductions. In October, providers with previously paid claims to which the payment reductions had been applied, began receiving FFS payment adjustments to reflect this correction.

Additional information regarding the ATB Medicaid Payment Reductions is available on the DOH website

As a reminder, Medicaid Managed Care Plans are mandated to pay State rates for HHSC services and should refer to the May 27, 2020 notice Reminder: State Mandated Provider Rates vs MMC ATB from NYSDOH.

Questions should be submitted to BH.Transition@health.ny.gov.