Health Home TCM Legacy Rates

Legacy Rate Extension

Please be advised that the DOH is seeking Centers for Medicare and Medicaid Services (CMS) approval under the State Plan Amendment to extend the legacy Health Home rates for the former OMH and COBRA Targeted Case Management (TCM) agencies as well as the OASAS Managed Addiction Treatment Services (MATS Agencies). The requested approval is for the allowance of legacy providers to bill directly using legacy rates for dates of service up to and including November 30, 2016.


Rate Code Rate Code Description Phase 1 Phase 2 Phase 3
1851 HEALTH HOME/OMH-TCM Effective January 1, 2012 until November 30, 2016 Effective April 1, 2012 until November 30, 2016 Effective July 1, 2012 until November 30, 2016
1852 HEALTH HOME OUTREACH/OMH-TCM
1880 HEALTH HOME/AIDS/HIV CASE MANAGEMENT
1881 HEALTH HOME OUTREACH/AIDS/HIV CASE MANAGEMENT

Rates for the Chronic Illness Demonstration Program (CIDP) were not extended and were in effect for one year as follows:

Rate Code Rate Code Description All Phases
1885 HEALTH HOME/CIDP CASE MANAGEMENT April 1, 2012 –March 31, 2013

OASAS Managed Addiction Treatment Services (MATS) programs will extended as shown below.

Rate Code Rate Code Description Phase 1 Phase 2 Phase 3
1882 HEALTH HOME/MATS Effective August 1, 2012 until November 30, 2016 Effective date of SPA approval until November 30, 2016 Not Applicable