Health Homes Serving Adults and Children

• Medicaid Managed Care Plan Claim Denials for Health Home Services – October 2019 (PDF)
• Medicaid Managed Care Plan Billing and Payment Protocol for Health Home Services – Effective: July 1, 2018, Revised: March 2019 (PDF)
• Billing and Documentation Guidance for Health Home Adult Rates with Clinical and Functional Adjustments – Effective: May 1, 2018, Revised: March 2019 (PDF)
• Current Health Home Rate Codes – Effective on/after October 2018 (PDF)
• Coverage Code Compatibility with the Health Home Program – Updated January 2020 (PDF)
• Restriction Exception (R/E) Code Compatibility with the Health Home Program (PDF) – Updated January 2020 (PDF)
• Temporary Health Home Billing Procedures effective December 1, 2016 (PDF)
• Outreach Reprogramming Guidance (PDF)

Health Home Serving Adults

• Health Home Plus (HH+) Rates and Guidance (PDF)

Health Home Serving Children

• HHSC – Message to HH Community RE HH Payments and HHSC – July 19, 2016 FINAL (PDF)
• Health Home HML Rate For Children (PDF)

• CSC – Information on Denied Health Home Claims (PDF)
• eMedNY – New York State Medicaid: Medicaid Eligibility Verification System (MEVS) Methods (PDF)

• Health Home Rate Codes in Effect on/after October 2017 (PDF)
• Health Home Rate Codes in Effect on/after December 2016 (PDF)
• Health Home HML Rate For Adults- December 2016 (PDF)
• Updated Billing Guidance - November 2016 (PDF)
• Restriction Exception (R/E) Code Compatibility with the Health Home Program- May 9, 2017 (PDF)
• Phase 1 and Phase 2 Health Home Serving Children- October 27, 2015 (PDF)
• Behavioral Health Transition – April 2015 (PDF)
• Health Home Base Rates (PDF)
• TCM legacy Rate Extension
• Billing Guidance for the Administration of the NYS Eligibility Assessment for Behavioral Health Home and Community Based Services (BH HCBS) and the NYS Community Mental Health Assessment (PDF)