Current Health Home Rate Codes

  • Rate Codes are also available in Portable Document Format (PDF)

Health Home Rate Codes in Effect for Health Home Services on/after April 2023

Updated April 2023

Health Home Rate Codes in Effect for Health Home Services on/after April 1, 2023 (Rate changes highlighted in yellow)
Rate Code Rate Description Rates Apply to Rates Effective April 1, 2022 Rates Effective April 1, 2023***
Upstate * Downstate* Upstate * Downstate*
1853 Health Home Plus/Care Management Health Homes Serving Adults $790.50 $843.20 $822.12 $876.93
1860 Health Home Services - Adult Home Transition ** HHs Serving Adult Home Class Members   $800.00
1861 Adult Home Assessment and Management Fee ** HHs Serving Adult Home Class Members $200.00
1864 Health Home Services - Children (Low) Health Homes Serving Children $227.25 $242.40 $227.25 $242.40
1865 Health Home Services - Children (Med) Health Homes Serving Children $454.50 $483.79 $454.50 $483.79
1866 Health Home Services - Children (High) Health Homes Serving Children $757.50 $806.99 $757.50 $806.99
1868 Health Home-CANS Assessment (Children) Health Homes Serving Children $186.85 $186.85 $186.85 $186.85
1869 Health Home Services - Children (Low) (Inc FFP) Health Homes Serving Children $227.25 $242.40 $227.25 $242.40
1870 Health Home Services - Children (Med) (Inc FFP) Health Homes Serving Children $454.50 $483.79 $454.50 $483.79
1871 Health Home Services - Children (High) (Inc FFP) Health Homes Serving Children $757.50 $806.99 $757.50 $806.99
1873 Health Home Care Management Health Homes Serving Adults $202.00 $215.13 $202.00 $215.13
1874 Health Home High Risk/Need Care Management Health Homes Serving Adults $363.60 $386.83 $363.60 $386.83
Notes:
* Downstate includes NYC, Dutchess, Nassau, Orange, Putnam, Rockland, Suffolk and Westchester Counties. Upstate includes all other counties.
** Rates only apply to impacted Adult Home class members.
***Rates Effective April 1, 2023.
The HARP BH HCBS Services Matrix and Fee Schedule can be found on the Office of Mental Health (OMH)'s Billing Behavioral Health (BH) Medicaid Services Under Managed Care, under: BH Rate Updates and Requirements (see: Medicaid Reimbursement Rates - Approved Medicaid fee-for-service rates for all OMH programs) at: https://omh.ny.gov/omhweb/bho/billing-services.html