New York State Children's Medicaid System Transformation

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Childrens Home and Community Based Services Rate Summary effective 4/1/2021

  4/1/2021-9/30/2022 12/1/2021-9/30/2022 10/1/2022-Ongoing
Rate Code Description Billing Unit Upstate Downstate Upstate Downstate Upstate Downstate
7933 DAY HABILITATION 15 mininute $29.25 $32.80 $29.25 $32.80 $23.40 $26.24
7934 DAY HABILITATION GROUP OF 2 15 mininute $19.01 $21.33 $19.01 $21.33 $15.21 $17.06
7935 DAY HABILITATION GROUP OF 3 15 mininute $14.14 $15.85 $14.14 $15.85 $11.31 $12.68
8003 CAREGIVER/FAMILY SUPPORTS AND SERVICES 15 mininute $30.28 $33.95 $30.28 $33.95 $24.22 $27.16
8004 CAREGIVER FAMILY SUPPORTS AND SERVICES GROUP OF 2 15 mininute $19.68 $22.06 $19.68 $22.06 $15.74 $17.65
8005 CAREGIVER FAMILY SUPPORTS AND SERVICES GROUP OF 3 15 mininute $14.63 $16.41 $14.63 $16.41 $11.70 $13.13
8006 PREVOCATIONAL SERVICES 15 mininute $22.43 $25.15 $22.43 $25.15 $17.94 $20.12
8007 PRE-VOCATIONAL GROUP OF 2 15 mininute $14.58 $16.35 $14.58 $16.35 $11.66 $13.08
8008 PRE-VOCATIONAL GROUP OF 3 15 mininute $10.84 $12.16 $10.84 $12.16 $8.67 $9.73
8009 COMMUNITY ADVOCACY AND SUPPORT INDIV 15 mininute $42.00 $47.10 $42.00 $47.10 $33.60 $37.68
8010 COMMUNITY ADVOCACY AND SUPPORT GROUP OF 2 15 mininute $27.30 $30.61 $27.30 $30.61 $21.84 $24.49
8011 COMMUNITY ADVOCACY AND SUPPORT GROUP OF 3 15 mininute $20.30 $22.76 $20.30 $22.76 $16.24 $18.21
8012 COMMUNITY HCBS HAB 15 mininute $13.00 $13.04 $13.00 $13.04 $10.40 $10.43
8013 COMMUNITY HCBS HAB GROUP OF 2 15 mininute $8.13 $8.14 $8.13 $8.14 $6.50 $6.51
8014 COMMUNITY HCBS HAB GROUP OF 3 15 mininute $6.15 $6.50 $6.15 $6.50 $4.92 $5.20
8015 SUPPORTED EMPLOYMENT 15 mininute $26.59 $29.81 $26.59 $29.81 $21.27 $23.85
8016 PALLIATIVE CARE - PAIN AND SYMPTOM MANAGEMENT 15 mininute $104.34 $117.01 $104.34 $117.01 $83.47 $93.61
8017 PALLIATIVE CARE - BEREAVEMENT SERVICES 30 mininute $83.80 $93.99 $83.80 $93.99 $67.04 $75.19
8018 PALLIATIVE CARE - MASSAGE THERAPY 15 mininute $49.50 $55.51 $49.50 $55.51 $39.60 $44.41
8019 PALLIATIVE CARE - EXPRESSIVE THERAPY 15 mininute $34.33 $38.50 $34.33 $38.50 $27.46 $30.80
7952 BEREAVEMENT ASSESSMENT/COUNSELING episodic - - $2,718.76 $3,049.26 $2,175.01 $2,439.41
7946 BEREAVEMENT HH U LOW (Bereavement End of Life Low - Upstate) episodic - - $281.25   $225.00  
7949 BEREAVEMENT HH D LOW (Bereavement End of Life Low - Downstate) episodic - -   $300.00   $240.00
7947 BEREAVEMENT HH U MED (Bereavement End of Life Medium - Upstate) episodic - - $562.50   $450.00  
7950 BEREAVEMENT HH D MED (Bereavement End of Life Medium - Downstate) episodic - -   $598.75   $479.00
7948 BEREAVEMENT HH U HIGH (Bereavement End of Life High - Upstate) episodic - - $937.50   $750.00  
7951 BEREAVEMENT HH D HIGH (Bereavement End of Life High - Downstate) episodic - -   $998.75   $799.00
8023 PLANNED RESPITE - INDIVIDUAL (UP TO 6 HOURS) 15 mininute $15.35 $17.21 $15.35 $17.21 $12.28 $13.77
8024 PLANNED RESPITE - INDIVIDUAL (6-12 HOURS) per diem $366.51 $411.08 $366.51 $411.08 $293.21 $328.86
8025 PLANNED RESPITE - INDIVIDUAL (12-24 HOURS) per diem $628.30 $704.69 $628.30 $704.69 $502.64 $563.75
8027 PLANNED RESPITE - GROUP (UP TO 6 HOURS) 15 mininute $7.43 $8.33 $7.43 $8.33 $5.94 $6.66
8026 PLANNED RESPITE - GROUP (6-12 HOURS) per diem $177.15 $198.69 $177.15 $198.69 $141.72 $158.95
8028 CRISIS RESPITE (UP TO 6 HOURS) 15 mininute $17.83 $19.99 $17.83 $19.99 $14.26 $15.99
8029 CRISIS RESPITE (6-12 HOURS) per diem $425.53 $477.26 $425.53 $477.26 $340.42 $381.81
8030 CRISIS RESPITE (12-24 HOURS) per diem $729.43 $818.06 $729.43 $818.06 $583.54 $654.45
8032 ENVIR MODS - $1.00 UNIT per unit $1.00 $1.00 $1.00 $1.00 $1.00 $1.00
8034 ENVIR MODS - $10.00 UNIT per unit $10.00 $10.00 $10.00 $10.00 $10.00 $10.00
8035 ENVIR MODS - $100.00 UNIT per unit $100.00 $100.00 $100.00 $100.00 $100.00 $100.00
8036 ENVIR MODS - $1000.00 UNIT per unit $1,000.00 $1,000.00 $1,000.00 $1,000.00 $1,000.00 $1,000.00
8037 ADAPTIVE AND ASSISTIVE EQUIPMENT - $1.00 UNIT per unit $1.00 $1.00 $1.00 $1.00 $1.00 $1.00
8038 ADAPTIVE AND ASSISTIVE EQUIPMENT - $10.00 UNIT per unit $10.00 $10.00 $10.00 $10.00 $10.00 $10.00
8039 ADAPTIVE AND ASSISTIVE EQUIPMENT - $100.00 UNIT per unit $100.00 $100.00 $100.00 $100.00 $100.00 $100.00
8040 ADAPTIVE AND ASSISTIVE EQUIPMENT - $1000.00 UNIT per unit $1,000.00 $1,000.00 $1,000.00 $1,000.00 $1,000.00 $1,000.00
8041 VEHICLE MODIFICATIONS - $1.00 UNIT per unit $1.00 $1.00 $1.00 $1.00 $1.00 $1.00
8042 VEHICLE MODIFICATIONS - $10.00 UNIT per unit $10.00 $10.00 $10.00 $10.00 $10.00 $10.00
8043 VEHICLE MODIFICATIONS - $100.00 UNIT per unit $100.00 $100.00 $100.00 $100.00 $100.00 $100.00
8044 VEHICLE MODIFICATIONS - $1000.00 UNIT per unit $1,000.00 $1,000.00 $1,000.00 $1,000.00 $1,000.00 $1,000.00