New York State Children's Medicaid System Transformation

Childrens Home and Community Based Services Rate Summary effective 4/1/2019-9/9/2020

Rate Code Description Billing Unit Upstate Rate Downstate Rate
7933 DAY HABILITATION 15 minute $ 23.40 $ 26.24
7934 DAY HABILITATION GROUP OF 2 15 minute $ 15.21 $ 17.06
7935 DAY HABILITATION GROUP OF 3 15 minute $ 11.31 $ 12.68
8003 CAREGIVER/FAMILY SUPPORTS AND SERVICES 15 minute $ 24.22 $ 27.16
8004 CAREGIVER FAMILY SUPPORTS AND SERVICES GROUP OF 2 15 minute $ 15.74 $ 17.65
8005 CAREGIVER FAMILY SUPPORTS AND SERVICES GROUP OF 3 15 minute $ 11.70 $ 13.13
8006 PREVOCATIONAL SERVICES 15 minute $ 17.94 $ 20.12
8007 PRE-VOCATIONAL GROUP OF 2 15 minute $ 11.66 $ 13.08
8008 PRE-VOCATIONAL GROUP OF 3 15 minute $ 8.67 $ 9.73
8009 COMMUNITY ADVOCACY AND SUPPORT INDIV 15 minute $ 33.60 $ 37.68
8010 COMMUNITY ADVOCACY AND SUPPORT GROUP OF 2 15 minute $ 21.84 $ 24.49
8011 COMMUNITY ADVOCACY AND SUPPORT GROUP OF 3 15 minute $ 16.24 $ 18.21
8012 COMMUNITY HCBS HAB 15 minute $ 10.40 $ 10.43
8013 COMMUNITY HCBS HAB GROUP OF 2 15 minute $ 6.50 $ 6.51
8014 COMMUNITY HCBS HAB GROUP OF 3 15 minute $ 4.92 $ 5.20
8015 SUPPORTED EMPLOYMENT 15 minute $ 21.27 $ 23.85
8016 PALLIATIVE CARE - PAIN AND SYMPTOM MANAGEMENT 15 minute $ 47.49 $ 53.26
8017 PALLIATIVE CARE - BEREAVEMENT SERVICES 15 minute $ 38.14 $ 42.78
8018 PALLIATIVE CARE - MASSAGE THERAPY 15 minute $ 22.53 $ 25.27
8019 PALLIATIVE CARE - EXPRESSIVE THERAPY 15 minute $ 15.62 $ 17.52
8023 PLANNED RESPITE - INDIVIDUAL (UP TO 6 HOURS) 15 minute $ 12.28 $ 13.77
8024 PLANNED RESPITE - INDIVIDUAL (6-12 HOURS) per diem $ 223.41 $ 250.56
8027 PLANNED RESPITE - GROUP (UP TO 6 HOURS) 15 minute $ 5.94 $ 6.66
8028 CRISIS RESPITE (UP TO 6 HOURS) 15 minute $ 14.26 $ 15.99
8029 CRISIS RESPITE (6-12 HOURS) per diem $ 259.35 $ 290.86
8030 CRISIS RESPITE (12-24 HOURS) per diem $ 583.54 $ 654.45
8032 ENVIR MODS - $1.00 UNIT per unit $ 1.00 $ 1.00
8034 ENVIR MODS - $10.00 UNIT per unit $ 10.00 $ 10.00
8035 ENVIR MODS - $100.00 UNIT per unit $ 100.00 $ 100.00
8036 ENVIR MODS - $1000.00 UNIT per unit $ 1,000.00 $ 1,000.00
8037 ADAPTIVE AND ASSISTIVE EQUIPMENT - $1.00 UNIT per unit $ 1.00 $ 1.00
8038 ADAPTIVE AND ASSISTIVE EQUIPMENT - $10.00 UNIT per unit $ 10.00 $ 10.00
8039 ADAPTIVE AND ASSISTIVE EQUIPMENT - $100.00 UNIT per unit $ 100.00 $ 100.00
8040 ADAPTIVE AND ASSISTIVE EQUIPMENT - $1000.00 UNIT per unit $ 1,000.00 $ 1,000.00
8041 VEHICLE MODIFICATIONS - $1.00 UNIT per unit $ 1.00 $ 1.00
8042 VEHICLE MODIFICATIONS - $10.00 UNIT per unit $ 10.00 $ 10.00
8043 VEHICLE MODIFICATIONS - $100.00 UNIT per unit $ 100.00 $ 100.00
8044 VEHICLE MODIFICATIONS - $1000.00 UNIT per unit $ 1,000.00 $ 1,000.00