October 29, 2025
Now appearing on the Fidelis website:
“Fidelis Care has postponed the start date for Concurrent Review: Group (CPT 90853) & Family Therapy (CPT 90847) to January 1, 2026. All treatment for Substance Use Disorder is excluded from the Concurrent Review requirements. Note: Concurrent Authorization required only after 30 visits per calendar year, per CPT Code.”
NYSCouncilAdvocacyWorks! See below from OMH.
What we have achieved together and to this point is an exemption of SUD services from the new Fidelis URM requirement (thank you OASAS), and a delay until January 1, 2026 on mental health services.
We will continue to push, kick and scream on behalf of the New Yorkers we serve and the agencies that serve them. Never say never!
———- Forwarded message ———
From: Hetzel, Emily (OMH) <Emily.Hetzel@omh.ny.gov>
Date: Tue, Oct 28, 2025 at 3:47 PM
Subject: RE: Fidelis
To: Lauri Cole <lauri@nyscouncil.org>
Hi Lauri,
After extensive engagement with Fidelis regarding the new concurrent review requirements for family and group psychotherapy, we were just notified that Fidelis will postpone the effective date to January 1st.
Fidelis plans to update the authorization grid and provider posting this week with this information. We will follow up with Fidelis requesting that providers are notified about the effective date postponement as soon as possible.
We are still engaging with Fidelis on some of the requested documentation and other aspects of this concurrent review requirement and anticipate there may be additional updates in the coming weeks.
Please let us know if there are additional concerns that, from your perspective, still need to be addressed.
Thank you,
Emily
Emily Hetzel
Acting Director, Bureau of Medicaid Policy
Medicaid Compliance Officer
Office of Mental Health
Division of Community Program Policy and Management