OASAS Outpatient Medicaid Time Duration COVID Changes

May 20, 2021

Good afternoon,

We have some good news!

We just received word from OASAS Counsel’s Office that the temporary minimum duration changes for billing of certain OASAS services (see Notice below dated July 6, and see document attached) that OASAS first announced last year are now officially approved by CMS.  

To this point OASAS documents listing the temporary minimum duration changes have been marked ‘DRAFT’ in recognition of the fact that the state had not received an ‘official’ approval from CMS to make these changes although OASAS was quite certain the changes would be approved.

Expect a formal communication from OASAS shortly.  Note: We will request that the communication from OASAS address related issues including instructions for retroactive claiming, and an effective date.

Stand by for more.
See below and attached references.


July 6, 2020

Dear Providers,

You recently received notification from OASAS regarding Preliminary Guidance for Reopening.  Though OASAS continues to recommend Telepractice for the delivery of treatment services, we are aware that programs will gradually be re-introducing services delivered on site.

As noted in the guidance providers need to continue weighing risk/benefit factors in determining what services to offer, and in what manner.

To address the continuing need for Social Distancing during reopening, OASAS is temporarily reducing Medicaid reimbursement minimum timeframes for the following services:

Procedure

Code

Current Minimum

Temporary Minimum

Group Counseling

H0005/90853

60 minutes

50 minutes

Intensive Outpatient1Services

S9480

3 hours per day

2 ¼ hours per day

Outpatient Rehab Half1,2Day

H2001

2 hours per service date

1.5 hours per service date

Outpatient Rehab Half1,2Day

H2036

4 hours per service date

3 hours per service date

Discrete services may also be used for reimbursement as long as the services support the level of care needs of those identified via the LOCADTR 3.0 as needing this level of care.
For Outpatient Rehab Services a group counseling session of 50 minutes will meet the OPR service requirement.

The temporary minimum duration will be effective starting on July 1, 2020 and will continue until the requirement for Social Distancing has been removed.

If you have further questions regarding this information please email the PICM Mailbox at PICM@oasas.ny.gov.

Sincerely,
Patricia Lincourt, LCSW
Associate Commissioner of Addiction Treatment and Recovery
Office of Addiction Services and Supports