May 2, 2024

Several weeks ago we told all NYS Council members that we had been tracking changes to the weights associated with certain OASAS and OMH outpatient clinic services since last December when we first learned these changes were coming and would positively impact rates.

Last month OMH shared the letter OASAS and OMH sent to the MCOs on 4/18 describing these mandated rate changes.  Today OASAS appears to be sharing that same letter with the MCOs.  Note that OASAS also includes a note to Part 822 providers (below).

Read the information in the document attached carefully as some of it impacts both OASAS and OMH outpatient clinics while other information is limited to one or the other licensed outpatient clinic program.

MCOs have 90 days from the date of the letter (4/18) to adjust their technology and begin paying the new rates, effective on the dates listed in the letter.  (Note that there are two effective dates discussed.)

If you need assistance we are here to help.

FROM OASAS:

ATTENTION Part 822 Providers:

Effective July 1, 2024 the Psychotherapy (Group and Family Group) rates will be adjusted, consistent with the State Fiscal Year (SFY) 2023-2024 and 2024-2025 Enacted State Budget.

OASAS and OMH are issuing this guidance simultaneously to support consistency in reimbursement for OMH and OASAS providers. 

Please note that Group Psychotherapy (CPT code 90853 and 90849) requires that the professional staff who delivers the service can provide psychotherapy consistent with their scope of practice in NYS. This includes LCSW, LMHC, and psychologists licensed in New York through the state education department.

The attached letter contains the details of the change for both OASAS and OMH providers. The letter has also been sent to alert Mainstream Medicaid Managed Care Plans, Health and Recovery Plans, HIV Special Needs Plans, and Medicaid Advantage Plus Plans of the adjustments to ensure compliance with the statutorily required payment of government rates.

If you have further questions, please email PICM@oasas.ny.gov

Thank you.

Communications Department

NYS Office of Addiction Services and Supports (OASAS)