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September 4, 2019
Children’s System: Aligned Home and Community Based Services (HCBS) Billing Webinar
2
Introduction and Housekeeping
Slides and recording will be posted at MCTAC.org
Reminders:
• Information and timelines are current as of the date of
the presentation.
• This presentation is not an official document. For full
details please refer to the provider and billing manuals.
3
Agenda
• HCBS Overview
• Fundamental Requirements
• Continuity of Care
• Billing for HCBS
4
Overview: What are Home and Community Based Services (HCBS)?HCBS Services are an array of Medicaid funded services designed to offer
support and services to children in non-institutionalized settings that enable
them to remain at home and in the community.
HCBS provides a family-driven, youth guided, culturally, and linguistically
appropriate system of care that accounts for the strengths, preferences, and
needs of the individual, as well as the desired outcome.
Services are individualized to meet the health, developmental, and behavioral
health needs of each child or youth.
All HCBS services that are deemed appropriate for an HCBS eligible child to
receive must be included on the child’s Plan of Care.
5
Menu of Services
Caregiver Family Supports
and Services
Pre-Vocational Services
Community Self-Advocacy
Training and Support
Supported Employment
Palliative Care Pain & Symptom
Management
Palliative Care Bereavement
Services
Palliative Care Massage Therapy
Palliative Care Expressive
Therapy
Respite (Planned &
Crisis)Day Habilitation
Community Habilitation
Vehicle Modifications
Environmental Modifications
Adaptive & Assistive
Equipment
Non Medical Transportation
5
6
Timeline Update
Managed care services and enrollment are pending CMS approval
*For a full list of services included in this carve-in, please refer to the billing manual
7
Fundamental Requirements
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Designation• Providers are required to receive designation from NYS to provide HCBS
services.
• Staff qualifications, modality rules and limits, and exclusions for these
services are state-mandated.
The following services do not require State designation from NYS. They will be
coordinated between the Care Management agency/C-YES, LDSS/MMCP and
the Department of Health (DOH)
• Environmental Modifications
• Vehicle Modifications
• Adaptive and Assistive Equipment
9
Medicaid
• To be paid for delivering a Medicaid service, all designated providers are required to enroll in Medicaid.
• Prior to delivering services, providers should ensure that the individual is enrolled and active with Medicaid and the appropriate MMCP.
• Claims will not be paid if a claim is submitted for an individual who is not enrolled with Medicaid; an individual is not eligible for HCBS; or if the claim was submitted to an incorrect MMCP.
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Medicaid Managed Care Contracting
To be paid for services delivered to a child enrolled in a Medicaid Managed Care Plan, a
provider must be contracted and credentialed with that MMCP for the service rendered (i.e.in
the MMCP’s network).
Single Case Agreements (SCA) may be executed between a MMCP and a provider when an
out of network provider has been approved by a MMCP to deliver specific services to a specific
MMCP enrollee. Medicaid Managed Care Plans must execute SCAs with non-participating
providers to meet the clinical needs of children when in network services are not available.
Reimbursement in any SCA must be at least equivalent to NYS Medicaid/APG rates.
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Rates
• NYS law requires that Medicaid Managed Care Plans pay
Ambulatory Patient Group (APG) rates or Government rates
(otherwise known as Medicaid fee-for-service rates) for services
administered by a MMCP.
• Upon the transition date of the respective services, MMCPs will
be required to pay APG or government rates for at least 24
months. This applies to the Aligned Children’s HCBS.
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Claim Submission
• Electronic claims will be submitted using the 837i claim form to
both Medicaid FFS and Medicaid Managed Care. Paper claims
(UB-04) and web-based claiming will also be accepted by
MMCPs.
• Each service has a unique rate code. If an individual receives
multiple services in the same day with the same CPT code, but
separate rate codes, all services would be payable.
13
Claim Submission Billing requirements depend on the type of service provided; however, every claim submitted will require at least the following:
• Use of the 837i (electronic) or UB-04 (paper) claim format
• Medicaid fee-for-service rate code
• Valid CPT code(s)
• CPT code modifiers (as needed)
• Units of Service
• Revenue Codes
Required fields must be completed.
More information about required fields of the UB-04 can be found on the MCTAC Billing Tool: https://billing.ctacny.org/
14
Claims Testing
Providers are expected to claims test with MMCPs for all
delivered services prior to the service implementation date
and upon executing a new contract.
There is still time to claims test with MMCPs!
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Medicaid Managed Care Plan Claiming
• MMCPs will not pay claims if submitted without the applicable rate code,
CPT code, and modifiers. If an individual service has multiple modifiers
listed, they must all be included on the claim submission.
• Providers must adhere to timely filing guidelines as outlined in their contract
with the MMCP. When a clean claim is received by the MMCP they must
adjudicate within 30 days for electronic claims and 45 days for paper claims.
• If a provider does not have a contract or a Single Case Agreement in place
with the MMCP, the claim can be denied.
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Medicaid Fee-For-Service Claiming (eMedNY)
Claims for services delivered to an individual in receipt of fee-for-
service Medicaid are submitted by providers to eMedNY. Claim
submissions need to adhere to the 90-day timely filing rules for
Medicaid FFS.
See https://www.emedny.org for training on use of the eMedNY
system.
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Multiple Services Provided on the Same Date
In some cases, an individual can receive multiple services on the
same day. This can include multiple services within the same
program type (e.g., an evaluation and a family counseling session
or an individual session and group session), or services provided by
separate programs.
If these services are allowed per the service combination grid they
would both be reimbursable when billed using the appropriate rate
code and CPT code.
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Service Combinations
• Only certain combinations of aligned HCBS and State
Plan services are allowed by Medicaid within an
individual’s current treatment plan.
• When determining which service should be utilized,
MMCPs, providers, families, and care managers should
discuss which services best meet the individual needs of
the child.
19
HCBS Settings
Allowable settings in compliance with Medicaid regulations and the Home and
Community Based Settings Final Rule (§441.301(c)(4) and §441.710) will
exhibit characteristics and qualities most often articulated by the individual
child/youth and family/caregiver as key determinants of independence and
community integration.
Services should be offered in the setting least restrictive for desired
outcomes, including the most integrated home or other community-based
settings where the beneficiary lives, works, engages in services and/or
socializes. While remaining inclusive of those in the family and caregiver
network.
20
Continuity of Care
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No UM for 180 days (OLP,
PSR, CPST)
No UM for 90 days (FPSS,
SSI/SSI-R OLP, PSR,
CPST)
No UM (crisis intervention)
1/1/19 7/1/19 10/1/19 1/1/20 4/1/204/1/19 7/1/20
No UM for 90 days for children
newly enrolled in HCBS after
10/1/19 (HCBS)
No UM for 90 days (YPSS)
Continuity of Care Provisions for Children’s Medicaid System Transformation
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1/1/19 7/1/19 10/1/19 1/1/20 4/1/204/1/19 7/1/20
Continuity of Care Provisions for Children’s Medicaid System Transformation
For Child from 1915c waivers or
participating in Children’s Waiver with
POC, MMC does not conduct UR for
CFTSS added to POC, and does not
change LTSS in POC, for 180 days
from CFTSS carve in
For new enrollee with HCBS, no POC
change for HCBS/LTSS for 180 days
from enrollment, for 24 months from
CFTSS or HCBS carve in
Same provider/same service for
24 months from any BH including
SPA benefit inclusion for episode
of care
12/31/20
6/30/21
12/31/21
9/30/21
12/31/20
12/31/21
9/30/216/30/21
6/30/21
For Child participating in Children’s
Waiver, no POC change for HCBS,
LTSS or CFTSS added to POC for
180 days from HCBS carve in
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Continuity of Care Provisions
• Plans may not apply utilization review criteria for a period of 90 days (10/1/19-1/1/20) from the implementation date of HCBS newly carved into managed care.
• For children transitioning from a 1915c waiver, Plans must continue to authorize covered HCBS in accordance with the most recent POC for at least 180 days following the date of transition of children’s specialty services newly carved into managed care.
• Service frequency, scope, level, quantity and existing providers at the time of the transition will remain unchanged (unless such changes are requested by the enrollee or the provider refuses to work with the Plan) for not less than 180 days, during which time, a new POC is to be developed.
• During the initial 180 days of the transition, the Plan will authorize any children’s specialty services newly carved into managed care that are added to the POC under a person-centered process without conducting utilization review.
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Continuity of Care Provisions• For continuity of care purposes the Plan must allow children to continue with their
care providers, including medical, BH and HCBS providers, for a continuous Episode of Care. This requirement will be in place for the first 24 months of the transition. It applies only to episodes of care that were ongoing during the transition period from FFS to managed care.
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Billing For HCBS
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Caregiver Family Supports and Services
Caregiver/Family Supports and Services enhance the child’s ability to function as part of a
caregiver/family unit and enhance the caregiver/family’s ability to care for the child in the home
and/or community. Family is broadly defined, and can include families created through birth,
foster care, adoption, or a self-created unit.
Caregiver Family Supports and Services is divided into individual and group services:
• Caregiver/Family Supports and Services Individual
• Caregiver Family Supports and Services Group of 2
• Caregiver Family Supports and Services Group of 3
Services are billed in 15 min units
Services limited to 3 hours or 12 units per day
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Caregiver Family Supports and Services Service Rate Code Procedure Code Modifier Unit Measure Unit Limit
Caregiver Family
Supports and
Services -
Individual
8003 H2014 UK, HA 15 min 12/day
Caregiver Family
Supports and
Services - Group
of 2
8004 H2014 UK, HA, UN 15 min 12/day
Caregiver Family
Supports and
Services - Group
of 3
8005 H2014 UK, HA, UP 15 min 12/day
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Prevocational ServicesServices individually designed to prepare a child age 14-20 to engage in paid or volunteer work or career
exploration. Prevocational Services teach concepts such as appropriate work habits, acceptable job
behaviors, compliance with job requirements, attendance, task completion, problem solving, and safety.
Prevocational services are not job-specific, but rather are geared toward facilitating success in any work
environment for children who are not receiving other prevocational services.
Prevocational Services are divided into individual and group services:
• Prevocational Individual
• Prevocational Group of 2
• Prevocational Group of 3
Services are billed in 15 min units
Services limited to 2 hours or 8 units per day
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Prevocational Services
Service Rate Code Procedure
Code
Modifier Unit Measure Unit Limit
Prevocational
Services-
Individual
8006 T2015 HA 15 min 8/day
Prevocational
Services -
Group of 2
8007 T2015 HA, UN 15 min 8/day
Prevocational
Services -
Group of 3
8008 T2015 HA, UP 15 min 8/day
29
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Community Self-Advocacy Training and Support Community self-advocacy training and support improves the child’s ability to participate in and gain from the community experience and enables the child/youth’s environment to respond appropriately to the child/youth’s disability and/or health care issues.
Community Self-Advocacy Training and Support is divided into individual and group services:
• Community Self-Advocacy and Training and Support Individual
• Community Self-Advocacy and Training and Support Group of 2
• Community Self-Advocacy and Training and Support Group of 3
Services are billed in 15 min units
Services limited to 3 hours or 12 units per day
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Community Self-Advocacy Training and Support
Service Rate
Code
Procedure
Code
Modifier Unit Measure Unit Limit
Community Self
Advocacy Training
& Support -
Individual
8009 H2015 HA 15 min 12/day
Community Self
Advocacy Training
& Support - Group
of 2
8010 H2015 HA, UN 15 min 12/day
Community Self
Advocacy Training
& Support - Group
of 3
8011 H2015 HA, UP 15 min 12/day
31
32
Supported Employment Supported employment services are individually designed to support children age 14-20 to
perform in an integrated work setting in the community through the provision of intensive,
ongoing support, including coping skills and other training to enable the child to maintain
competitive, customized or self-employment.
Supportive Employment is billed as an individual service only.
Services are billed in 15 min units
Services limited to 3 hours or 12 units per day
33
Supported Employment
Service Rate Code Procedure
Code
Modifier Unit Measure Unit Limit
Supported
Employment
8015 H2023 HA 15 min 12/day
33
34
Palliative Care Services
Palliative care is specialized medical care focused on providing relief from the
symptoms and stress of a chronic condition or life-threatening illness. The goal is to
improve quality of life for both the child and the family.
Palliative care is provided by a specially-trained team of doctors, nurses, social
workers and other specialists who work together with a child’s doctors to provide an
extra layer of support.
It is appropriate at any stage of a chronic condition or life-threatening illness and can
be provided along with curative treatment.
Children must meet LOC functional criteria and suffer from the symptoms and stress of
chronic medical conditions OR illnesses that put individuals at risk for death before age
21.
35
Palliative Care Pain and Symptom Management
Pain and Symptom Management is relief and/or control of the
child’s pain and suffering related to their illness or condition.
Services are billed in 15 min units
No limit as required by physician order
36
Palliative Care Pain & Symptom Management
Service Rate Code Procedure Code Modifier Unit Measure Unit Limit
Palliative Care
Pain and
Symptom
Management
8016 99347 TJ 15 min No limit as
required by
participant’s
physician order
36
Palliative care benefits may not duplicate Hospice or other State Plan benefits accessible to
participants.
37
Palliative Care Bereavement
Palliative care Bereavement is help for participants and their families to cope
with grief related to the participant’s end-of-life experience. Bereavement
counseling services are inclusive for those participants in receipt of hospice
care through a hospice provider.
Services are billed in 30 min units
Services limited to the lesser of 10 units per month or 120 units per calendar
year
38
Palliative Care Bereavement
Service Rate Code Procedure
Code
Modifier Unit Measure Unit Limit
Palliative Care
Bereavement
8017 90832 TJ 30 min Limited to the
lesser of 10
units per
month or 120
units per
calendar year
38
Palliative care benefits may not duplicate Hospice or other State Plan benefits accessible to
participants.
39
Palliative Care Massage Therapy
Palliative Care Massage Therapy works to improve muscle tone,
circulation, range of motion and address physical symptoms related
to a child’s illness.
Services are billed in 15 min units
Services limited to 72 units per year
40
Palliative Care Massage Therapy
Service Rate Code Procedure
Code
Modifier Unit Measure Unit Limit
Palliative Care
Massage Therapy
8018 97124 TJ 15 min 72 units/year
40
Palliative care benefits may not duplicate Hospice or other State Plan benefits accessible
to participants.
41
Palliative Care Expressive Therapy
Palliative care Expressive Therapy (art, music and play) helps
children better understand and express their reactions to their
illness or condition through creative and kinesthetic treatment.
Services are billed in 15 min units
Services limited to 48 units per year
42
Palliative Care Expressive Therapy
Service Rate Code Procedure
Code
Modifier Unit Measure Unit Limit
Palliative Care
Expressive
Therapy
8019 96152 TJ 15 min 48 units/year
42
Palliative care benefits may not duplicate Hospice or other State Plan benefits accessible
to participants.
43
Respite - PlannedPlanned Respite services provide planned short-term relief for family/caregivers that is needed to enhance the family/caregiver’s ability to support the child’s functional, mental health/substance use disorder, developmental, and/or health care issues. The service is direct care for the child by staff trained to provide supervision and pro-social activities that match the child's developmental stage to maintain the enrollee’s health and safety.
Planned Respite is divided into individual and group services:
• Planned Respite - Individual (up to 4 hours)
• Planned Respite – Individual (over 4 hours)
• Planned Respite - Group (up to 4 hours)
Services are billed in 15 min units for individual (up to 4 hours) and group
• Services are limited to 16 units per day
Services are billed per diem for individual (over 4 hours)
• Service limited to 1 per diem per day
44
Respite - Planned
Service Rate Code Procedure Code Modifier Unit Measure Unit Limit
Planned Respite
& -Individual (up
to 4 hours)
8023 S5150 HA 15 min 16/day
Planned Respite-
Individual per
diem (over 4
hours)
8024 S5151 HA Per Diem 1/day
Planned Respite-
Group (up to 4
hours)
8027 S5150 HA, HQ 15 min 16/day
44
45
Respite - CrisisCrisis Respite is a short-term intervention strategy for children and their families/caregivers
which is necessary to address a child’s behavioral health, developmental, or medical crisis or
trauma, including acutely challenging emotional or medical crisis in which the child is unable to
manage without intensive assistance and support.
Crisis Respite Services: Individual services only
• Crisis Respite (up to 4 hours)
• Crisis Respite (more than 4 hours, less than 12 hours)
• Crisis Respite (more than 12 hours, less than 24 hours)
Services are billed in 15 min units for respite (up to 4 hours)
• Services are limited to 16 units per day
Services are billed per diem for respite more than 4 hours
• Service limited to 1 per diem per day
46
Respite - Crisis
Service Rate Code Procedure
Code
Modifier Unit Measure Unit Limit
Crisis Respite -up
to 4 hours)
8028 S5150 HA, ET 15 min 16/day
Crisis Respite-
more than 4
hours, less than
12 hours
8029 S5151 HA,ET Per Diem 1/day
Crisis Respite-
Individual Group
(12+ hours, less
than 24)
8030 S5151 HA, ET, HK Per Diem 1/day
46
47
Day Habilitation Assistance with acquisition, retention or improvement in self-help, socialization and adaptive skills including communication, and travel that regularly takes place in a nonresidential setting, separate from the person's private residence or other residential arrangement. Activities and environments are designed to foster acquisition of skills, appropriate behavior, greater independence, community inclusion, relationship building, self-advocacy and informed choice.
Habilitation is divided into individual and group services
• Day HCBS Habilitation
• Day HCBS Habilitation Group of 2
• Day HCBS Habilitation Group of 3
Services are billed in 15 min units
Service limited to 24 units per day
48
Day Habilitation
• Group and individual Day Habilitation cannot be billed as overlapping services.
• Supplemental services are not available to individuals residing in certified residential settings, because the residence is paid for staffing on weekday evenings and anytime on weekends.
• Children have a maximum daily amount of services that are available to individuals based upon their residence. Individuals residing in certified settings are limited to a maximum of 6 hours of non-residential services (or its equivalent) which must commence no later than 3 pm on weekdays.
49
Day HabilitationService Rate Code Procedure
Code
Modifier Unit Measure Unit Limit
Day
Habilitation
7933 T2020 HA 15 min 24/day
Day Habilitation
Group of 2
7934 T2020 HA, UN 15 min 24/day
Day Habilitation
Group of 3 or
more
7935 T2020 HA, UP 15 min 24/day
49
50
Community Habilitation Community Habilitation covers services and supports related to the person’s acquisition,
maintenance and enhancement of skills necessary to independently perform ADLs, IADLs
and/or Health-Related tasks.
Services may not be duplicative of any services that may be available under Community First
Choice Option.
• Community HCBS Habilitation
• Community HCBS Habilitation Group of 2
• Community HCBS Habilitation Group of 3
Services are billed in 15 min units
Service limited to 24 units per day
51
Community HabilitationService Rate Code Procedure
Code
Modifier Unit Measure Unit Limit
Community
Habilitation
8012 H2014 HA 15 min 24/day
Community
Habilitation
Group of 2
8013 H2014 HA, UN 15 min 24/day
Communication
Habilitation
Group of 3 or
more
8014 H2014 HA, UP 15 min 24/day
51
52
Environmental Modifications
This service provides internal and external physical adaptations to the home or
other eligible residences of the enrolled child which are identified as necessary
to support the health, welfare and safety of the child or that enable the child to
function with greater independence in the home and without which the child
would require institutional and/or more restrictive living setting.
In most instances, a specific type of Environmental Modification is a one-time
benefit. However, in reasonable circumstances, a second modification may be
considered for funding.
53
Vehicle Modifications
This service provides physical adaptations to the primary vehicle of the enrolled child
who are identified as necessary to support the health, welfare and safety of the child or
that enable the child to function with greater independence.
Adaptive & Assistive Equipment
Adaptive and Assistive Equipment provides technological aids and devices which
enable him/her to accomplish daily living tasks that are necessary to support the
health, welfare, and safety of the child.
54
Environmental & Vehicle Modifications, Adaptive & Assistive Equipment
The LDSS will be responsible for the authorization of E-Mods, V-Mods, and AT in accordance with the child’s Plan of Care and this administrative directive for all children participating in the Children’s Waiver.
For individuals enrolled in MMC, once a service the individual is receiving is added to the MMC benefit package, the LDSS will coordinate with the individual’s MMCP to share information about services authorized for him or her to facilitate a smooth transition of services, with no gaps in service delivery.
Are limited to only those services not reimbursable under the Community First Choice Option (CFCO) State Medicaid Plan, Medicaid State Plan under 1905(a) of the Social Security Act or other federal/state funding streams.
55
Environmental & Vehicle Modifications, Adaptive & Assistive Equipment
Contracts for Environmental, Vehicle modifications and Adaptive and Assistive
Equipment may not exceed $15,000 per year without prior approval from the
LDSS in conjunction with NYSDOH or the MCO. The State may consider
exceptions when medically necessary, including but not limited to a significant
change in the child’s needs or capabilities.
Please note: Any E-Mod, V-Mod and/or AT approval process that began prior to
April 1, 2019 will continue to be processed and paid for under the procedures in
place at the time the request was initiated.
56
Environmental & Vehicle Modifications, Adaptive & Assistive EquipmentWebinar on Children’s Aligned HCBS Authorization & Payment for Adaptive and Assistive
Equipment, Vehicle Modifications, Environmental Modifications and Non-Medical Transportation:
https://ctacny.org/training/childrens-aligned-hcbs-authorization-payment-adaptiveassistive-
equipment-veh-mods
Environmental Modifications Guidelines
https://www.health.ny.gov/health_care/medicaid/publications/docs/adm/19adm03_att2.pdf
Vehicle Modifications Guidelines
https://www.health.ny.gov/health_care/medicaid/publications/docs/adm/19adm03_att3.pdf
Adaptive & Assistive Equipment Guidelines
https://www.health.ny.gov/health_care/medicaid/publications/docs/adm/19adm03_att1.pdf
Description and Cost Projection Form:
https://www.health.ny.gov/health_care/medicaid/publications/docs/adm/19adm03_att4.pdf
Final Cost Form:
https://www.health.ny.gov/health_care/medicaid/publications/docs/adm/19adm03_att6.pdf
57
Non-Medical Transportation
Non-Medical Transportation will be billed Fee For Service
• For members in Health Home, MMCP approves POC and forwards
completed NYS DOH POC Grid for NMT for Children’s HCBS (completed
by HHCM) to Transportation Manager.
• For members not in Health Home, MMCP must complete (and update as
needed) the NMT Grid and forward to Transportation Manager.
• NMT Grid and contacts for Transportation Managers can be found at
https://www.emedny.org/ProviderManuals/Transportation/index.aspx
58
Service Combinations
Please refer to the billing manual for allowable service
combinations.
59
Some Commonly Asked QuestionsAre the limits hard limits?
The billing manual outlines the daily unit limits. In acknowledgement of the need for checks against fraud and abuse, but to ensure a client's access to services, service utilization in excess of the annual claim limits and "soft" unit limits will be based on medical necessity and subject to post-payment review. Documentation of the medical necessity for extended durations must be kept on file in the client's record. Please refer to UM Guidance for details on annual and daily limits.
How do we handle no-shows (ie. providers driving to a location and then can’t bill for the service because the child doesn’t show up)?
All of HCBS requires face-to-face, therefore a no-show is not billable.
Can a provider bill for a service when the child is not present?
Some services (for example Caregiver Family Supports and Services) allow you to meet with collaterals/families without child present. Please refer to the manual for more guidance.
60
Resources
61
Medicaid-Enrolled Provider To be paid for delivering a Medicaid service, all providers eligible to enroll in Medicaid are
required to enroll in Medicaid. Information on how to become a Medicaid provider is available on
the eMedNY website: https://www.emedny.org
Additional information specific to Medicaid provider enrollment for Children’s services is available
at the following link: https://ctacny.org/training/medicaid-provider-enrollment-new-childrens-spa-
and-hcbs-providers
Memo on Medicaid Provider Enrollment for Individual Practitioners and Designated Agencies:
https://ctacny.org/sites/default/files/Provider%20Enrollment%20and%20NPI%20memo%20FINAL
%2003.08.19_0.pdf
62
HCBS WorkflowHCBS Plan of Care Workflow: https://www.health.ny.gov/health_care/medicaid/redesign/behavioral_health/children/docs/childrens_hcbs_poc_workflow.pdf
Children’s HCBS Referral Form to HCBS Provider: https://www.health.ny.gov/health_care/medicaid/redesign/behavioral_health/children/docs/childrens_hcbs_referral_hcbs_provider_fillable.pdf
Children’s HCBS Authorization and Care Manager Notification Form: https://www.health.ny.gov/health_care/medicaid/redesign/behavioral_health/children/docs/childrens_hcbs_authorization_cm_notification_form_fillable.pdf
1915(c) Children’s Waiver and 1115 Waiver Amendments: https://www.health.ny.gov/health_care/medicaid/redesign/behavioral_health/children/1115_waiver_amend.htm
63
Tools Select the Tools Tab at www.mctac.org
Billing Tool – Children System specific
updates. https://billing.ctacny.org/
Glossary of Terms- Interactive online glossary of
frequently used managed care terminology.
Includes a printable top acronyms "cheat sheet.”
https://glossary.ctacny.org/
Managed Care Plan Matrix – comprehensive resource
for MCO contact information relevant to adults and
children. https://matrix.ctacny.org/
64
Resources and InformationProvider List https://pndslookup.health.ny.gov/
List of NYS Health Homes by County
https://www.health.ny.gov/health_care/medicaid/program/medicaid_health_homes/hh_map/index.htm
C-YES
Contact info: 1-833-333-CYES (1-833-333-2937); TTY: 1-888-329-1541
https://nymedicaidchoice.com/news/c-yes-helping-children-and-youth-access-home-and-community-based-services-0
Children’s Behavioral Health Transition to Managed Care
https://www.health.ny.gov/health_care/medicaid/redesign/behavioral_health/children/index.htm
65
Email Resources Please specify if kids system/managed care specific in subject line:
DOH Transition Mailbox
NYS OMH Managed Care Mailbox
NYS OASAS Mailbox:
NYSDOH Health Homes for Children:
NYS OCFS Mailbox:
66
Questions
Please send questions to: [email protected]
Logistical questions usually receive a response in 1 business day or less.
Longer & more complicated questions
can take longer.
We appreciate your interest and patience!
Visit www.mctac.org to view past trainings, sign-up for updates and event announcements, and access resources
