Health Home Billing

Below are links to most recent resources

Please call Computer Science Corporation (CSC) at (800)343-9000 with questions regarding denied claims

Health Homes Serving Adults and Children

  • Restriction Exception (R/E) Code Compatibility with the Health Home Program - (Web) - (PDF) - September 2024
  • Current Health Home Rate Codes - (Web) - (PDF) - Corrected August 2024
  • Medicaid Managed Care Plan Claim Denials for Health Home Services - (Web) - (PDF) - October 2019
  • Medicaid Managed Care Plan Billing and Payment Protocol for Health Home Services - (Web) - (PDF) - Effective: July 1, 2018, Revised: March 2019
  • Billing and Documentation Guidance for Health Home Adult Rates with Clinical and Functional Adjustments - (Web) - (PDF) - Effective: May 1, 2018, Revised: March 2024
  • Temporary Health Home Billing Procedures - (Web) - (PDF) - Effective December 1, 2016
  • Outreach Reprogramming Guidance - (Web) - (PDF)

Health Home Serving Adults

  • Health Home Plus (HH+) Rates and Guidance - (PDF) (external link)

Health Home Serving Children

  • UPDATED Health Home Serving Children Care Management Core Services Requirements and Billing Policy HH0017 September 2024 - (Web) - (PDF)
    • Tracked Changes - HHSC Core Service Requirements & Billing Policy HH0017 - (Web) - (PDF)
  • HHSC Core Service Requirements Policy FAQ September 2024 - (Web) - (PDF)
  • Home and Community Based Services (HCBS) Children's Waiver Eligibility Assessment Fee Guidance - (Web) - (PDF) - 5.31.2024 - Updated August 27, 2024
  • HHSC - Message to HH Community RE HH Payments and HHSC - (Web) - (PDF) - July 19, 2016 FINAL
  • Health Home HML Rate For Children - (Web) - (PDF)
  • CSC - Information on Denied Health Home Claims - (Web) - (PDF)
  • eMedNY - New York State Medicaid: Medicaid Eligibility Verification System (MEVS) Methods - (PDF) (external link)
  • Restriction Exception (R/E) Code Compatibility with the Health Home Program - (Web) - (PDF) - July 2024 ARCHIVED September 2024
  • Home and Community Based Services (HCBS) Children's Waiver Eligibility Assessment Fee Guidance - (Web) - (PDF) - 5.31.2024 - Archived August 2024
  • Health Home Rate Codes - (Web) - (PDF) - Corrected July 2024 - Archived August 2024
  • Health Home Rate Codes - (Web) - (PDF) - Updated May 2024 - Archived July 2024
  • Restriction Exception (R/E) Code Compatibility with the Health Home Program - (Web) - (PDF) - November 2023 Archived July 2024
  • Coverage Code Compatibility with the Health Home Program - (Web) - (PDF)
  • Billing and Documentation Guidance for Health Home Adult Rates with Clinical and Functional Adjustments - (Web) - (PDF) - Effective: May 1, 2018, Revised: March 2019 Archived March 2024
  • Health Home Rate Codes - (Web) - (PDF) - Updated April 2024
  • Health Home Rate Codes - April 2023 - (Web) - (PDF) - Updated April 2024
  • Health Home Rate Codes - (Web) - (PDF) - Updated May 2022
  • Health Home Rate Codes in Effect on/after April 2022 - (Web) - (PDF) - Updated May 2022
  • Restriction Exception (R/E) Code Compatibility with the Health Home Program - (PDF) - July 2023
  • Restriction Exception (R/E) Code Compatibility with the Health Home Program - (PDF) - April 1, 2022
  • Restriction Exception (R/E) Code Compatibility with the Health Home Program - (PDF) - February 2021
  • Health Home Rate Codes in Effect on/after July 2020 - (Web) - (PDF)
  • Health Home Rate Codes in Effect on/after October 2018 - (Web) - (PDF)
  • Health Home Rate Codes in Effect on/after October 2017 - (Web) - (PDF)
  • Health Home Rate Codes in Effect on/after December 2016 - (Web) - (PDF)
  • Health Home HML Rate For Adults - (Web) - (PDF) - December 2016
  • Updated Billing Guidance - (Web) - (PDF) - November 2016
  • Restriction Exception (R/E) Code Compatibility with the Health Home Program - (Web) - (PDF) - May 9, 2017
  • Phase 1 and Phase 2 Health Home Serving Children - (Web) - (PDF) - October 27, 2015
  • Behavioral Health Transition - (Web) - (PDF) - April 2015
  • Health Home Base Rates - (Web) - (PDF)
  • TCM legacy Rate Extension - (Web)
  • Billing Guidance for the Administration of the NYS Eligibility Assessment for Behavioral Health Home and Community Based Services (BH HCBS) and the NYS Community Mental Health Assessment - (Web) - (PDF)