Update for NYS HBCS Providers: the Community Mental Health Assessment Billing Policy

New York State recently provided an update on the Community Mental Health Billing Policy.

“Care Management Agencies (CMA) will bill NYS Medicaid directly through the eMedNY system. This process will be used for newly and previously completed assessments for individuals enrolled in Health and Recovery Plan (HARP) or HARP-eligible individuals enrolled in HIV Special Needs Plans. For dates of service beginning October 1, 2015, in New York City and July 1, 2016, throughout the rest of NYS, claims for unpaid assessments completed for these enrolled individuals can be directly submitted to eMedNY. This will be the process until direct billing to Medicaid Managed Care Organizations (MMCO) is implemented, targeted to begin Fall 2017. “

Click the following link to see the update:


Remember, in order to bill for “BH HCBS Eligibility Assessment or the Community Mental Health Assessment (CMHA) for a HARP flagged individual, the Assessor must verify the individual is enrolled in a HARP through EPACES/EMEDNY.” 

See the full procedure on the NYS Department of Health website: https://www.health.ny.gov/.

Stay connected as policy shifts to support practice for these services. SAE remains committed to providers and helping with service shifts toward the realization of the Medicaid Redesign.