Inpatient and Residential
820 Residential Service Codes
Medicaid Fees for Residential Addiction Services Under OASAS Part 8201
| Service | Rate Code | Region | 7/1/2016 | 11/1/2021 | 7/1/2022 | 4/1/2022 | 7/1/2022 | 1/1/2023 | 3/1/2023 | 4/1/2023 | 4/1/2024 |
| Stabilization | 1144 | Upstate | $151.53 | $166.68 | $151.53 | $175.68 | $159.71 | $167.70 | $192.85 | $200.56 | $206.26 |
| Stabilization | 1144 | Downstate | $165.27 | $181.80 | $165.27 | $191.61 | $174.19 | $182.90 | $222.12 | $231.01 | $237.57 |
| Rehabiliation | 1145 | Upstate | $142.01 | $156.21 | $142.01 | $164.65 | $149.68 | $157.16 | $164.24 | $170.81 | $175.66 |
| Rehabiliation | 1145 | Downstate | $163.56 | $179.92 | $163.56 | $189.63 | $172.39 | $181.01 | $189.15 | $196.72 | $202.31 |
| Reintegration | 1146 | Upstate | NA | $173.13 | $115.42 | $182.48 | $121.65 | $127.73 | $127.73 | $132.84 | $136.61 |
| Reintegration | 1146 | Downstate | NA | $202.55 | $135.03 | $213.48 | $142.32 | $149.44 | $149.44 | $155.41 | $159.82 |
1 Fees are the daily rate for treatment services only. Room and board are covered by Congregate Care level II.
Documents
- Part 820 Provider Program List (Excel) - Spreadsheet containing a list of Part 820 provider programs, including county, provider name, program name and number, element of care, stabilization, reintegration, rehabilitation, certified capacity, address and contact information. For the most up-to-date contact information, please check the Provider Directory System.
- Article 28 Inpatient Rehabilitation Programs (Excel) - Rate Codes and Fees for inpatient rehabilitation services for Article 28 providers.
- Article 32 Inpatient Rehabilitation Programs (Excel) - Part 818 Per diem rates for Article 32 freestanding rehabilitation programs.
Withdrawal and Stabilization
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Article 28 Medically Managed Detox Rate Codes
Article 28 provider-specific rates and rate codes for medically managed detoxification services.
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Article 28 Inpatient Withdrawals Rates
Article 28 provider specific rates for medically supervised inpatient withdrawal services.
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Article 32 - Inpatient Withdrawal Rates
Article 32 Freestanding Medically Supervised Inpatient Withdrawal Services.
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Outpatient Withdrawal Rates
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Medically Supervised Outpatient Withdrawal and Stabilization
Effective January 1, 2021, the reimbursement methodology for Part 816.8 programs - Medically Supervised Outpatient Withdrawal and Stabilization (MSOW) from a provider-specific fee to Ambulatory Patient Groups (APGs)
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Residential Services for Youth
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Rehabilitation Services for Youth (RRSY) Rates and Codes
Part 817 Rates and billing codes for billing Rehabilitation Services for Youth (RRSY) programs for youth and young adults.
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Addiction Treatment Centers
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Inpatient Rehabilitation ATC Rates
Rate codes for inpatient rehabilitation services in state-operated Addiction Treatment Centers (ATCs).
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Medication Billing
Guidance on billing Sublocade intramuscular injection and oral buprenorphine in ambulatory settings), as well as billing for Vivitrol for outpatient programs.
Please note that changes to Chapters 69 and 71 of the Insurance Laws of 2016 prohibit prior Insurance authorization for medications for treatment of substance use disorder.
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Buprenorphine Billing
Information on billing for buprenorphine in outpatient clinic or rehabilitation settings and in opioid treatment programs (OTPs).
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Billing for Medication Management
An OASAS and Office of Mental Health memo on billing medication management for co-occurring disorders.
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Contact Practice Innovation & Care Management Unit
If you have any questions, contact the Division of Practice Innovation and Care Management (PICM).