April 1, 2025 Rate Update for Cost-of-Living-Adjustment (COLA)

The Situation Report | July 7,  2025

Effective April 1, 2025, the mental health outpatient service rates have been increased to reflect a legislatively mandated 2.6 percent COLA, consistent with the State Fiscal Year 2025-26 Enacted State Budget and will be reflected in premiums upon State and Federal approvals.

The Department of Health recently alerted Mainstream Medicaid Managed Care Plans, HARPs, HIV SNPs, and MAP Plans (collectively referred to therein as “MMCPs” herein) of the adjustments to ensure compliance with the statutorily required payment of government rates. NYS will issue an additional notification to MMCPs upon Division of Budget (DOB) approval. Please refer to the OMH Medicaid Reimbursement Rates webpage for the following services that will be receiving the COLA.

•Assertive Community Treatment (ACT)
•Continuing Day Treatment (CDT)
•Comprehensive Psychiatric Emergency Program (CPEP)
•Partial Hospitalization (PH)
•Personalized Recovery Oriented Services (PROS)
•Mental Health Outpatient Treatment Rehabilitation Services (MHOTRS) under Ambulatory Patient Groups (APGs)
•Community Oriented Recovery and Empowerment (CORE) Services
•Adult Behavioral Health Home and Community Based Services (BH HCBS)
•Crisis Intervention: Mobile Crisis Services
•Crisis Intervention: Crisis Residences
•Health Home Plus (HH+)

HCANYS will provide updates, if any, as they become available.