New York Medicaid Behavioral Health Billing: Manuals, Codes and Payers
New York publishes a joint behavioral health billing and coding manual for Medicaid managed care, and most members are in a mainstream or HARP plan. This page lists the manuals, the plans, and what to check. Checked against state sources on 9/30/26.
Get My Free ConsultationIn this guide
- ✓ The OMH billing and coding manual
- ✓ Mainstream and HARP plans with provider links
- ✓ What to check before you bill
- ✓ Where the codes are published
New York Medicaid Billing at a glance
This page covers new york medicaid billing for behavioral health claims: where the state provider manuals and code lists live, and which HCPCS codes apply to psychotherapists and psychiatrists. Rules vary by state and by payer, so confirm current requirements with the state Medicaid agency before you bill.
Use this New York Medicaid Billing guide as a starting point. New York Medicaid Billing rules differ by plan, so check whether a claim goes to the state fee-for-service program or to a managed care plan. Keep a copy of the current New York Medicaid Billing manual your practice follows, and review your New York Medicaid Billing process whenever the state issues an update.
New York Medicaid at a glance
State manuals and fee schedules
| Document | What it covers |
|---|---|
| NY Medicaid (Department of Health) | The state Medicaid agency. |
| OMH Managed Care Behavioral Health Billing and Coding Manual (October 2025) | Joint OMH, OASAS and DOH manual for mainstream and HARP plans, as listed by OMH. |
| OMH behavioral health billing services page | Landing page for OMH billing guidance. |
| eMedNY provider manuals | Fee schedules and provider manuals, including the clinical psychology fee schedule. |
| DOH managed care plan directory | Plans and their websites. |
Managed care plans and payer sites
| Payer | Provider site |
|---|---|
| Healthfirst | Provider manual |
| Fidelis Care | Providers |
| EmblemHealth (HIP) | Providers |
| MetroPlusHealth | Providers |
| CDPHP | Providers |
| MVP Health Care | Providers |
| Independent Health | Providers |
| UnitedHealthcare Community Plan of New York | Provider site |
Also contracted: Excellus, Highmark Western and Northeastern NY, Anthem HealthPlus (Empire) and Molina. Use the DOH directory for their websites.
What is changing
- The OMH manual on file is dated October 2025; check the OMH billing page for a newer edition.
- Medicaid Advantage Plus (MAP) and HARP arrangements change; confirm the member's plan type on each visit.
Current as of 9/30/2026. Reconfirm before you bill.
New York Medicaid billing: frequently asked questions
Where is New York's behavioral health billing manual?
OMH publishes the Managed Care Behavioral Health Billing and Coding Manual, a joint OMH, OASAS and DOH document for mainstream and HARP plans. The October 2025 edition is linked above.
What is a HARP?
A Health and Recovery Plan is a Medicaid managed care plan for members with serious mental illness or substance use needs. The DOH directory lists HARP plans.
Do the plans follow the state manual?
The manual applies to managed care billing, but each plan publishes its own manual with additional rules. Read both.
Where this information comes from
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