ALL Children’s HCBS Providers

IMPACTED DATE: 10/24/24

IMPACTED PLANS: Medicaid and HIV SNP

Effective 10/24/2024, per New State Department of Health (NYSDOH) mandated guidelines, MetroPlusHealth has implemented the following updated billing changes for Children’s Waiver HCBS Group Planned Respite.

Billing Guidance for Planned Respite Group 2

• Effective 10/24/2024, two *new rate codes (8065* and 8066*) for Group Planned Respite provided to 2 participants, have been established by DOH. Providers should utilize these two new rate codes when billing for Group Planned Respite for 2 participants.
• Effective 10/24/2024, providers should bill using rate codes 8026 and 8027 for Group Planned Respite provided to 3 participants.
• To avoid denials, providers should follow the billing guidelines including use of appropriate Rate code, Procedure code, Modifiers outlined in below table.

If you have any questions regarding this memo, please contact MetroPlusHealth at: [email protected].

> View & Download the PDF