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RE: Billing Guidance for Delivering Services in a Language Other Than English (LOE) Within MHOTRS Programs Impacted Plans: Medicaid, HARP, HIV SNP, AND MAP

Effective October 1, 2023, The NYS Office of Mental Health (OMH) and the NYS Department of Health (DOH) have updated the billing guidance for delivering interpreter services in an LOE (Language Other Than English), including American Sign Language within a OMH MHOTRS Program. This updated guidance establishes an additional new modifier combination to obtain an enhanced reimbursement when translation services are provided by a vendor or any translation professional, other than a MHOTRS staff person.

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RE: TELEHEALTH – CHANGES TO AUDIO-ONLY BILLING

TO: ALL PROVIDERS As of January 1, 2025, per New York State Medicaid updated guidance, the American Medical Association (AMA)…

Availity Eligibility and Claim Inquiry Update

Effective on April 28, 2025, MetroPlusHealth starts a strategic partnership with Availity® to serve as our 270/271 (Member Eligibility Inquiry/Response)…

RE: eConsults Expansion

TO: All MetroPlusHealth Providers Effective as of March 1, 2025, MetroPlusHealth will reimburse eConsult services for Hospital Outpatient Departments (OPDs),…

RE: SBHC COVERED SERVICES

IMPACTED PLANS: MEDICAID & HIV SNP (also known as Partnership in Care) Dear MetroPlusHealth Provider, Effective May 1, 2025, onwards,…
last updated: March 13, 2024

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