Assertive Community Treatment (ACT) Provider Bulletin

This bulletin provides important updates regarding changes in Assertive Community Treatment (ACT) billing and reimbursement, mandated by the New York State (NYS) Office of Mental Health (OMH). These changes, effective October 1, 2023, align with the SFY 2023-2024 Enacted State Budget.

Key Updates for ACT Providers:

For Adults:

• 100 Slot ACT Teams: A new reimbursement rate for 100 Slot ACT teams will be established. Initially, only 68 Slot ACT teams are eligible to apply for conversion to 100 Slots.
• Rate Increase for 36 Slot ACT Teams: Effective October 1, 2023, 36 Slot teams will see an increase in their reimbursement rate.

For Youth:

• Slot Adjustments:
  • New 28 Slot ACT teams will be established.
  • Current 36 Slot teams will convert to 28 Slot teams.
  • Current 48 Slot teams will convert to 36 Slot teams.
• Rate Increases for Youth ACT Providers: All Youth ACT providers will receive a rate increase effective October 1, 2023.
• New Rate Codes: Effective 1/1/2025, new rate codes (4513-4515) will be introduced to improve service utilization tracking for Youth ACT services.

Important Reminders:

Providers will need to ensure they use the new rate codes for Youth ACT services delivered starting 1/1/2025. Adult ACT billing codes will remain unchanged and should continue to be used for the Young Adult ACT population (ages 18-25).

For full details on these changes, please refer to the official guidance provided by the New York State Office of Mental Health at the following link: https://omh.ny.gov/omhweb/bho/act-billing-reimbursement-changes.pdf

For questions or more information, contact Provider Relations at 1-800-450-8753.