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DOH Activates New Rates for Certain NHTD/TBI Services

The Centers for Medicare and Medicaid Services (CMS) approved an amendment to the Appendix K for the Nursing Home Transition and Diversion (NHTD) and Traumatic Brain Injury (TBI) Waivers on Aug. 18, 2022.

This approval established new rates to supplement the rates currently in use for TBI Home and Community Support Services (HCSS) Nursing Supervisor Visit as well as NHTD/TBI Structured Day Program (SDP) services provided face to face.

The new rates are effective April 1, 2021; were added to eMedNY between Dec. 9, 2022 and Dec. 15, 2022; and are active to Medicaid Management Information System (MMIS) Provider IDs in Cycle #2366. The eMedNY notice is available here.

LeadingAge NY has been monitoring the Department’s implementation of the NHTD/TBI workforce stipend program. We are aware that providers and their staff are frustrated that they did not receive the funds before the holiday. The Department has been reviewing them for accuracy and will soon be submitting a request to the Rates Unit and Division of the Budget (DOB) for approval. Once approved, each provider will automatically receive their payment through an electronic funds transfer. It is our understanding that no additional billing/claims will be needed from the provider.

Contact: Meg Everett, meverett@leadingageny.org, 518-867-8871