New York Codes Rules Regulations (Last Updated: March 27,2024) |
TITLE 10. Department of Health |
Chapter II. Administrative Rules and Regulations |
Subchapter L. Hospitals and Related Facilities |
Part 86. Reporting and Rate Certifications for Facilities |
Subpart 86-8. Outpatient Services: Ambulatory Patient Group |
Sec. 86-8.1. Scope
Latest version.
- (a) This Subpart shall govern Medicaid rates of payments for ambulatory care services provided in the following categories of facilities for the following periods:(1) outpatient services provided by general hospitals on and after December 1, 2008;(2) emergency department services provided by general hospitals on and after January 1, 2009;(3) ambulatory surgery services provided by general hospitals on and after December 1, 2008;(4) ambulatory services provided by diagnostic and treatment centers on and after September 1, 2009;(5) ambulatory surgery services provided by free-standing ambulatory surgery centers on and after September 1, 2009; and(6) hospital-based mental hygiene services on and after July 1, 2010, including:(i) mental retardation clinics;(ii) mental health clinics;(iii) alcoholism and drug abuse clinics and outpatient rehabilitation; and(iv) methadone clinics.(b) Notwithstanding subdivision (a) of this section, the provisions of this Subpart shall not apply to the following:(1) facilities whose Medicaid reimbursement is governed by subdivision 8 of section 2807 of the Public Health Law, except when the provisions of this Subpart are made applicable pursuant to paragraph (f) of such subdivision; and(2) payments made on behalf of persons enrolled in Medicaid managed care or in the family health plus program.