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Some NHTD Rates Change: New TBI Rates Coming Soon

eMedNY has notified providers of rate changes for certain services under the Nursing Home Transition and Diversion (NHTD) waiver program. Also, the state Department of Health (DOH) has announced a stakeholder group for the transition of the NHTD and Traumatic Brain Injury (TBI) programs to managed care.

The following rate changes were implemented July 13 and are effective retroactive to April 1, 2015:

  • Home and community support services/HCSS ($23.53 per hour for upstate and $22.45 for downstate);
  • HCSS nursing visit ($61.80 per visit for upstate and downstate);
  • Positive behavior intervention and supports ($54.04 per hour for upstate and $70.04 for downstate);
  • Structured day program ($17.56 per hour for upstate and $22.66 for downstate);
  • Independent living skills training ($36.02 per hour for upstate and $47.74 for downstate);
  • Community integration counseling ($72.03 per hour for upstate and $93.73 for downstate);
  • Ongoing service coordination ($393.92 monthly for upstate and $511.91 for downstate);
  • Initial service coordination ($537.99 one-time for upstate and $699.37 for downstate);
  • Initial service coordination/transition level I ($931.91 one-time for upstate and $1,211.28 for downstate); and
  • Initial service coordination/transition level II ($1,325.84 one-time for upstate and $1723.19 for downstate).

New rates for TBI services, retroactive to April 1, are expected soon.

For more information on NHTD/TBI rates, contact Thomas Sheedy at DOH: (518) 486-7164.

Stakeholder group

DOH is inviting various stakeholders on a workgroup to help develop a plan for transitioning NHTD and TBI to managed care.

As reported earlier, this transition has been delayed to January 1, 2017.

Stakeholder meetings will be held on August 24, November 18 and January 27, 2016 in Albany. Those wanting to attend should send an e-mail to waivertransition@health.ny.gov.

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