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August 2025 Top of Mind
Medicaid providers: OASAS outpatient rehab billing code changes
Effective June 11, 2025, rate codes 1573, 1561, 1570 and 1558 are no longer billable rate codes. Providers will now need to use the state-required billing guidance outlined in the Ambulatory Patient Group Manual. Under the new guidelines, programs will no longer be required to have a separate designation as an outpatient rehabilitation program.
Action you should take
When billing for OASAS outpatient rehabilitation services, use the following appropriate HCPCS and rate code combination, based on your existing program certification(s):
| Rate Codes | APG CPT/HCPCS Codes |
|---|---|
Outpatient Clinic: 1540 / 1528 |
H2001 – Outpatient Rehabilitation, Half Day (2–4 hours) H2036 – Outpatient Rehabilitation, Full Day (4+ hours) |
Opioid Treatment Program (OTP): 1564 / 1567 |
|
Certified Outpatient Program (COP): 1036 / 1039 |
Get more info
Review the New York Office of Addiction Services and Supports Part 822 Blanket Waivers for additional information.
If you have further questions, you may contact your Provider Relations advocate.
