School-Based Health Center Carve-In

DOH has postponed the implementation of the School-Based Health Center (SBHC) carve-in to no sooner than May 1, 2025. This delay follows feedback from health centers requesting additional time to prepare and coordinate with Medicaid Managed Care plans.

CHCANYS worked with DOH to ensure that PPS protections remain in place. DOH has released guidance confirming that health centers may continue to bill for supplemental wraparound payments and use Court-Ordered Rate Codes (CORC) as part of the carve-in process.

During the March 18, 2025, CHCANYS Reimbursement Committee meeting, Peter Epp and Dolores DiRe from CohnReznick presented key considerations to support health centers during this transition. See the recordingand slidesfrom that presentation.

For additional information, including billing guidance and the updated implementation timeline, refer to the NYS Department of Health's Mainstream Medicaid Managed Care and SBHCs Guide.