Approved State Directed Payment Preprints

Uniform dollar increase and minimum fee schedule for home and community-based services and behavioral health outpatient services established by the state for the rating period covering July 1, 2025 through June 30, 2026, incorporated in the capitation rates through a risk-based rate adjustment.

The uniform dollar increase for inpatient discharges and outpatient visits to qualifying critical access hospitals for the rating period covering July 1, 2025 through June 30, 2026, incorporated in the capitation rates through a separate payment term amount of up to $94,725,164.

Uniform dollar increase for eligible inpatient hospital and outpatient hospital services at Government general hospitals, other than those operated by the State of New York or the State University of New York, located in a city with a population of over one million for the rating period covering April 1, 2024, through March 31, 2025, incorporated in the capitation rates through a separate payment term of up to $2,287,256,013.

Uniform increase for inpatient and outpatient services delivered by qualifying financially distressed hospitals for the rating period, April 1, 2025 through March 31, 2026, incorporated into the capitation rates through a separate payment term up to $1,840,386,150.

Uniform increase for Sole Community Hospitals as established by the state for outpatient services for the rating period, April 1, 2025 through March 31, 2026, incorporated into the capitation rates through a separate payment term up to $145,653,499.

Uniform increase established by the state for inpatient and outpatient hospital services provided by Rural Type A/B hospitals for the rating period covering January 1, 2025 through December 31, 2025, incorporated in the capitation rates through a separate payment term of up to $190,000,000.

Uniform increase established by the state for inpatient and outpatient hospital services provided by Diagnosis-Related Group (DRG) hospitals for the rating period covering January 1, 2025 through December 31, 2025, incorporated in the capitation rates through a separate payment term of up to $1,011,000,000.

Uniform increase established by the state for qualified licensed professionals employed by a state university owned or operated hospital or affiliated practice, state owned and operated school of dentistry, or public hospital district for the rating period covering January 1, 2025 through December 31, 2025, incorporated in the capitation rates through a separate payment term of up to $132,480,000.

Uniform percentage increase for inpatient and outpatient services for qualifying classes of hospitals for the rating period covering January 1, 2025 through December 31, 2025, incorporated in the capitation rates through a separate payment term of up to $424,720,803.

Uniform percentage increase established by the state for inpatient and outpatient hospital services for the rating period, January 1, 2025 through December 31, 2025, incorporated into the capitation rates through a separate payment term up to $2,335,007,317.