Approved State Directed Payment Preprints

Minimum Fee Schedule for primary care services for the rating period covering January1, 2026 through December 31, 2026, incorporated in the capitation rates through a risk-based rate adjustment of up to $10,750,000.

Population-based payment for primary care services for the rating period covering January 1, 2026 through December 31, 2026, incorporated in the capitation rates through a separate payment term amount of up to $29,300,000.

Uniform dollar increase for inpatient and outpatient hospital services to qualifying non-critical access hospitals for rating periods covering July 1, 2025 through June 30, 2026,incorporated in the capitation rates through a separate payment term amount of up to$104,752,459.

Uniform increase for non-state owned or operated hospitals 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 of up to $1,410,710,373.

Uniform increase for nursing facility services provided by Class II (publicly owned) nursing facilities with greater than 500 licensed beds for the rating period, July 1, 2025 through June 30, 2026, incorporated into the capitation rates through a separate payment term up to $18,207,438.

Uniform dollar increase for inpatient and outpatient hospital services to qualifying hospitals for rating periods covering July 1, 2025 through June 30, 2026, incorporated in the capitation rates through a separate payment term amount of up to $75,251,849.

The uniform dollar increase established by the state for direct care workers providing personal care services to eligible enrollees for the rating period covering October 1, 2025, until September 30, 2026 incorporated in the capitation rates through a risk-based rate adjustment.

Uniform dollar increase for eligible behavioral health inpatient services for the rating period covering July 1, 2025 through June 30, 2026, incorporated in the capitation rates through a risk-based rate adjustment of up to $136,400,000.

The uniform dollar increase for Early and Periodic Screening, Diagnostic, and Treatment (EPSDT) screening services for the rating period covering July 1, 2025 through June 30, 2026, incorporated in the capitation rates through a risk-based rate adjustment.

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, 2025, through March 31, 2026, incorporated in the capitation rates through a separate payment term of up to $2,450,610,170.