Notification of Billing Updates: Dual Diagnosis (DD) – Inpatient Services
TO: All Behavioral Health Providers
IMPACTED PLANS: Medicaid, HIV SNP, HARP and MAP
Dear MetroPlusHealth Provider,
This memo is to provide notification of billing updates for the Dual Diagnosis (DD) Inpatient Services program for adults and children retro-effective January 1, 2025.
Reimbursement Criteria
Only New York State (NYS) hospital-based specialized inpatient psychiatric units that are certified and licensed by the Office of Mental Health (OMH) to provide DD-Inpatient Services, are eligible to receive the separate reimbursement rate for dates of service (retro) effective 1/1/2025 onwards.
- A DD-Inpatient Services unit provides specialized inpatient psychiatric services and care dedicated solely to the treatment of adults and children with diagnoses of both mental illness and developmental disability.
Billing Rate Codes:
- 4607 Psychiatric Exempt Dual Diagnosis Child Rate
- 4608 Psychiatric Exempt Dual Diagnosis Adult Rate
If you have any questions regarding this memo, please contact MetroPlusHealth at [email protected].
last updated: October 20, 2025