Feb 25, 2026
New York State
Department of Health
Bureau of Early Intervention (BEI) Electronic Mailing List
Early Intervention 4% Rate Modifier – Retroactive Escrow Payment
Dear
Colleague:
The New York State Department of Health (Department) Bureau of
Early Intervention is pleased to announce that payment of the 4% rate increase retroactive to April 1, 2025, for
eligible EI services payable from municipal escrow will be made on March 18,
2026.
For Early Intervention (EI) Medicaid claims, the Office of Health
Insurance Programs (OHIP) has not yet updated eMedNY to be able to process the
4% rate modifier.
The Department will provide an update when the 4% rate modifier is
implemented in eMedNY for claims payable from Medicaid.
The 4% rate modifier is applied to core in-person EI services that
are provided to children who reside in rural and underserved areas of New York
State that meet certain criteria. The following core services are eligible for
the 4% rate modifier: screenings, multidisciplinary evaluations (MDEs),
bilingual add-ons, and speech therapy, occupational therapy, physical therapy,
and special instruction services authorized as Basic Home and Community visits.
Telehealth services are not eligible for the modifier.
Counties and providers do not have to take any additional action
in the data system (EI-Hub), e.g., service authorizations or claim code. The
EI-HUB will apply the 4% rate modifier based on the service type and child’s
residential zip code.
Pursuant to
the 4% Medicaid State Plan Amendment, the eligible zip codes will be reviewed
periodically, not less than annually.
If you have any questions regarding this notice, please contact
the Bureau of Early Intervention at EIP.Fiscal@health.ny.gov or by phone at (518)
473-7016.