The State Plan Amendment (SPA) enabling health centers to bill for Community Health Worker (CHW) services has been officially approved. This amendment, initially passed as part of the 2024 state budget, marks an important step toward expanding reimbursement options for health centers.
Currently, CHW services are reimbursed at $35 per 30-minute unit, with a maximum of 12 units per patient per year. The Medicaid CHW Services Policy Manual, last updated in January 2024, provides foundational guidance on these services. However, it does not yet address FQHC-specific implementation details.
CHCANYS has requested updated guidance from DOH tailored for health centers. Once available, we will distribute a one-pager outlining the CHW scope of practice, documentation standards, and eligibility criteria to ensure smooth implementation.