NEW YORK STATE
MEDICAID PROGRAM
INF
ORMATION FOR ALL PROVIDERS
MANAGED CARE INFORMATION
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Information for All Providers – Managed Care Information
July 22, 2024
Table of Contents
PREPAID CAPITATION PLANS (PCP) ....................................................................................... 3
COUNTY/DISTRICT CODES ........................................................................................................ 7
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Information for All Providers – Managed Care Information
July 22, 2024
Prepaid Capitation Plans (PCP)
Key
Plan Type Abbreviation
description
Model Contract Link
Partial LTC
Long Term Care: Partial Capitation
https://www.health.ny.gov/health_care/medicaid/redesign/mrt90/2023/
docs/part_cap_model.pdf
LTC Pace
Long Term Care: PACE
http://www.health.ny.gov/health_care/medicaid/redesign/docs/mrt90_pac
e_model_contract.pdf
Medicaid Adv Plus
Long Term Care: Medicaid Advantage
Plus
https://www.health.ny.gov/health_care/medicaid/redesign/mrt90/
docs/2022-2026-map_model_contract.pdf
FHP
Family Health Plus
http://www.health.ny.gov/health_care/managed_care/docs/medicaid_ma
naged_care_fhp_hiv-snp_model_contract.pdf
SNP
Special Needs Plan
http://www.health.ny.gov/health_care/managed_care/docs/medicaid_ma
naged_care_fhp_hiv-snp_model_contract.pdf
Mainstream
Medical Assistance
http://www.health.ny.gov/health_care/managed_care/docs/medicaid_ma
naged_care_fhp_hiv-snp_model_contract.pdf
FIDA IDD
Fully Integrated Duals Advantage Plan –
Intellectual and Developmental Disabilities
https://opwdd.ny.gov/opwdd_services_supports/people_first_waiver/care
_management/FIDA_IDD
HARP
Health and Recovery Plan
http://www.health.ny.gov/health_care/managed_care/docs/medicaid_ma
naged_care_fhp_hiv-snp_model_contract.pdf
Plan Code
Plan ID#
Telephone Number
Plan Type
92
00894519
(800) 597-3380
Mainstream
AA
04004537
(800) 454-3730
HARP
AC
03114514
Managed Long Term Care Inc)
(866) 263-9083
TTY (800) 662-1220
LTC Pace
AH
03458546
(855) 456-9126
TTY (711)
Partial LTC
C2
01249265
(716) 887-6900
Mainstream
C3
06283361
(716)887-8680
HARP
C7
01234037
(877) 226-8500
TTY (800) 650-2774
LTC Pace
CC
03320725
(888)303-4333
TTY (716) 285-8248
LTC Pace
CD
04342316
HARP
CG
01183013
(518) 641-3500
(800) 926-7626
Mainstream
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Information for All Providers – Managed Care Information
July 22, 2024
Plan Code
Plan ID#
PCP Provider Name
Telephone Number
Plan Type
CH
03072740
Catholic Health Life PACE
(855) 671-3341
TTY (716) 819-5084
LTC Pace
CM
05357520
Centers Plan for Medicaid
Advantage Plus
(833)-274-5627
TTY: 1800 421 1220
Medicaid Adv Plus
CP
03506989
Centers Plan for Healthy Living
(855) 270-1600
TTY (800) 421-1220
Partial LTC
E7
01674982
Senior Care Connection
(855) 376-7888
TTY (800) 662-1220
LTC Pace
EA
05410146
Elderserve Health MAP, INC
1-800-580-7000
TTY/TDD: 711
Medicaid Adv Plus
ED
03253707
Elderplan, Inc., Homefirst
(866) 389-2656
TTY (800) 662-1220
Partial LTC
EE
04342343
Excellus – Blue Option Plus - HARP
HARP
EG
03690851
KALOS Health
(ErieNiagara MLTCP
Inc)
(800) 894-2464
TTY (800) 662-1220
Partial LTC
EH
03234044
RiverSpring at Home
(Elderserve Health Inc)
(800) 370-3600
TTY (866) 236-5800
Partial LTC
FZ
04190745
Fallon Health Weinberg PACE
(855) 665-1113
(TTY 711)
LTC PACE
GD
01788325
Fidelis Care at Home
(888) 343-3547
TTY (800) 695-8544
Partial LTC
H1
02104369
Senior Health
Partners
(Healthfirst PHSP,
Inc)
(866) 585-9280
TTY (800) 662-1220
Partial LTC
HA
06259723
Hamaspik MAP INC
(855) 552-4642
TTY/TDD: (855) 854-
4030
Medicaid Adv Plus
HC
03522947
Hamaspik Choice
(855) 552-4642
TTY (877) 544-6220
Partial LTC
HF
04003696
Healthfirst PHSP Person Wellness Plan
(866) 463-6743
HARP
HI
04082293
HIP of Greater NY
(646) 447-5000
HARP
HT,98,99
00313979
HIP of Greater NY
(646) 447-5000
Mainstream
HW
01131584
HIP Westchester
(646) 447-5000
Mainstream
HY
01202822
HIP Nassau
(646) 447-5000
Mainstream
IC
03866960
iCircle Service of the Finger Lakes
(844) 424-7253
TTY (711)
Partial LTC
IE
01208997
Independent Health Association
(800) 736-5771
Mainstream
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Information for All Providers – Managed Care Information
July 22, 2024
Plan Code
Plan ID#
PCP Provider Name
Telephone Number
Plan Type
IH
04342325
Independent Health’s
MediSource Connect - HARP
HARP
IL
01278899
ElderOne
(Independent Living for Seniors)
(855) 457-4636
TTY (800) 662-1220
LTC Pace
IS
01519162
PACE CNY
(Loretto HMO)
(888) 728-7223
TTY (800) 662-1220
LTC Pace
KP
01617894
Anthem HP, LLC
(800) 454-3730
Mainstream
KX
02644562
Anthem Blue Cross and Blue Shield
HP
(866) 805-4589
TTY (800) 855-2880
Partial LTC
MA
04342334
MVP Harmonious Health Care Plan -
HARP
HARP
MC
06097149
MetroPlus Health Ultracare
855-552-4642
Medicaid Adv Plus
MH
03420808
HealthFirst Complete Care
(HealthFirst Health Plan)
(888) 260-1010
TTY (888) 542-3821
Medicaid Adv Plus
MO
01403176
United HealthCare of NY, Inc.
(877) 842-3210
Mainstream
MP
03466906
MetroPlus MLTC
(855) 355-6582
TTY (800) 881-2812
Partial LTC
MR
00477023
Excellus
(800) 920-8889
Mainstream
MT
04053201
Metroplus Health Plan Inc.
(800) 597-3380
HARP
MV
01111375
MVP, Inc.
(800) 684-9286
Mainstream
NC
04004486
HealthierLife
(800) 749-0820
HARP
OD
02191582
Amida Care Inc., (VidaCare, Inc., SN)
(646) 786-1800
SNP
OM
02191362
Metroplus Partnership Care SN
(800) 303-9626
SNP
PO
04099212
Partners Health Plan
(855) 747-5483
TTY (711)
FIDA-IDD
SF
01479670
HealthFirst PHSP, Inc.
(866) 463-6743
Mainstream
SP
01421250
Fidelis Care New York
(800) 749-0820
Mainstream
SP
01751046
Fidelis Care New York
(800) 749-0820
Mainstream
SW
03459881
Senior Whole Health
(877) 353-0185
TTY (711)
Partial LTC
TN
04342292
Molina Healthcare Plan of NY
HARP
TO
03685774
Molina Healthcare of New York Inc.
(TONY)
(315) 476-7921
Mainstream
TS
03056544
Total Senior Care PACE
(866) 939-8613
TTY (800) 662-1220
LTC Pace
UC
04054091
United Healthcare of New York
(877) 842-3210
HARP
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Information for All Providers – Managed Care Information
July 22, 2024
Plan Code
Plan ID#
PCP Provider Name
Telephone Number
Plan Type
UM
06788572
UnitedHealthcare Dual Complete NY-
001
(866) 547-0772
TTY: 711
Medicaid Adv
Plus
VA
03529059
Nascentia Health
(VNA Homecare Options)
(855) 877-8868
TTY (711)
Partial LTC
VC
01750467
VNS Health MLTC
(VNS Choice)
(888) 867-6555
TTY (711)
Partial LTC
VL
03420399
Village Care Max
(800) 469-6292
TTY (800) 662-1220
Partial LTC
VM
04682248
VillageCareMAX Total Advantage
(800) 469-6292
TTY (800) 662-1220
Medicaid Adv Plus
VS
03420871
VNS Choice Select Health SNP
(866) 469-7774
SNP
YF
02927631
Fidelis Care MAP
(877) 533-2404
TTY (800)558-1125
Medicaid Adv Plus
YH
02932896
Senior Whole Health MAP
(877) 353-0185
TTY (711)
Medicaid Adv Plus
YL
03173113
Elderplan MAP
(866) 386-9437
TTY (800) 662-1220
Medicaid Adv Plus
YN
02914056
VNS Health Total
(VNS Choice Plus M/M)
(866) 597-6674
TTY 711
Medicaid Adv Plus
YO
03173080
Anthem HealthPlus Full Dual
Advantage LTSS
(866) 805-4589
TTY (800) 855/2880
Medicaid Adv Plus
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Information for All Providers – Managed Care Information
July 22, 2024
County/District Codes
Below is a listing of all the counties and their corresponding district codes.
01
Albany
02 Allegany
03 Broome
04 Cattaraugus
05 Cayuga
06 Chautauqua
07 Chemung
08 Chenango
09 Clinton
10 Columbia
11 Cortland
12 Delaware
13 Dutchess
14 Erie
15 Essex
16 Franklin
17 Fulton
18 Genesee
19 Greene
20 Hamilton
21 Herkimer
22 Jefferson
23 Lewis
24 Livingston
25 Madison
26 Monroe
27
Montgomery
28 Nassau
29 Niagara
30 Oneida
31 Onondaga
32 Ontario
33
Orange
34
Orleans
35 Oswego
36 Otsego
37 Putnam
38 Rensselaer
39 Rockland
40 St. Lawrence
41 Saratoga
42 Schenectady
43 Schoharie
44 Schuyler
45 Seneca
46 Steuben
47 Suffolk
48 Sullivan
49 Tioga
50 Tompkins
51 Ulster
52 Warren
53 Washington
54 Wayne
55 Westchester
56 Wyoming
57 Yates
66 New York City
78 New York State of Health
97 Office of Mental Health
Administered
98 Office for People with
Developmental Disabilities
99
Breast & Cervical Cancer
Treatment Program