MedicaidAdministrativeMedium impact
[New York] Reminder: state mandate — behavioral health appointment wait times
Anthem BCBS·NY · Psychiatry·Specialty Services
Effective date
Apr 1, 2026
We identified it
May 3, 2026
Summary
New York State Medicaid now requires behavioral health providers to meet specific appointment wait time standards (10 business days for initial outpatient appointments, 7 calendar days post-discharge) and attest annually to compliance through Availity Essentials. Billing teams must ensure contracted behavioral health providers have completed this attestation to maintain network participation and avoid claim issues.
Action Required
By April 1, 2026: Verify that all contracted behavioral health providers in New York have completed annual attestation of appointment wait time compliance via Availity Essentials Digital Post Office. Billing team should maintain documentation of provider attestations on file. Coordinate with credentialing/contracting department to ensure non-compliant providers are flagged for remediation. Failure to maintain provider compliance may result in network adequacy violations and claim processing delays for Medicaid behavioral health services.