Billing Guidelines Update for 29-I VFCAs

The New York State Department of Health (NYSDOH) recently changed the billing guidelines for 29-I Voluntary Foster Care Agencies (VFCAs).

Please make note of the following:

• The Article 29-I VFCA Health Facility Billing Manual was updated to remove the Non-Billable Services Chart in Appendix C.
• For practitioners who render office visits in an Article 29-I Health Facility, you may now submit claims for any, and all medically necessary services within your scope of practice as permitted by the Article 29-I Health Facility’s license.
• Effective Nov. 20, 2025, VFCA office visit claims submitted to EmblemHealth must include all procedure codes necessary to capture the totality of the service(s) delivered.
• Procedure codes that are not listed in the manual for an office visit claim are considered non-billable codes. The services for these non-billable codes will be captured for encounter data, and the claim lines will pay $0. 

Note: A VFCA claim must reflect the units delivered in the encounter. If a non-billable procedure code is used on a claim, it will be treated as one unit on the claim and will pay $0. Only billable codes on the claim will be eligible for payment and reflected in the paid amount.

View the billing manual and get more information at the New York State Department of Health.

If you still have questions, email us at medicaid_care_coordination_@emblemhealth.com.