10/1/25 Medicaid Wrap Rates Released (Cycle 2551)

The October 1, 2025 Medicaid wrap rate package has been released in Cycle 2551, with a check date of July 29, 2026. This rate package is based on health center 2024 MCVR submissions, and DOH will reprocess claims using the updated rates.

If your health center is owed money, the amount will be paid in a lump sum.

If your health center has a liability:

• DOH will withhold 15% from weekly Medicaid payments until the liability is repaid.
• Interest would normally begin after 10 weeks at Prime + 2% (currently over 10%).
• CHCANYS advocated for this interest to be waived, and DOH has agreed to do so for health centers included in our waiver request.
• If the 15% withholding would not repay the liability within one year, DOH may increase the withholding percentage so the balance is repaid within 12 months.

CHCANYS also worked with DOH to ensure the NYRx Reinvestment payments were released before this rate package so any wrap rate liability would not be recovered from those payments.

If your health center believes it may have a liability and would like CHCANYS to request an interest waiver on its behalf, please complete this form by July 17: https://forms.office.com/r/m3pyYnuLPn

DOH requires MMIS/Provider ID numbers for each site included in the waiver request so the interest waiver can be applied to the correct Medicaid payments.