2020 Calendar Year Forms (January to December)

Select schedules have been combined below allowing you to print sections of the CFR by only having to open one file.  In order to print an individual schedule please scroll down to that section.

To print schedules by a particular grouping, use the links below:

Core Schedules PDF Icon Image (571KB) (CFR-1 - CFR-6 & DMH-1)

Claiming Schedules PDF Icon Image (147KB) (DMH-2 - DMH-3)

OMH Supplemental Schedules PDF Icon Image (170KB) (OMH-1 -4)

Abbreviated Filer Schedules PDF Icon Image (434KB)

OPWDD Supplemental Schedules PDF Icon Image (188KB) (OPWDD-1, 2, & 5)

Mini-Abbreviated Filer Schedules PDF Icon Image (252KB)

SED Supplemental Schedules PDF Icon Image (210KB) (SED-1 & 4)

To print Individual Schedules, use the links below:

CFR-i PDF Icon Image (93KB) Agency Identification and Certification Statement

CFR-ii PDF Icon Image (120KB) Accountant's Report - Voluntary Agency or County Government

CFR-iiA PDF Icon Image (99KB) Accountant's Report - Voluntary Agency or County Government

CFR-iii PDF Icon Image (96KB) County/NYC Certification Statement

CFR-iv PDF Icon Image (159KB) Supplemental Attestation Schedule

CFR-1 PDF Icon Image (499KB) Program/Site Data

CFR-2 PDF Icon Image (273KB) Agency Fiscal Summary

CFR-2A PDF Icon Image (155KB) Agency Fiscal Data

CFR-3 PDF Icon Image (264KB) Agency Administration

CFR-4 PDF Icon Image (214KB) Personal Services

CFR-4A PDF Icon Image (187KB) Contracted Direct Care and Clinical Personal Services

CFR-5 PDF Icon Image (158KB) Transactions with Related Organizations/Individuals

CFR-6 PDF Icon Image (KB) Governing Board and Compensation Summary

DMH-1 PDF Icon Image (237KB) Program Fiscal Summary

DMH-2 PDF Icon Image (244KB) Aid to Localities/Direct Contract Summary

DMH-3 PDF Icon Image (197KB) Aid to Localities and Direct Contracts Program Funding Source Summary

OMH-1 PDF Icon Image (216KB) Units of Service by Program/Site

OMH-2 PDF Icon Image (350KB) Medicaid Units of Service by Program/Site

OMH-3 PDF Icon Image (78KB) Client Information

OMH-4 PDF Icon Image (83KB) Units of Service by Payor by Program/Site

OPWDD-1 PDF Icon Image (141KB) Schedule of Services-ICF/DD, CRs, IRAs, and Day Treatment Programs

OPWDD-2 PDF Icon Image (149KB) ICF/DD & CR Medical Supplies

OPWDD-5 PDF Icon Image (206KB) Capital Schedule

SED-1 PDF Icon Image (670KB) Program and Enrollment Data

SED-4 PDF Icon Image (144KB) Related Service Capacity, Need and Productivity

SUPP-1 PDF Icon Image (158KB) Supplemental Schedule

COVID-19 PDF Icon Image (246KB) Informational Schedule

COVID-19S PDF Icon Image (249KB) Informational Schedule

Last Updated: December 31, 2020