February 2026 Top of Mind

NYCE PPO Plan members can now access the Optum Behavioral Health Network

Getting calls from New York City Employees PPO Plan members who want to schedule an appointment with you?

It’s not a mistake – NYCE PPO plan members are no longer covered by Carelon. As of Jan. 1, 2026, they must work with an Optum Behavioral Health-contracted provider* for mental health and substance use disorder treatment.

Two key administrative changes you must follow

As an Optum-contracted provider, you’ll need to follow the NYCE PPO Plan processes and systems when you provide service(s) to their members. Optum is not managing the benefits for the plan. We have simply made our network of providers available to their members.

To prevent claim denials and payment delays, update your processes to manage NYCE PPO claims accurately:

1. Use Payer ID 26992 on your NYCE PPO Plan claims. Do not use the Optum Behavioral Health payer ID (87726). Claims submitted to Optum will be denied and you will need to resubmit them to the NYCE PPO plan. If you aren’t currently enrolled to receive ERAs from this Payer ID, please work with your clearinghouse to do so today. Be sure to set up your payment method through NYCE PPO as well to help ensure prompt payments.
2. Use the secure NYCE PPO Provider Portal (not the Provider Express secure portal) for these members. You need to use the NYCE portal to check benefits, submit prior authorization requests and manage claims and appeals for this plan. This information will not be available through the Optum Provider Express secure portal. But – you can use the same One Healthcare ID to log into both portals. You do not need to create an ID specifically for the NYCE PPO provider portal.

National impacts of this change

Using an Optum-contracted provider for mental health and substance abuse disorder treatment applies to current New York City employees, non-Medicare retirees and their dependents nationwide who have coverage through the NYCE PPO plan. It also applies to upstate New York counties and the 13 downstate New York Counties: Bronx, Duchess, Kings, Nassau, New York, Orange, Putnam, Queens, Richmond, Rockland, Suffolk, Ulster and Westchester.

Questions?

• Need additional information? Check out our Quick Reference Guide.
• Log into the secure NYCE PPO Provider PortaL with your One Healthcare ID.
• NYCE PPO Plan questions: Call the NYCE PPO Provider Service Center at 1-844-849-5750, 7 a.m. – 7 p.m. CT, Monday – Friday.
• Optum Behavioral Health credentialing or contracting questions: Call the Optum Provider Service Center at 1-877-614-0484, 7 a.m. – 7 p.m. CT, Monday – Friday.

* United Behavioral Health operates under the brand Optum on some contracts, not all. Regardless of whether it says United Behavioral Health or Optum, they are one in the same.