What is EI-Hub?
EI-Hub is New York State's web-based case management and billing system for the Early Intervention Program. It launched in October 2024 and is managed by PCG (Public Consulting Group) under a state contract.
EI-Hub is the central system for everything in the EI program: referrals, evaluations, service authorizations, session notes, billing submissions, and payment processing. Every agency and individual provider in the state is required to use it.
Centralizing everything under one system should have made things simpler. Instead, the rollout was called a disaster by therapists and agencies across the state.
What went wrong with the EI-Hub rollout
The October 15, 2024 go-live date was met with immediate system failures. Within the first weeks of operation, providers began reporting that claims submitted through EI-Hub were being rejected at rates far above anything previously experienced. Some agencies reported rejection rates approaching 90% of all submitted claims.
The problems stacked up fast:
- System errors in claim processing. The billing module had technical errors that caused properly submitted claims to be rejected on procedural grounds unrelated to the actual service rendered.
- Provider enrollment data mismatches. Some providers whose credentials were correctly registered under the old system found their information had not migrated correctly to EI-Hub, causing automatic rejection of all their submissions.
- Authorization mismatches. Cases that had valid service authorizations under the old system were sometimes not correctly reflected in EI-Hub, leading claims to be rejected as unauthorized.
- Inadequate provider training. Many therapists and agency billing staff had limited time to learn the new system before it went live, resulting in submission errors from the provider side on top of the system errors.
The human impact
The practical result was that therapists were showing up to homes across New York City, delivering services to infants and toddlers with developmental delays and not getting paid. Some went weeks without a check. Some reported going into the December holiday period with significant outstanding unpaid claims.
"The week before Christmas I had therapists reach out to me saying that they were not reimbursed what they were expected to be reimbursed, and that they did not have money for their holidays," said one agency administrator quoted in reporting from North Country Public Radio in January 2025.
The 2025 rate increase, and the telehealth surprise
Adding to the confusion: on January 1, 2025, New York State submitted paperwork to implement a 5% rate increase for EI services. It was the first pay increase for providers since 1994, more than 30 years of rates being flat or declining in real terms.
The rate increase was genuinely good news. But buried in the same state plan amendment was a provision few providers had seen coming: a proposed 20–22% decrease in telehealth EI reimbursement rates in New York City.
"Who's going to work with a 22% decrease?" one Staten Island speech pathologist told reporters. "That's a big cut. That's nearly a quarter of your pay."
For therapists who had built telehealth practices during and after the pandemic, often serving families in remote areas, bilingual families who were easier to reach virtually, or children for whom telehealth worked surprisingly well, this proposal was effectively a termination of those services.
What the current state looks like (March 2026)
The EI-Hub system is more stable than it was in late 2024, but it is not fully resolved. Claim rejection rates have improved significantly for most providers, but the system still has known issues with certain claim types and provider enrollment edge cases.
The 5% rate increase was implemented retroactively to October 2024, but as of early 2026, federal CMS approval for the full increase is still pending for certain provider categories. With the current federal administration's Medicaid policy direction, advocates have expressed concern that the increase may not be fully implemented.
The telehealth rate cut proposal drew significant pushback from providers and advocates, and its implementation timeline has been delayed. The current status is unclear and worth monitoring if telehealth is part of your practice.
How to protect your income from EI-Hub problems
Option 1: Work with an agency that handles billing for you
This is the most reliable way to protect your income from EI-Hub problems. Tech-forward agencies like Bloomer Health have built their own billing infrastructure that sits on top of EI-Hub. You submit your session documentation through their platform, and they handle the translation to EI-Hub claims, error checking, resubmission, and payment tracking.
For these agencies, EI-Hub is a backend system their billing staff deals with, not something you touch directly. If a claim is rejected, their team catches it and resolves it without it affecting your payment cycle.
Option 2: Submit claims as quickly as possible after each session
If you're an individual provider or working with an agency that requires you to submit your own claims, the single most important habit is submitting immediately after each session rather than batching claims at the end of the week. This minimizes the claims volume in flux at any one time and makes errors easier to catch early.
Option 3: Track every claim submission with a confirmation number
EI-Hub generates a submission confirmation number for each claim. Keep a record. If a claim disappears or is rejected without a clear reason, the confirmation number is your starting point for resolution with the state's EI-Hub help desk.
Option 4: Know your escalation path
For unresolved billing issues, the relevant contacts are:
- EI-Hub Help Desk: The primary technical support contact for system issues. Response times improved significantly after the initial rollout period but can still be slow during high-volume periods.
- NYC DOHMH Early Intervention Program: EITA@health.nyc.gov for NYC-specific issues.
- NYS DOH Bureau of Early Intervention: beipub@health.ny.gov for statewide policy questions.
- Your agency's billing coordinator: If you're working through an agency, they should be your first call. They have experience navigating these issues and direct lines to resolution paths.
Option 5: Document everything
If you're in a dispute with an agency over unpaid claims, or experiencing a billing issue you believe is the agency's responsibility rather than a system error, you need documentation: session notes with timestamps, submission confirmations, correspondence with the agency's billing staff, and records of when you followed up. Disputes are hard to resolve without a paper trail.
The bigger picture: NY ranks last in EI nationally
The EI-Hub problems didn't happen in isolation. New York State ranks 50th in the nation for EI delivery. The rate structure that was lower in 2022 than it was in 1994. A state billing system that caused a crisis at rollout. These are symptoms of a program that has been chronically underfunded and under-reformed for decades.
Since 2019, over 2,500 therapists have left the EI program in New York State because of insufficient rates of pay. The children who need these services are losing qualified providers at exactly the moment they should be receiving consistent, intensive therapy.
Advocating for better rates and better systems matters. Organizations like The Children's Agenda and statewide provider groups have been central to pushing for the rate increases that have partially materialized. Staying connected to those advocacy efforts, even as an individual provider, is worth doing.
The one thing that actually solves this for therapists
The EI-Hub situation really does show why your agency choice matters. The agencies that weathered the 2024 billing crisis best were the ones that had invested in their own billing infrastructure and had the organizational capacity to absorb system errors without passing the pain to providers.
If billing problems are hitting your paycheck right now, that's worth taking seriously. There are agencies in NYC that have made the investment. Working with one of them is the most practical protection you have against the next EI-Hub disruption.