CY2024 EPS HHA MW ROS Medicaid Rates

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Certified Home Health Agencies

New York State Medicaid - Episodic Payment System

Rate
Code		 Rate Code Description 1/1/20
Effective Date
Latest Approved		 4/1/22
Effective Date
1% Enhancement		 10/1/2022
Minimum Wage
Increase 5.25% 		1/1/2024
Minimum Wage
Increase .55%
4810 EPS START OF CARE, CLIN A, FUNC E, AGE GRP 1 $2,036.63 $2,057.00 $2,164.99 $2,176.90
4811 EPS START OF CARE, CLIN A, FUNC E, AGE GRP 2 $2,266.91 $2,289.58 $2,409.78 $2,423.03
4812 EPS START OF CARE, CLIN A, FUNC E, AGE GRP 3 $2,266.91 $2,289.58 $2,409.78 $2,423.03
4813 EPS START OF CARE, CLIN A, FUNC E, AGE GRP 4 $2,635.34 $2,661.69 $2,801.43 $2,816.84
4814 EPS START OF CARE, CLIN A, FUNC E, AGE GRP 5 $2,635.34 $2,661.69 $2,801.43 $2,816.84
4815 EPS START OF CARE, CLIN A, FUNC E, AGE GRP 6 $2,777.76 $2,805.54 $2,952.83 $2,969.07
4816 EPS START OF CARE, CLIN A, FUNC F, AGE GRP 1 $3,161.71 $3,193.33 $3,360.98 $3,379.47
4817 EPS START OF CARE, CLIN A, FUNC F, AGE GRP 2 $3,687.78 $3,724.66 $3,920.20 $3,941.76
4818 EPS START OF CARE, CLIN A, FUNC F, AGE GRP 3 $3,687.78 $3,724.66 $3,920.20 $3,941.76
4819 EPS START OF CARE, CLIN A, FUNC F, AGE GRP 4 $4,079.96 $4,120.76 $4,337.10 $4,360.95
4820 EPS START OF CARE, CLIN A, FUNC F, AGE GRP 5 $4,079.96 $4,120.76 $4,337.10 $4,360.95
4821 EPS START OF CARE, CLIN A, FUNC F, AGE GRP 6 $4,533.28 $4,578.61 $4,818.99 $4,845.49
4822 EPS START OF CARE, CLIN A, FUNC G, AGE GRP 1 $3,820.52 $3,858.73 $4,061.31 $4,083.65
4823 EPS START OF CARE, CLIN A, FUNC G, AGE GRP 2 $4,103.92 $4,144.96 $4,362.57 $4,386.56
4824 EPS START OF CARE, CLIN A, FUNC G, AGE GRP 3 $4,103.92 $4,144.96 $4,362.57 $4,386.56
4825 EPS START OF CARE, CLIN A, FUNC G, AGE GRP 4 $4,960.44 $5,010.04 $5,273.07 $5,302.07
4826 EPS START OF CARE, CLIN A, FUNC G, AGE GRP 5 $4,960.44 $5,010.04 $5,273.07 $5,302.07
4827 EPS START OF CARE, CLIN A, FUNC G, AGE GRP 6 $6,360.35 $6,423.95 $6,761.21 $6,798.40
4828 EPS START OF CARE, CLIN B, FUNC E, AGE GRP 1 $2,291.03 $2,313.94 $2,435.42 $2,448.81
4829 EPS START OF CARE, CLIN B, FUNC E, AGE GRP 2 $2,487.44 $2,512.31 $2,644.21 $2,658.75
4830 EPS START OF CARE, CLIN B, FUNC E, AGE GRP 3 $2,487.44 $2,512.31 $2,644.21 $2,658.75
4831 EPS START OF CARE, CLIN B, FUNC E, AGE GRP 4 $2,573.06 $2,598.79 $2,735.23 $2,750.27
4832 EPS START OF CARE, CLIN B, FUNC E, AGE GRP 5 $2,573.06 $2,598.79 $2,735.23 $2,750.27
4833 EPS START OF CARE, CLIN B, FUNC E, AGE GRP 6 $2,800.71 $2,828.72 $2,977.22 $2,993.59
4834 EPS START OF CARE, CLIN B, FUNC F, AGE GRP 1 $3,512.24 $3,547.36 $3,733.60 $3,754.13
4835 EPS START OF CARE, CLIN B, FUNC F, AGE GRP 2 $3,778.23 $3,816.01 $4,016.35 $4,038.44
4836 EPS START OF CARE, CLIN B, FUNC F, AGE GRP 3 $3,778.23 $3,816.01 $4,016.35 $4,038.44
4837 EPS START OF CARE, CLIN B, FUNC F, AGE GRP 4 $4,216.11 $4,258.27 $4,481.83 $4,506.48
4838 EPS START OF CARE, CLIN B, FUNC F, AGE GRP 5 $4,216.11 $4,258.27 $4,481.83 $4,506.48
4839 EPS START OF CARE, CLIN B, FUNC F, AGE GRP 6 $4,627.07 $4,673.34 $4,918.69 $4,945.74
4840 EPS START OF CARE, CLIN B, FUNC G, AGE GRP 1 $4,915.44 $4,964.59 $5,225.24 $5,253.98
4841 EPS START OF CARE, CLIN B, FUNC G, AGE GRP 2 $5,543.06 $5,598.49 $5,892.41 $5,924.82
4842 EPS START OF CARE, CLIN B, FUNC G, AGE GRP 3 $5,543.06 $5,598.49 $5,892.41 $5,924.82
4843 EPS START OF CARE, CLIN B, FUNC G, AGE GRP 4 $6,582.34 $6,648.16 $6,997.19 $7,035.67
4844 EPS START OF CARE, CLIN B, FUNC G, AGE GRP 5 $6,582.34 $6,648.16 $6,997.19 $7,035.67
4845 EPS START OF CARE, CLIN B, FUNC G, AGE GRP 6 $7,187.88 $7,259.76 $7,640.90 $7,682.92
4846 EPS START OF CARE, CLIN C, FUNC E, AGE GRP 1 $2,511.16 $2,536.27 $2,669.43 $2,684.11
4847 EPS START OF CARE, CLIN C, FUNC E, AGE GRP 2 $2,849.21 $2,877.70 $3,028.78 $3,045.44
4848 EPS START OF CARE, CLIN C, FUNC E, AGE GRP 3 $2,849.21 $2,877.70 $3,028.78 $3,045.44
4849 EPS START OF CARE, CLIN C, FUNC E, AGE GRP 4 $3,086.25 $3,117.11 $3,280.76 $3,298.80
4850 EPS START OF CARE, CLIN C, FUNC E, AGE GRP 5 $3,086.25 $3,117.11 $3,280.76 $3,298.80
4851 EPS START OF CARE, CLIN C, FUNC E, AGE GRP 6 $3,782.27 $3,820.09 $4,020.65 $4,042.76
4852 EPS START OF CARE, CLIN C, FUNC F, AGE GRP 1 $4,511.25 $4,556.36 $4,795.57 $4,821.95
4853 EPS START OF CARE, CLIN C, FUNC F, AGE GRP 2 $5,210.64 $5,262.75 $5,539.04 $5,569.50
4854 EPS START OF CARE, CLIN C, FUNC F, AGE GRP 3 $5,210.64 $5,262.75 $5,539.04 $5,569.50
4855 EPS START OF CARE, CLIN C, FUNC F, AGE GRP 4 $5,793.68 $5,851.62 $6,158.83 $6,192.70
4856 EPS START OF CARE, CLIN C, FUNC F, AGE GRP 5 $5,793.68 $5,851.62 $6,158.83 $6,192.70
4857 EPS START OF CARE, CLIN C, FUNC F, AGE GRP 6 $6,089.15 $6,150.04 $6,472.92 $6,508.52
4858 EPS START OF CARE, CLIN C, FUNC G, AGE GRP 1 $5,647.17 $5,703.64 $6,003.08 $6,036.10
4859 EPS START OF CARE, CLIN C, FUNC G, AGE GRP 2 $7,942.98 $8,022.41 $8,443.59 $8,490.03
4860 EPS START OF CARE, CLIN C, FUNC G, AGE GRP 3 $7,942.98 $8,022.41 $8,443.59 $8,490.03
4861 EPS START OF CARE, CLIN C, FUNC G, AGE GRP 4 $7,969.83 $8,049.53 $8,472.13 $8,518.73
4862 EPS START OF CARE, CLIN C, FUNC G, AGE GRP 5 $7,969.83 $8,049.53 $8,472.13 $8,518.73
4863 EPS START OF CARE, CLIN C, FUNC G, AGE GRP 6 $9,236.38 $9,328.74 $9,818.50 $9,872.50
4864 EPS RECERTIFICATION, CLIN A, FUNC E, AGE GRP 1 $1,496.68 $1,511.65 $1,591.01 $1,599.76
4865 EPS RECERTIFICATION, CLIN A, FUNC E, AGE GRP 2 $1,635.88 $1,652.24 $1,738.98 $1,748.54
4866 EPS RECERTIFICATION, CLIN A, FUNC E, AGE GRP 3 $1,635.88 $1,652.24 $1,738.98 $1,748.54
4867 EPS RECERTIFICATION, CLIN A, FUNC E, AGE GRP 4 $2,387.46 $2,411.33 $2,537.93 $2,551.89
4868 EPS RECERTIFICATION, CLIN A, FUNC E, AGE GRP 5 $2,387.46 $2,411.33 $2,537.93 $2,551.89
4869 EPS RECERTIFICATION, CLIN A, FUNC E, AGE GRP 6 $2,531.39 $2,556.70 $2,690.93 $2,705.73
4870 EPS RECERTIFICATION, CLIN A, FUNC F, AGE GRP 1 $3,560.28 $3,595.88 $3,784.67 $3,805.49
4871 EPS RECERTIFICATION, CLIN A, FUNC F, AGE GRP 2 $3,737.70 $3,775.08 $3,973.27 $3,995.12
4872 EPS RECERTIFICATION, CLIN A, FUNC F, AGE GRP 3 $3,737.70 $3,775.08 $3,973.27 $3,995.12
4873 EPS RECERTIFICATION, CLIN A, FUNC F, AGE GRP 4 $4,819.60 $4,867.80 $5,123.36 $5,151.54
4874 EPS RECERTIFICATION, CLIN A, FUNC F, AGE GRP 5 $4,819.60 $4,867.80 $5,123.36 $5,151.54
4875 EPS RECERTIFICATION, CLIN A, FUNC F, AGE GRP 6 $5,304.94 $5,357.99 $5,639.28 $5,670.30
4876 EPS RECERTIFICATION, CLIN A, FUNC G, AGE GRP 1 $4,412.54 $4,456.67 $4,690.64 $4,716.44
4877 EPS RECERTIFICATION, CLIN A, FUNC G, AGE GRP 2 $4,204.08 $4,246.12 $4,469.04 $4,493.62
4878 EPS RECERTIFICATION, CLIN A, FUNC G, AGE GRP 3 $4,204.08 $4,246.12 $4,469.04 $4,493.62
4879 EPS RECERTIFICATION, CLIN A, FUNC G, AGE GRP 4 $6,084.43 $6,145.27 $6,467.90 $6,503.47
4880 EPS RECERTIFICATION, CLIN A, FUNC G, AGE GRP 5 $6,084.43 $6,145.27 $6,467.90 $6,503.47
4881 EPS RECERTIFICATION, CLIN A, FUNC G, AGE GRP 6 $7,595.12 $7,671.07 $8,073.80 $8,118.21
4882 EPS RECERTIFICATION, CLIN B, FUNC E, AGE GRP 1 $1,748.99 $1,766.48 $1,859.22 $1,869.45
4883 EPS RECERTIFICATION, CLIN B, FUNC E, AGE GRP 2 $1,910.82 $1,929.93 $2,031.25 $2,042.42
4884 EPS RECERTIFICATION, CLIN B, FUNC E, AGE GRP 3 $1,910.82 $1,929.93 $2,031.25 $2,042.42
4885 EPS RECERTIFICATION, CLIN B, FUNC E, AGE GRP 4 $2,445.08 $2,469.53 $2,599.18 $2,613.48
4886 EPS RECERTIFICATION, CLIN B, FUNC E, AGE GRP 5 $2,445.08 $2,469.53 $2,599.18 $2,613.48
4887 EPS RECERTIFICATION, CLIN B, FUNC E, AGE GRP 6 $2,720.27 $2,747.47 $2,891.72 $2,907.62
4888 EPS RECERTIFICATION, CLIN B, FUNC F, AGE GRP 1 $3,692.48 $3,729.40 $3,925.20 $3,946.79
4889 EPS RECERTIFICATION, CLIN B, FUNC F, AGE GRP 2 $4,288.41 $4,331.29 $4,558.69 $4,583.76
4890 EPS RECERTIFICATION, CLIN B, FUNC F, AGE GRP 3 $4,288.41 $4,331.29 $4,558.69 $4,583.76
4891 EPS RECERTIFICATION, CLIN B, FUNC F, AGE GRP 4 $5,308.99 $5,362.08 $5,643.59 $5,674.63
4892 EPS RECERTIFICATION, CLIN B, FUNC F, AGE GRP 5 $5,308.99 $5,362.08 $5,643.59 $5,674.63
4893 EPS RECERTIFICATION, CLIN B, FUNC F, AGE GRP 6 $5,780.92 $5,838.73 $6,145.26 $6,179.06
4894 EPS RECERTIFICATION, CLIN B, FUNC G, AGE GRP 1 $5,019.77 $5,069.97 $5,336.14 $5,365.49
4895 EPS RECERTIFICATION, CLIN B, FUNC G, AGE GRP 2 $6,088.04 $6,148.92 $6,471.74 $6,507.33
4896 EPS RECERTIFICATION, CLIN B, FUNC G, AGE GRP 3 $6,088.04 $6,148.92 $6,471.74 $6,507.33
4897 EPS RECERTIFICATION, CLIN B, FUNC G, AGE GRP 4 $8,435.56 $8,519.92 $8,967.21 $9,016.53
4898 EPS RECERTIFICATION, CLIN B, FUNC G, AGE GRP 5 $8,435.56 $8,519.92 $8,967.21 $9,016.53
4899 EPS RECERTIFICATION, CLIN B, FUNC G, AGE GRP 6 $9,258.78 $9,351.37 $9,842.31 $9,896.44
4900 EPS RECERTIFICATION, CLIN C, FUNC E, AGE GRP 1 $1,783.87 $1,801.71 $1,896.30 $1,906.73
4901 EPS RECERTIFICATION, CLIN C, FUNC E, AGE GRP 2 $2,463.52 $2,488.16 $2,618.78 $2,633.18
4902 EPS RECERTIFICATION, CLIN C, FUNC E, AGE GRP 3 $2,463.52 $2,488.16 $2,618.78 $2,633.18
4903 EPS RECERTIFICATION, CLIN C, FUNC E, AGE GRP 4 $3,678.18 $3,714.96 $3,910.00 $3,931.51
4904 EPS RECERTIFICATION, CLIN C, FUNC E, AGE GRP 5 $3,678.18 $3,714.96 $3,910.00 $3,931.51
4905 EPS RECERTIFICATION, CLIN C, FUNC E, AGE GRP 6 $2,997.65 $3,027.63 $3,186.58 $3,204.11
4906 EPS RECERTIFICATION, CLIN C, FUNC F, AGE GRP 1 $4,803.16 $4,851.19 $5,105.88 $5,133.96
4907 EPS RECERTIFICATION, CLIN C, FUNC F, AGE GRP 2 $6,228.07 $6,290.35 $6,620.59 $6,657.00
4908 EPS RECERTIFICATION, CLIN C, FUNC F, AGE GRP 3 $6,228.07 $6,290.35 $6,620.59 $6,657.00
4909 EPS RECERTIFICATION, CLIN C, FUNC F, AGE GRP 4 $6,891.58 $6,960.50 $7,325.92 $7,366.21
4910 EPS RECERTIFICATION, CLIN C, FUNC F, AGE GRP 5 $6,891.58 $6,960.50 $7,325.92 $7,366.21
4911 EPS RECERTIFICATION, CLIN C, FUNC F, AGE GRP 6 $7,928.35 $8,007.63 $8,428.03 $8,474.38
4912 EPS RECERTIFICATION, CLIN C, FUNC G, AGE GRP 1 $7,412.10 $7,486.22 $7,879.25 $7,922.59
4913 EPS RECERTIFICATION, CLIN C, FUNC G, AGE GRP 2 $11,621.63 $11,737.85 $12,354.08 $12,422.03
4914 EPS RECERTIFICATION, CLIN C, FUNC G, AGE GRP 3 $11,621.63 $11,737.85 $12,354.08 $12,422.03
4915 EPS RECERTIFICATION, CLIN C, FUNC G, AGE GRP 4 $10,131.57 $10,232.88 $10,770.11 $10,829.35
4916 EPS RECERTIFICATION, CLIN C, FUNC G, AGE GRP 5 $10,131.57 $10,232.88 $10,770.11 $10,829.35
4917 EPS RECERTIFICATION, CLIN C, FUNC G, AGE GRP 6 $14,053.64 $14,194.17 $14,939.37 $15,021.54
4920 EPS MATERNITY, NO OASIS, 18 AND OLDER $1,496.68 $1,511.65 $1,591.01 $1,599.76
Rate
Code		 Rate Code Description 1/1/19
Effective Date
Latest Approved		 4/1/22
Effective Date
1% Enhancement		 10/1/2022
Minimum Wage
Increase 5.61% 		1/1/2024
Minimum Wage
Increase .61%
4810 EPS START OF CARE, CLIN A, FUNC E, AGE GRP 1 $2,321.72 $2,344.94 $2,476.49 $2,491.60
4811 EPS START OF CARE, CLIN A, FUNC E, AGE GRP 2 $2,584.22 $2,610.06 $2,756.49 $2,773.30
4812 EPS START OF CARE, CLIN A, FUNC E, AGE GRP 3 $2,584.22 $2,610.06 $2,756.49 $2,773.30
4813 EPS START OF CARE, CLIN A, FUNC E, AGE GRP 4 $3,004.23 $3,034.28 $3,204.50 $3,224.05
4814 EPS START OF CARE, CLIN A, FUNC E, AGE GRP 5 $3,004.23 $3,034.28 $3,204.50 $3,224.05
4815 EPS START OF CARE, CLIN A, FUNC E, AGE GRP 6 $3,166.59 $3,198.26 $3,377.68 $3,398.28
4816 EPS START OF CARE, CLIN A, FUNC F, AGE GRP 1 $3,604.29 $3,640.34 $3,844.56 $3,868.01
4817 EPS START OF CARE, CLIN A, FUNC F, AGE GRP 2 $4,203.99 $4,246.03 $4,484.23 $4,511.58
4818 EPS START OF CARE, CLIN A, FUNC F, AGE GRP 3 $4,203.99 $4,246.03 $4,484.23 $4,511.58
4819 EPS START OF CARE, CLIN A, FUNC F, AGE GRP 4 $4,651.07 $4,697.58 $4,961.12 $4,991.38
4820 EPS START OF CARE, CLIN A, FUNC F, AGE GRP 5 $4,651.07 $4,697.58 $4,961.12 $4,991.38
4821 EPS START OF CARE, CLIN A, FUNC F, AGE GRP 6 $5,167.84 $5,219.52 $5,512.34 $5,545.97
4822 EPS START OF CARE, CLIN A, FUNC G, AGE GRP 1 $4,355.32 $4,398.87 $4,645.65 $4,673.99
4823 EPS START OF CARE, CLIN A, FUNC G, AGE GRP 2 $4,678.38 $4,725.16 $4,990.24 $5,020.68
4824 EPS START OF CARE, CLIN A, FUNC G, AGE GRP 3 $4,678.38 $4,725.16 $4,990.24 $5,020.68
4825 EPS START OF CARE, CLIN A, FUNC G, AGE GRP 4 $5,654.80 $5,711.35 $6,031.75 $6,068.54
4826 EPS START OF CARE, CLIN A, FUNC G, AGE GRP 5 $5,654.80 $5,711.35 $6,031.75 $6,068.54
4827 EPS START OF CARE, CLIN A, FUNC G, AGE GRP 6 $7,250.67 $7,323.17 $7,734.00 $7,781.18
4828 EPS START OF CARE, CLIN B, FUNC E, AGE GRP 1 $2,611.73 $2,637.85 $2,785.83 $2,802.82
4829 EPS START OF CARE, CLIN B, FUNC E, AGE GRP 2 $2,835.63 $2,863.99 $3,024.66 $3,043.11
4830 EPS START OF CARE, CLIN B, FUNC E, AGE GRP 3 $2,835.63 $2,863.99 $3,024.66 $3,043.11
4831 EPS START OF CARE, CLIN B, FUNC E, AGE GRP 4 $2,933.23 $2,962.57 $3,128.76 $3,147.85
4832 EPS START OF CARE, CLIN B, FUNC E, AGE GRP 5 $2,933.23 $2,962.57 $3,128.76 $3,147.85
4833 EPS START OF CARE, CLIN B, FUNC E, AGE GRP 6 $3,192.75 $3,224.68 $3,405.58 $3,426.35
4834 EPS START OF CARE, CLIN B, FUNC F, AGE GRP 1 $4,003.88 $4,043.92 $4,270.79 $4,296.84
4835 EPS START OF CARE, CLIN B, FUNC F, AGE GRP 2 $4,307.11 $4,350.18 $4,594.22 $4,622.24
4836 EPS START OF CARE, CLIN B, FUNC F, AGE GRP 3 $4,307.11 $4,350.18 $4,594.22 $4,622.24
4837 EPS START OF CARE, CLIN B, FUNC F, AGE GRP 4 $4,806.28 $4,854.34 $5,126.67 $5,157.94
4838 EPS START OF CARE, CLIN B, FUNC F, AGE GRP 5 $4,806.28 $4,854.34 $5,126.67 $5,157.94
4839 EPS START OF CARE, CLIN B, FUNC F, AGE GRP 6 $5,274.76 $5,327.51 $5,626.38 $5,660.70
4840 EPS START OF CARE, CLIN B, FUNC G, AGE GRP 1 $5,603.50 $5,659.54 $5,977.04 $6,013.50
4841 EPS START OF CARE, CLIN B, FUNC G, AGE GRP 2 $6,318.97 $6,382.15 $6,740.19 $6,781.31
4842 EPS START OF CARE, CLIN B, FUNC G, AGE GRP 3 $6,318.97 $6,382.15 $6,740.19 $6,781.31
4843 EPS START OF CARE, CLIN B, FUNC G, AGE GRP 4 $7,503.73 $7,578.77 $8,003.94 $8,052.76
4844 EPS START OF CARE, CLIN B, FUNC G, AGE GRP 5 $7,503.73 $7,578.77 $8,003.94 $8,052.76
4845 EPS START OF CARE, CLIN B, FUNC G, AGE GRP 6 $8,194.02 $8,275.96 $8,740.24 $8,793.56
4846 EPS START OF CARE, CLIN C, FUNC E, AGE GRP 1 $2,862.67 $2,891.30 $3,053.50 $3,072.13
4847 EPS START OF CARE, CLIN C, FUNC E, AGE GRP 2 $3,248.05 $3,280.53 $3,464.56 $3,485.69
4848 EPS START OF CARE, CLIN C, FUNC E, AGE GRP 3 $3,248.05 $3,280.53 $3,464.56 $3,485.69
4849 EPS START OF CARE, CLIN C, FUNC E, AGE GRP 4 $3,518.27 $3,553.45 $3,752.80 $3,775.69
4850 EPS START OF CARE, CLIN C, FUNC E, AGE GRP 5 $3,518.27 $3,553.45 $3,752.80 $3,775.69
4851 EPS START OF CARE, CLIN C, FUNC E, AGE GRP 6 $4,311.70 $4,354.82 $4,599.12 $4,627.17
4852 EPS START OF CARE, CLIN C, FUNC F, AGE GRP 1 $5,142.72 $5,194.15 $5,485.54 $5,519.00
4853 EPS START OF CARE, CLIN C, FUNC F, AGE GRP 2 $5,940.02 $5,999.42 $6,335.99 $6,374.64
4854 EPS START OF CARE, CLIN C, FUNC F, AGE GRP 3 $5,940.02 $5,999.42 $6,335.99 $6,374.64
4855 EPS START OF CARE, CLIN C, FUNC F, AGE GRP 4 $6,604.67 $6,670.71 $7,044.94 $7,087.91
4856 EPS START OF CARE, CLIN C, FUNC F, AGE GRP 5 $6,604.67 $6,670.71 $7,044.94 $7,087.91
4857 EPS START OF CARE, CLIN C, FUNC F, AGE GRP 6 $6,941.51 $7,010.92 $7,404.24 $7,449.41
4858 EPS START OF CARE, CLIN C, FUNC G, AGE GRP 1 $6,437.65 $6,502.03 $6,866.79 $6,908.68
4859 EPS START OF CARE, CLIN C, FUNC G, AGE GRP 2 $9,054.85 $9,145.39 $9,658.45 $9,717.37
4860 EPS START OF CARE, CLIN C, FUNC G, AGE GRP 3 $9,054.85 $9,145.39 $9,658.45 $9,717.37
4861 EPS START OF CARE, CLIN C, FUNC G, AGE GRP 4 $9,085.44 $9,176.29 $9,691.08 $9,750.20
4862 EPS START OF CARE, CLIN C, FUNC G, AGE GRP 5 $9,085.44 $9,176.29 $9,691.08 $9,750.20
4863 EPS START OF CARE, CLIN C, FUNC G, AGE GRP 6 $10,529.28 $10,634.57 $11,231.17 $11,299.68
4864 EPS RECERTIFICATION, CLIN A, FUNC E, AGE GRP 1 $1,706.19 $1,723.25 $1,819.92 $1,831.02
4865 EPS RECERTIFICATION, CLIN A, FUNC E, AGE GRP 2 $1,864.87 $1,883.52 $1,989.18 $2,001.31
4866 EPS RECERTIFICATION, CLIN A, FUNC E, AGE GRP 3 $1,864.87 $1,883.52 $1,989.18 $2,001.31
4867 EPS RECERTIFICATION, CLIN A, FUNC E, AGE GRP 4 $2,721.67 $2,748.88 $2,903.09 $2,920.80
4868 EPS RECERTIFICATION, CLIN A, FUNC E, AGE GRP 5 $2,721.67 $2,748.88 $2,903.09 $2,920.80
4869 EPS RECERTIFICATION, CLIN A, FUNC E, AGE GRP 6 $2,885.74 $2,914.60 $3,078.10 $3,096.88
4870 EPS RECERTIFICATION, CLIN A, FUNC F, AGE GRP 1 $4,058.64 $4,099.22 $4,329.19 $4,355.60
4871 EPS RECERTIFICATION, CLIN A, FUNC F, AGE GRP 2 $4,260.90 $4,303.51 $4,544.94 $4,572.66
4872 EPS RECERTIFICATION, CLIN A, FUNC F, AGE GRP 3 $4,260.90 $4,303.51 $4,544.94 $4,572.66
4873 EPS RECERTIFICATION, CLIN A, FUNC F, AGE GRP 4 $5,494.25 $5,549.19 $5,860.50 $5,896.25
4874 EPS RECERTIFICATION, CLIN A, FUNC F, AGE GRP 5 $5,494.25 $5,549.19 $5,860.50 $5,896.25
4875 EPS RECERTIFICATION, CLIN A, FUNC F, AGE GRP 6 $6,047.53 $6,108.01 $6,450.67 $6,490.02
4876 EPS RECERTIFICATION, CLIN A, FUNC G, AGE GRP 1 $5,030.21 $5,080.51 $5,365.53 $5,398.26
4877 EPS RECERTIFICATION, CLIN A, FUNC G, AGE GRP 2 $4,792.57 $4,840.50 $5,112.05 $5,143.23
4878 EPS RECERTIFICATION, CLIN A, FUNC G, AGE GRP 3 $4,792.57 $4,840.50 $5,112.05 $5,143.23
4879 EPS RECERTIFICATION, CLIN A, FUNC G, AGE GRP 4 $6,936.12 $7,005.48 $7,398.49 $7,443.62
4880 EPS RECERTIFICATION, CLIN A, FUNC G, AGE GRP 5 $6,936.12 $7,005.48 $7,398.49 $7,443.62
4881 EPS RECERTIFICATION, CLIN A, FUNC G, AGE GRP 6 $8,658.27 $8,744.86 $9,235.44 $9,291.78
4882 EPS RECERTIFICATION, CLIN B, FUNC E, AGE GRP 1 $1,993.80 $2,013.74 $2,126.71 $2,139.68
4883 EPS RECERTIFICATION, CLIN B, FUNC E, AGE GRP 2 $2,178.29 $2,200.07 $2,323.50 $2,337.67
4884 EPS RECERTIFICATION, CLIN B, FUNC E, AGE GRP 3 $2,178.29 $2,200.07 $2,323.50 $2,337.67
4885 EPS RECERTIFICATION, CLIN B, FUNC E, AGE GRP 4 $2,787.35 $2,815.23 $2,973.16 $2,991.30
4886 EPS RECERTIFICATION, CLIN B, FUNC E, AGE GRP 5 $2,787.35 $2,815.23 $2,973.16 $2,991.30
4887 EPS RECERTIFICATION, CLIN B, FUNC E, AGE GRP 6 $3,101.05 $3,132.07 $3,307.77 $3,327.95
4888 EPS RECERTIFICATION, CLIN B, FUNC F, AGE GRP 1 $4,209.37 $4,251.46 $4,489.97 $4,517.36
4889 EPS RECERTIFICATION, CLIN B, FUNC F, AGE GRP 2 $4,888.70 $4,937.58 $5,214.58 $5,246.39
4890 EPS RECERTIFICATION, CLIN B, FUNC F, AGE GRP 3 $4,888.70 $4,937.58 $5,214.58 $5,246.39
4891 EPS RECERTIFICATION, CLIN B, FUNC F, AGE GRP 4 $6,052.14 $6,112.66 $6,455.58 $6,494.96
4892 EPS RECERTIFICATION, CLIN B, FUNC F, AGE GRP 5 $6,052.14 $6,112.66 $6,455.58 $6,494.96
4893 EPS RECERTIFICATION, CLIN B, FUNC F, AGE GRP 6 $6,590.12 $6,656.02 $7,029.43 $7,072.31
4894 EPS RECERTIFICATION, CLIN B, FUNC G, AGE GRP 1 $5,722.44 $5,779.67 $6,103.90 $6,141.13
4895 EPS RECERTIFICATION, CLIN B, FUNC G, AGE GRP 2 $6,940.23 $7,009.64 $7,402.88 $7,448.04
4896 EPS RECERTIFICATION, CLIN B, FUNC G, AGE GRP 3 $6,940.23 $7,009.64 $7,402.88 $7,448.04
4897 EPS RECERTIFICATION, CLIN B, FUNC G, AGE GRP 4 $9,616.36 $9,712.53 $10,257.40 $10,319.97
4898 EPS RECERTIFICATION, CLIN B, FUNC G, AGE GRP 5 $9,616.36 $9,712.53 $10,257.40 $10,319.97
4899 EPS RECERTIFICATION, CLIN B, FUNC G, AGE GRP 6 $10,554.82 $10,660.37 $11,258.41 $11,327.09
4900 EPS RECERTIFICATION, CLIN C, FUNC E, AGE GRP 1 $2,033.59 $2,053.92 $2,169.15 $2,182.38
4901 EPS RECERTIFICATION, CLIN C, FUNC E, AGE GRP 2 $2,808.36 $2,836.44 $2,995.57 $3,013.84
4902 EPS RECERTIFICATION, CLIN C, FUNC E, AGE GRP 3 $2,808.36 $2,836.44 $2,995.57 $3,013.84
4903 EPS RECERTIFICATION, CLIN C, FUNC E, AGE GRP 4 $4,193.05 $4,234.98 $4,472.57 $4,499.85
4904 EPS RECERTIFICATION, CLIN C, FUNC E, AGE GRP 5 $4,193.05 $4,234.98 $4,472.57 $4,499.85
4905 EPS RECERTIFICATION, CLIN C, FUNC E, AGE GRP 6 $3,417.24 $3,451.42 $3,645.04 $3,667.27
4906 EPS RECERTIFICATION, CLIN C, FUNC F, AGE GRP 1 $5,475.50 $5,530.25 $5,840.50 $5,876.13
4907 EPS RECERTIFICATION, CLIN C, FUNC F, AGE GRP 2 $7,099.86 $7,170.86 $7,573.15 $7,619.35
4908 EPS RECERTIFICATION, CLIN C, FUNC F, AGE GRP 3 $7,099.86 $7,170.86 $7,573.15 $7,619.35
4909 EPS RECERTIFICATION, CLIN C, FUNC F, AGE GRP 4 $7,856.26 $7,934.82 $8,379.96 $8,431.08
4910 EPS RECERTIFICATION, CLIN C, FUNC F, AGE GRP 5 $7,856.26 $7,934.82 $8,379.96 $8,431.08
4911 EPS RECERTIFICATION, CLIN C, FUNC F, AGE GRP 6 $9,038.16 $9,128.54 $9,640.65 $9,699.46
4912 EPS RECERTIFICATION, CLIN C, FUNC G, AGE GRP 1 $8,449.64 $8,534.13 $9,012.90 $9,067.88
4913 EPS RECERTIFICATION, CLIN C, FUNC G, AGE GRP 2 $13,248.41 $13,380.89 $14,131.56 $14,217.76
4914 EPS RECERTIFICATION, CLIN C, FUNC G, AGE GRP 3 $13,248.41 $13,380.89 $14,131.56 $14,217.76
4915 EPS RECERTIFICATION, CLIN C, FUNC G, AGE GRP 4 $11,549.77 $11,665.27 $12,319.69 $12,394.84
4916 EPS RECERTIFICATION, CLIN C, FUNC G, AGE GRP 5 $11,549.77 $11,665.27 $12,319.69 $12,394.84
4917 EPS RECERTIFICATION, CLIN C, FUNC G, AGE GRP 6 $16,020.86 $16,181.07 $17,088.83 $17,193.07
4920 EPS MATERNITY, NO OASIS, 18 AND OLDER $1,706.19 $1,723.25 $1,819.92 $1,831.02
Rate
Code 		Rate Code Description 10/1/15
Effective Date
Latest Approved		 4/1/22
Effective Date
1% Enhancement		 10/1/2022
Minimum Wage
Increase 3.56%		 1/1/2023
Minimum Wage
Increase 1.83%		 1/1/2024
Minimum Wage
Increase 2.63%
4810 EPS START OF CARE, CLIN A, FUNC E, AGE GRP 1 $1,658.85 $1,675.44 $1,735.08 $1,766.83 $1,813.30
4811 EPS START OF CARE, CLIN A, FUNC E, AGE GRP 2 $1,846.42 $1,864.88 $1,931.27 $1,966.61 $2,018.33
4812 EPS START OF CARE, CLIN A, FUNC E, AGE GRP 3 $1,846.42 $1,864.88 $1,931.27 $1,966.61 $2,018.33
4813 EPS START OF CARE, CLIN A, FUNC E, AGE GRP 4 $2,146.51 $2,167.98 $2,245.16 $2,286.25 $2,346.38
4814 EPS START OF CARE, CLIN A, FUNC E, AGE GRP 5 $2,146.51 $2,167.98 $2,245.16 $2,286.25 $2,346.38
4815 EPS START OF CARE, CLIN A, FUNC E, AGE GRP 6 $2,262.51 $2,285.14 $2,366.49 $2,409.80 $2,473.18
4816 EPS START OF CARE, CLIN A, FUNC F, AGE GRP 1 $2,575.24 $2,600.99 $2,693.59 $2,742.88 $2,815.02
4817 EPS START OF CARE, CLIN A, FUNC F, AGE GRP 2 $3,003.73 $3,033.77 $3,141.77 $3,199.26 $3,283.40
4818 EPS START OF CARE, CLIN A, FUNC F, AGE GRP 3 $3,003.73 $3,033.77 $3,141.77 $3,199.26 $3,283.40
4819 EPS START OF CARE, CLIN A, FUNC F, AGE GRP 4 $3,323.16 $3,356.39 $3,475.88 $3,539.49 $3,632.58
4820 EPS START OF CARE, CLIN A, FUNC F, AGE GRP 5 $3,323.16 $3,356.39 $3,475.88 $3,539.49 $3,632.58
4821 EPS START OF CARE, CLIN A, FUNC F, AGE GRP 6 $3,692.40 $3,729.32 $3,862.09 $3,932.77 $4,036.20
4822 EPS START OF CARE, CLIN A, FUNC G, AGE GRP 1 $3,111.85 $3,142.97 $3,254.86 $3,314.42 $3,401.59
4823 EPS START OF CARE, CLIN A, FUNC G, AGE GRP 2 $3,342.68 $3,376.11 $3,496.30 $3,560.28 $3,653.92
4824 EPS START OF CARE, CLIN A, FUNC G, AGE GRP 3 $3,342.68 $3,376.11 $3,496.30 $3,560.28 $3,653.92
4825 EPS START OF CARE, CLIN A, FUNC G, AGE GRP 4 $4,040.32 $4,080.72 $4,226.00 $4,303.34 $4,416.52
4826 EPS START OF CARE, CLIN A, FUNC G, AGE GRP 5 $4,040.32 $4,080.72 $4,226.00 $4,303.34 $4,416.52
4827 EPS START OF CARE, CLIN A, FUNC G, AGE GRP 6 $5,180.56 $5,232.37 $5,418.64 $5,517.80 $5,662.92
4828 EPS START OF CARE, CLIN B, FUNC E, AGE GRP 1 $1,866.06 $1,884.72 $1,951.82 $1,987.54 $2,039.81
4829 EPS START OF CARE, CLIN B, FUNC E, AGE GRP 2 $2,026.04 $2,046.30 $2,119.15 $2,157.93 $2,214.68
4830 EPS START OF CARE, CLIN B, FUNC E, AGE GRP 3 $2,026.04 $2,046.30 $2,119.15 $2,157.93 $2,214.68
4831 EPS START OF CARE, CLIN B, FUNC E, AGE GRP 4 $2,095.78 $2,116.74 $2,192.09 $2,232.21 $2,290.92
4832 EPS START OF CARE, CLIN B, FUNC E, AGE GRP 5 $2,095.78 $2,116.74 $2,192.09 $2,232.21 $2,290.92
4833 EPS START OF CARE, CLIN B, FUNC E, AGE GRP 6 $2,281.20 $2,304.01 $2,386.03 $2,429.69 $2,493.59
4834 EPS START OF CARE, CLIN B, FUNC F, AGE GRP 1 $2,860.75 $2,889.36 $2,992.22 $3,046.98 $3,127.12
4835 EPS START OF CARE, CLIN B, FUNC F, AGE GRP 2 $3,077.40 $3,108.17 $3,218.82 $3,277.72 $3,363.92
4836 EPS START OF CARE, CLIN B, FUNC F, AGE GRP 3 $3,077.40 $3,108.17 $3,218.82 $3,277.72 $3,363.92
4837 EPS START OF CARE, CLIN B, FUNC F, AGE GRP 4 $3,434.06 $3,468.40 $3,591.88 $3,657.61 $3,753.81
4838 EPS START OF CARE, CLIN B, FUNC F, AGE GRP 5 $3,434.06 $3,468.40 $3,591.88 $3,657.61 $3,753.81
4839 EPS START OF CARE, CLIN B, FUNC F, AGE GRP 6 $3,768.79 $3,806.48 $3,941.99 $4,014.13 $4,119.70
4840 EPS START OF CARE, CLIN B, FUNC G, AGE GRP 1 $4,003.67 $4,043.71 $4,187.66 $4,264.29 $4,376.44
4841 EPS START OF CARE, CLIN B, FUNC G, AGE GRP 2 $4,514.87 $4,560.02 $4,722.36 $4,808.78 $4,935.25
4842 EPS START OF CARE, CLIN B, FUNC G, AGE GRP 3 $4,514.87 $4,560.02 $4,722.36 $4,808.78 $4,935.25
4843 EPS START OF CARE, CLIN B, FUNC G, AGE GRP 4 $5,361.37 $5,414.98 $5,607.76 $5,710.38 $5,860.56
4844 EPS START OF CARE, CLIN B, FUNC G, AGE GRP 5 $5,361.37 $5,414.98 $5,607.76 $5,710.38 $5,860.56
4845 EPS START OF CARE, CLIN B, FUNC G, AGE GRP 6 $5,854.59 $5,913.14 $6,123.64 $6,235.70 $6,399.70
4846 EPS START OF CARE, CLIN C, FUNC E, AGE GRP 1 $2,045.36 $2,065.81 $2,139.36 $2,178.51 $2,235.80
4847 EPS START OF CARE, CLIN C, FUNC E, AGE GRP 2 $2,320.71 $2,343.92 $2,427.36 $2,471.78 $2,536.79
4848 EPS START OF CARE, CLIN C, FUNC E, AGE GRP 3 $2,320.71 $2,343.92 $2,427.36 $2,471.78 $2,536.79
4849 EPS START OF CARE, CLIN C, FUNC E, AGE GRP 4 $2,513.78 $2,538.92 $2,629.30 $2,677.42 $2,747.84
4850 EPS START OF CARE, CLIN C, FUNC E, AGE GRP 5 $2,513.78 $2,538.92 $2,629.30 $2,677.42 $2,747.84
4851 EPS START OF CARE, CLIN C, FUNC E, AGE GRP 6 $3,080.69 $3,111.50 $3,222.27 $3,281.24 $3,367.54
4852 EPS START OF CARE, CLIN C, FUNC F, AGE GRP 1 $3,674.45 $3,711.19 $3,843.31 $3,913.64 $4,016.57
4853 EPS START OF CARE, CLIN C, FUNC F, AGE GRP 2 $4,244.11 $4,286.55 $4,439.15 $4,520.39 $4,639.28
4854 EPS START OF CARE, CLIN C, FUNC F, AGE GRP 3 $4,244.11 $4,286.55 $4,439.15 $4,520.39 $4,639.28
4855 EPS START OF CARE, CLIN C, FUNC F, AGE GRP 4 $4,719.00 $4,766.19 $4,935.87 $5,026.20 $5,158.39
4856 EPS START OF CARE, CLIN C, FUNC F, AGE GRP 5 $4,719.00 $4,766.19 $4,935.87 $5,026.20 $5,158.39
4857 EPS START OF CARE, CLIN C, FUNC F, AGE GRP 6 $4,959.67 $5,009.27 $5,187.60 $5,282.53 $5,421.46
4858 EPS START OF CARE, CLIN C, FUNC G, AGE GRP 1 $4,599.67 $4,645.67 $4,811.05 $4,899.09 $5,027.94
4859 EPS START OF CARE, CLIN C, FUNC G, AGE GRP 2 $6,469.63 $6,534.33 $6,766.95 $6,890.79 $7,072.02
4860 EPS START OF CARE, CLIN C, FUNC G, AGE GRP 3 $6,469.63 $6,534.33 $6,766.95 $6,890.79 $7,072.02
4861 EPS START OF CARE, CLIN C, FUNC G, AGE GRP 4 $6,491.50 $6,556.42 $6,789.82 $6,914.07 $7,095.91
4862 EPS START OF CARE, CLIN C, FUNC G, AGE GRP 5 $6,491.50 $6,556.42 $6,789.82 $6,914.07 $7,095.91
4863 EPS START OF CARE, CLIN C, FUNC G, AGE GRP 6 $7,523.11 $7,598.34 $7,868.84 $8,012.84 $8,223.58
4864 EPS RECERTIFICATION, CLIN A, FUNC E, AGE GRP 1 $1,219.06 $1,231.25 $1,275.08 $1,298.41 $1,332.56
4865 EPS RECERTIFICATION, CLIN A, FUNC E, AGE GRP 2 $1,332.44 $1,345.76 $1,393.67 $1,419.17 $1,456.49
4866 EPS RECERTIFICATION, CLIN A, FUNC E, AGE GRP 3 $1,332.44 $1,345.76 $1,393.67 $1,419.17 $1,456.49
4867 EPS RECERTIFICATION, CLIN A, FUNC E, AGE GRP 4 $1,944.61 $1,964.06 $2,033.98 $2,071.20 $2,125.67
4868 EPS RECERTIFICATION, CLIN A, FUNC E, AGE GRP 5 $1,944.61 $1,964.06 $2,033.98 $2,071.20 $2,125.67
4869 EPS RECERTIFICATION, CLIN A, FUNC E, AGE GRP 6 $2,061.84 $2,082.46 $2,156.59 $2,196.06 $2,253.82
4870 EPS RECERTIFICATION, CLIN A, FUNC F, AGE GRP 1 $2,899.88 $2,928.88 $3,033.15 $3,088.66 $3,169.89
4871 EPS RECERTIFICATION, CLIN A, FUNC F, AGE GRP 2 $3,044.39 $3,074.83 $3,184.30 $3,242.57 $3,327.85
4872 EPS RECERTIFICATION, CLIN A, FUNC F, AGE GRP 3 $3,044.39 $3,074.83 $3,184.30 $3,242.57 $3,327.85
4873 EPS RECERTIFICATION, CLIN A, FUNC F, AGE GRP 4 $3,925.61 $3,964.87 $4,106.02 $4,181.16 $4,291.12
4874 EPS RECERTIFICATION, CLIN A, FUNC F, AGE GRP 5 $3,925.61 $3,964.87 $4,106.02 $4,181.16 $4,291.12
4875 EPS RECERTIFICATION, CLIN A, FUNC F, AGE GRP 6 $4,320.92 $4,364.13 $4,519.49 $4,602.20 $4,723.24
4876 EPS RECERTIFICATION, CLIN A, FUNC G, AGE GRP 1 $3,594.05 $3,629.99 $3,759.22 $3,828.01 $3,928.69
4877 EPS RECERTIFICATION, CLIN A, FUNC G, AGE GRP 2 $3,424.26 $3,458.50 $3,581.63 $3,647.17 $3,743.09
4878 EPS RECERTIFICATION, CLIN A, FUNC G, AGE GRP 3 $3,424.26 $3,458.50 $3,581.63 $3,647.17 $3,743.09
4879 EPS RECERTIFICATION, CLIN A, FUNC G, AGE GRP 4 $4,955.82 $5,005.38 $5,183.57 $5,278.43 $5,417.25
4880 EPS RECERTIFICATION, CLIN A, FUNC G, AGE GRP 5 $4,955.82 $5,005.38 $5,183.57 $5,278.43 $5,417.25
4881 EPS RECERTIFICATION, CLIN A, FUNC G, AGE GRP 6 $6,186.29 $6,248.15 $6,470.59 $6,589.00 $6,762.29
4882 EPS RECERTIFICATION, CLIN B, FUNC E, AGE GRP 1 $1,424.57 $1,438.82 $1,490.04 $1,517.31 $1,557.22
4883 EPS RECERTIFICATION, CLIN B, FUNC E, AGE GRP 2 $1,556.38 $1,571.94 $1,627.90 $1,657.69 $1,701.29
4884 EPS RECERTIFICATION, CLIN B, FUNC E, AGE GRP 3 $1,556.38 $1,571.94 $1,627.90 $1,657.69 $1,701.29
4885 EPS RECERTIFICATION, CLIN B, FUNC E, AGE GRP 4 $1,991.54 $2,011.46 $2,083.06 $2,121.18 $2,176.97
4886 EPS RECERTIFICATION, CLIN B, FUNC E, AGE GRP 5 $1,991.54 $2,011.46 $2,083.06 $2,121.18 $2,176.97
4887 EPS RECERTIFICATION, CLIN B, FUNC E, AGE GRP 6 $2,215.68 $2,237.84 $2,317.50 $2,359.91 $2,421.98
4888 EPS RECERTIFICATION, CLIN B, FUNC F, AGE GRP 1 $3,007.56 $3,037.64 $3,145.78 $3,203.35 $3,287.60
4889 EPS RECERTIFICATION, CLIN B, FUNC F, AGE GRP 2 $3,492.95 $3,527.88 $3,653.47 $3,720.33 $3,818.17
4890 EPS RECERTIFICATION, CLIN B, FUNC F, AGE GRP 3 $3,492.95 $3,527.88 $3,653.47 $3,720.33 $3,818.17
4891 EPS RECERTIFICATION, CLIN B, FUNC F, AGE GRP 4 $4,324.22 $4,367.46 $4,522.94 $4,605.71 $4,726.84
4892 EPS RECERTIFICATION, CLIN B, FUNC F, AGE GRP 5 $4,324.22 $4,367.46 $4,522.94 $4,605.71 $4,726.84
4893 EPS RECERTIFICATION, CLIN B, FUNC F, AGE GRP 6 $4,708.61 $4,755.70 $4,925.00 $5,015.13 $5,147.03
4894 EPS RECERTIFICATION, CLIN B, FUNC G, AGE GRP 1 $4,088.65 $4,129.54 $4,276.55 $4,354.81 $4,469.34
4895 EPS RECERTIFICATION, CLIN B, FUNC G, AGE GRP 2 $4,958.76 $5,008.35 $5,186.64 $5,281.56 $5,420.47
4896 EPS RECERTIFICATION, CLIN B, FUNC G, AGE GRP 3 $4,958.76 $5,008.35 $5,186.64 $5,281.56 $5,420.47
4897 EPS RECERTIFICATION, CLIN B, FUNC G, AGE GRP 4 $6,870.84 $6,939.55 $7,186.60 $7,318.11 $7,510.58
4898 EPS RECERTIFICATION, CLIN B, FUNC G, AGE GRP 5 $6,870.84 $6,939.55 $7,186.60 $7,318.11 $7,510.58
4899 EPS RECERTIFICATION, CLIN B, FUNC G, AGE GRP 6 $7,541.36 $7,616.77 $7,887.93 $8,032.28 $8,243.53
4900 EPS RECERTIFICATION, CLIN C, FUNC E, AGE GRP 1 $1,452.98 $1,467.51 $1,519.75 $1,547.56 $1,588.26
4901 EPS RECERTIFICATION, CLIN C, FUNC E, AGE GRP 2 $2,006.56 $2,026.63 $2,098.77 $2,137.18 $2,193.39
4902 EPS RECERTIFICATION, CLIN C, FUNC E, AGE GRP 3 $2,006.56 $2,026.63 $2,098.77 $2,137.18 $2,193.39
4903 EPS RECERTIFICATION, CLIN C, FUNC E, AGE GRP 4 $2,995.91 $3,025.87 $3,133.59 $3,190.93 $3,274.85
4904 EPS RECERTIFICATION, CLIN C, FUNC E, AGE GRP 5 $2,995.91 $3,025.87 $3,133.59 $3,190.93 $3,274.85
4905 EPS RECERTIFICATION, CLIN C, FUNC E, AGE GRP 6 $2,441.61 $2,466.03 $2,553.82 $2,600.55 $2,668.94
4906 EPS RECERTIFICATION, CLIN C, FUNC F, AGE GRP 1 $3,912.22 $3,951.34 $4,092.01 $4,166.89 $4,276.48
4907 EPS RECERTIFICATION, CLIN C, FUNC F, AGE GRP 2 $5,072.82 $5,123.55 $5,305.95 $5,403.05 $5,545.15
4908 EPS RECERTIFICATION, CLIN C, FUNC F, AGE GRP 3 $5,072.82 $5,123.55 $5,305.95 $5,403.05 $5,545.15
4909 EPS RECERTIFICATION, CLIN C, FUNC F, AGE GRP 4 $5,613.25 $5,669.38 $5,871.21 $5,978.65 $6,135.89
4910 EPS RECERTIFICATION, CLIN C, FUNC F, AGE GRP 5 $5,613.25 $5,669.38 $5,871.21 $5,978.65 $6,135.89
4911 EPS RECERTIFICATION, CLIN C, FUNC F, AGE GRP 6 $6,457.71 $6,522.29 $6,754.48 $6,878.09 $7,058.98
4912 EPS RECERTIFICATION, CLIN C, FUNC G, AGE GRP 1 $6,037.22 $6,097.59 $6,314.67 $6,430.23 $6,599.35
4913 EPS RECERTIFICATION, CLIN C, FUNC G, AGE GRP 2 $9,465.92 $9,560.58 $9,900.94 $10,082.13 $10,347.29
4914 EPS RECERTIFICATION, CLIN C, FUNC G, AGE GRP 3 $9,465.92 $9,560.58 $9,900.94 $10,082.13 $10,347.29
4915 EPS RECERTIFICATION, CLIN C, FUNC G, AGE GRP 4 $8,252.25 $8,334.77 $8,631.49 $8,789.45 $9,020.61
4916 EPS RECERTIFICATION, CLIN C, FUNC G, AGE GRP 5 $8,252.25 $8,334.77 $8,631.49 $8,789.45 $9,020.61
4917 EPS RECERTIFICATION, CLIN C, FUNC G, AGE GRP 6 $11,446.81 $11,561.28 $11,972.86 $12,191.96 $12,512.61
4920 EPS MATERNITY, NO OASIS, 18 AND OLDER $1,219.06 $1,231.25 $1,275.08 $1,298.41 $1,332.56