CY2024 EPS HHA MW ROS Medicaid Rates
Certified Home Health Agencies
New York State Medicaid - Episodic Payment System
+Nassau, Suffolk and Westchester
| 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 |
+New York City
| 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 |
+Rest of State
| 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 |
