Certified Hospice Program
Medicaid Rate Sheet
Effective: 10/01/2021 - 09/30/2022
- Rates also available in Excel Format (XLSX)
| Table of Contents |
|---|
| Albany-Schenectady-Troy |
| Binghamton |
| Buffalo |
| Elmira |
| Glens Falls |
| Nassau Suffolk |
| New York City |
| Niagara Falls |
| Orange County |
| Poughkeepsie |
| Rochester |
| Syracuse |
| Utica-Rome |
| Rural |
SMSA: Albany-Schenectady-Troy
Hospice Rate Sheets for the Counties of: ALBANY, GREENE, MONTGOMERY, RENSSELAER, SARATOGA, SCHENECTADY
| Rate Code |
Description | Base Rate | WRR Add-on * |
RTR Add-on * |
Total w/ addons |
|---|---|---|---|---|---|
| 3945 | Routine Home Care | $179.88 | $4.05 | $9.92 | $193.85 |
| 3946 | Inpatient Respite | $423.12 | $9.52 | $9.92 | $442.56 |
| 3947 | General Inpatient Care | $949.43 | $21.36 | $9.92 | $980.71 |
| 3948 | Continuous Home Care - Min 8 Hours | $423.28 | $9.52 | $9.92 | $442.72 |
| 3949 | Continuous Home Care - Min 9 Hours | $476.19 | $10.71 | $9.92 | $496.82 |
| 3950 | Continuous Home Care - Min 10 Hours | $529.10 | $11.90 | $9.92 | $550.92 |
| 3951 | Continuous Home Care - Min 11 Hours | $582.01 | $13.10 | $9.92 | $605.03 |
| 3952 | Continuous Home Care - Min 12 Hours | $634.92 | $14.29 | $9.92 | $659.13 |
| 3953 | Continuous Home Care - Min 13 Hours | $687.82 | $15.48 | $9.92 | $713.22 |
| 3954 | Continuous Home Care - Min 14 Hours | $740.73 | $16.67 | $9.92 | $767.32 |
| 3955 | Continuous Home Care - Min 15 Hours | $793.64 | $17.86 | $9.92 | $821.42 |
| 3956 | Continuous Home Care - Min 16 Hours | $846.55 | $19.05 | $9.92 | $875.52 |
| 3957 | Continuous Home Care - Min 17 Hours | $899.46 | $20.24 | $9.92 | $929.62 |
| 3958 | Continuous Home Care - Min 18 Hours | $952.37 | $21.43 | $9.92 | $983.72 |
| 3959 | Continuous Home Care - Min 19 Hours | $1,005.28 | $22.62 | $9.92 | $1,037.82 |
| 3960 | Continuous Home Care - Min 20 Hours | $1,058.19 | $23.81 | $9.92 | $1,091.92 |
| 3961 | Continuous Home Care - Min 21 Hours | $1,111.10 | $25.00 | $9.92 | $1,146.02 |
| 3962 | Continuous Home Care - Min 22 Hours | $1,164.01 | $26.19 | $9.92 | $1,200.12 |
| 3963 | Continuous Home Care - Min 23 Hours | $1,216.92 | $27.38 | $9.92 | $1,254.22 |
| 3964 | Continuous Home Care - Min 24 Hours | $1,269.83 | $28.57 | $9.92 | $1,308.32 |
| 3965 | Hospice Inpatient Respite Care Coinsurance Rate - 5% of 3946 | $21.16 | $0.48 | $0.50 | $22.14 |
| 3966 | Drugs Coinsurance Rate | $1.00 | $0.00 | $0.00 | $1.00 |
| 3969 | Routine Home Care w/AIDS | $294.03 | $6.62 | $9.92 | $310.57 |
| 3970 | Routine Home Care w/Escort | $199.24 | $4.48 | $9.92 | $213.64 |
| 3971 | Continuous Home Care w/AIDS Min 8 Hours | $438.68 | $9.87 | $9.92 | $458.47 |
| 3972 | Continuous Home Care w/AIDS Min 9 Hours | $493.51 | $11.10 | $9.92 | $514.53 |
| 3973 | Continuous Home Care w/AIDS Min 10 Hours | $548.35 | $12.34 | $9.92 | $570.61 |
| 3974 | Continuous Home Care w/AIDS Min 11 Hours | $603.18 | $13.57 | $9.92 | $626.67 |
| 3975 | Continuous Home Care w/AIDS Min 12 Hours | $658.02 | $14.81 | $9.92 | $682.75 |
| 3976 | Continuous Home Care w/AIDS Min 13 Hours | $712.85 | $16.04 | $9.92 | $738.81 |
| 3977 | Continuous Home Care w/AIDS Min 14 Hours | $767.68 | $17.27 | $9.92 | $794.87 |
| 3978 | Continuous Home Care w/AIDS Min 15 Hours | $822.52 | $18.51 | $9.92 | $850.95 |
| 3979 | Continuous Home Care w/AIDS Min 16 Hours | $877.35 | $19.74 | $9.92 | $907.01 |
| 3980 | Continuous Home Care w/AIDS Min 17 Hours | $932.19 | $20.97 | $9.92 | $963.08 |
| 3981 | Continuous Home Care w/AIDS Min 18 Hours | $987.02 | $22.21 | $9.92 | $1,019.15 |
| 3982 | Continuous Home Care w/AIDS Min 19 Hours | $1,041.86 | $23.44 | $9.92 | $1,075.22 |
| 3983 | Continuous Home Care w/AIDS Min 20 Hours | $1,096.69 | $24.68 | $9.92 | $1,131.29 |
| 3984 | Continuous Home Care w/AIDS Min 21 Hours | $1,151.53 | $25.91 | $9.92 | $1,187.36 |
| 3985 | Continuous Home Care w/AIDS Min 22 Hours | $1,206.36 | $27.14 | $9.92 | $1,243.42 |
| 3986 | Continuous Home Care w/AIDS Min 23 Hours | $1,261.20 | $28.38 | $9.92 | $1,299.50 |
| 3987 | Continuous Home Care w/AIDS Min 24 Hours | $1,316.03 | $29.61 | $9.92 | $1,355.56 |
| 3988 | General Inpatient w/ AIDS | $1,055.20 | $23.74 | $9.92 | $1,088.86 |
| 3989 | Routine Home Care w/ AIDS Escort | $313.39 | $7.05 | $9.92 | $330.36 |
| 3991 | Service Intensity Add-on | $53.60 | $1.21 | $0.00 | $54.81 |
* WRR =´Worker Recruitment and Retention addon´ if applicable
* RTR =´Recruitment, Training and Retention addon´ if applicable
SMSA: Binghamton
Hospice Rate Sheets for the Counties of: BROOME, TIOGA
| Rate Code |
Description | Base Rate | WRP Add-on * |
RTR Add-on * |
Total w/ addons |
|---|---|---|---|---|---|
| 3945 | Routine Home Care | $180.06 | $4.05 | $9.92 | $194.03 |
| 3946 | Inpatient Respite | $423.49 | $9.53 | $9.92 | $442.94 |
| 3947 | General Inpatient Care | $950.31 | $21.38 | $9.92 | $981.61 |
| 3948 | Continuous Home Care - Min 8 Hours | $423.75 | $9.53 | $9.92 | $443.20 |
| 3949 | Continuous Home Care - Min 9 Hours | $476.72 | $10.73 | $9.92 | $497.37 |
| 3950 | Continuous Home Care - Min 10 Hours | $529.69 | $11.92 | $9.92 | $551.53 |
| 3951 | Continuous Home Care - Min 11 Hours | $582.66 | $13.11 | $9.92 | $605.69 |
| 3952 | Continuous Home Care - Min 12 Hours | $635.63 | $14.30 | $9.92 | $659.85 |
| 3953 | Continuous Home Care - Min 13 Hours | $688.60 | $15.49 | $9.92 | $714.01 |
| 3954 | Continuous Home Care - Min 14 Hours | $741.57 | $16.69 | $9.92 | $768.18 |
| 3955 | Continuous Home Care - Min 15 Hours | $794.54 | $17.88 | $9.92 | $822.34 |
| 3956 | Continuous Home Care - Min 16 Hours | $847.51 | $19.07 | $9.92 | $876.50 |
| 3957 | Continuous Home Care - Min 17 Hours | $900.48 | $20.26 | $9.92 | $930.66 |
| 3958 | Continuous Home Care - Min 18 Hours | $953.45 | $21.45 | $9.92 | $984.82 |
| 3959 | Continuous Home Care - Min 19 Hours | $1,006.41 | $22.64 | $9.92 | $1,038.97 |
| 3960 | Continuous Home Care - Min 20 Hours | $1,059.38 | $23.84 | $9.92 | $1,093.14 |
| 3961 | Continuous Home Care - Min 21 Hours | $1,112.35 | $25.03 | $9.92 | $1,147.30 |
| 3962 | Continuous Home Care - Min 22 Hours | $1,165.32 | $26.22 | $9.92 | $1,201.46 |
| 3963 | Continuous Home Care - Min 23 Hours | $1,218.29 | $27.41 | $9.92 | $1,255.62 |
| 3964 | Continuous Home Care - Min 24 Hours | $1,271.26 | $28.60 | $9.92 | $1,309.78 |
| 3965 | Hospice Inpatient Respite Care Coinsurance Rate - 5% of 3946 | $21.17 | $0.48 | $0.50 | $22.15 |
| 3966 | Drugs Coinsurance Rate | $1.00 | $0.00 | $0.00 | $1.00 |
| 3969 | Routine Home Care w/AIDS | $294.31 | $6.62 | $9.92 | $310.85 |
| 3970 | Routine Home Care w/Escort | $199.42 | $4.49 | $9.92 | $213.83 |
| 3971 | Continuous Home Care w/AIDS Min 8 Hours | $439.30 | $9.88 | $9.92 | $459.10 |
| 3972 | Continuous Home Care w/AIDS Min 9 Hours | $494.22 | $11.12 | $9.92 | $515.26 |
| 3973 | Continuous Home Care w/AIDS Min 10 Hours | $549.13 | $12.36 | $9.92 | $571.41 |
| 3974 | Continuous Home Care w/AIDS Min 11 Hours | $604.04 | $13.59 | $9.92 | $627.55 |
| 3975 | Continuous Home Care w/AIDS Min 12 Hours | $658.96 | $14.83 | $9.92 | $683.71 |
| 3976 | Continuous Home Care w/AIDS Min 13 Hours | $713.87 | $16.06 | $9.92 | $739.85 |
| 3977 | Continuous Home Care w/AIDS Min 14 Hours | $768.78 | $17.30 | $9.92 | $796.00 |
| 3978 | Continuous Home Care w/AIDS Min 15 Hours | $823.69 | $18.53 | $9.92 | $852.14 |
| 3979 | Continuous Home Care w/AIDS Min 16 Hours | $878.61 | $19.77 | $9.92 | $908.30 |
| 3980 | Continuous Home Care w/AIDS Min 17 Hours | $933.52 | $21.00 | $9.92 | $964.44 |
| 3981 | Continuous Home Care w/AIDS Min 18 Hours | $988.43 | $22.24 | $9.92 | $1,020.59 |
| 3982 | Continuous Home Care w/AIDS Min 19 Hours | $1,043.35 | $23.48 | $9.92 | $1,076.75 |
| 3983 | Continuous Home Care w/AIDS Min 20 Hours | $1,098.26 | $24.71 | $9.92 | $1,132.89 |
| 3984 | Continuous Home Care w/AIDS Min 21 Hours | $1,153.17 | $25.95 | $9.92 | $1,189.04 |
| 3985 | Continuous Home Care w/AIDS Min 22 Hours | $1,208.08 | $27.18 | $9.92 | $1,245.18 |
| 3986 | Continuous Home Care w/AIDS Min 23 Hours | $1,263.00 | $28.42 | $9.92 | $1,301.34 |
| 3987 | Continuous Home Care w/AIDS Min 24 Hours | $1,317.91 | $29.65 | $9.92 | $1,357.48 |
| 3988 | General Inpatient w/ AIDS | $1,056.17 | $23.76 | $9.92 | $1,089.85 |
| 3989 | Routine Home Care w/ AIDS Escort | $313.67 | $7.06 | $9.92 | $330.65 |
| 3991 | Service Intensity Add-on | $53.66 | $1.21 | $0.00 | $54.87 |
* WRR =´Worker Recruitment and Retention addon´ if applicable
* RTR =´Recruitment, Training and Retention addon´ if applicable
SMSA: Buffalo
Hospice Rate Sheets for the Counties of: ERIE
| Rate Code |
Description | Base Rate | WRP Add-on * |
RTR Add-on * |
Total w/ addons |
|---|---|---|---|---|---|
| 3945 | Routine Home Care | $209.60 | $4.72 | $9.92 | $224.24 |
| 3946 | Inpatient Respite | $487.10 | $10.96 | $9.92 | $507.98 |
| 3947 | General Inpatient Care | $1,099.62 | $24.74 | $9.92 | $1,134.28 |
| 3948 | Continuous Home Care - Min 8 Hours | $504.44 | $11.35 | $9.92 | $525.71 |
| 3949 | Continuous Home Care - Min 9 Hours | $567.50 | $12.77 | $9.92 | $590.19 |
| 3950 | Continuous Home Care - Min 10 Hours | $630.55 | $14.19 | $9.92 | $654.66 |
| 3951 | Continuous Home Care - Min 11 Hours | $693.61 | $15.61 | $9.92 | $719.14 |
| 3952 | Continuous Home Care - Min 12 Hours | $756.67 | $17.03 | $9.92 | $783.62 |
| 3953 | Continuous Home Care - Min 13 Hours | $819.72 | $18.44 | $9.92 | $848.08 |
| 3954 | Continuous Home Care - Min 14 Hours | $882.78 | $19.86 | $9.92 | $912.56 |
| 3955 | Continuous Home Care - Min 15 Hours | $945.83 | $21.28 | $9.92 | $977.03 |
| 3956 | Continuous Home Care - Min 16 Hours | $1,008.89 | $22.70 | $9.92 | $1,041.51 |
| 3957 | Continuous Home Care - Min 17 Hours | $1,071.94 | $24.12 | $9.92 | $1,105.98 |
| 3958 | Continuous Home Care - Min 18 Hours | $1,135.00 | $25.54 | $9.92 | $1,170.46 |
| 3959 | Continuous Home Care - Min 19 Hours | $1,198.05 | $26.96 | $9.92 | $1,234.93 |
| 3960 | Continuous Home Care - Min 20 Hours | $1,261.11 | $28.37 | $9.92 | $1,299.40 |
| 3961 | Continuous Home Care - Min 21 Hours | $1,324.16 | $29.79 | $9.92 | $1,363.87 |
| 3962 | Continuous Home Care - Min 22 Hours | $1,387.22 | $31.21 | $9.92 | $1,428.35 |
| 3963 | Continuous Home Care - Min 23 Hours | $1,450.27 | $32.63 | $9.92 | $1,492.82 |
| 3964 | Continuous Home Care - Min 24 Hours | $1,513.33 | $34.05 | $9.92 | $1,557.30 |
| 3965 | Hospice Inpatient Respite Care Coinsurance Rate - 5% of 3946 | $24.36 | $0.55 | $0.50 | $25.41 |
| 3966 | Drugs Coinsurance Rate | $1.00 | $0.00 | $0.00 | $1.00 |
| 3969 | Routine Home Care w/AIDS | $342.61 | $7.71 | $9.92 | $360.24 |
| 3970 | Routine Home Care w/Escort | $228.96 | $5.15 | $9.92 | $244.03 |
| 3971 | Continuous Home Care w/AIDS Min 8 Hours | $545.53 | $12.27 | $9.92 | $567.72 |
| 3972 | Continuous Home Care w/AIDS Min 9 Hours | $613.72 | $13.81 | $9.92 | $637.45 |
| 3973 | Continuous Home Care w/AIDS Min 10 Hours | $681.91 | $15.34 | $9.92 | $707.17 |
| 3974 | Continuous Home Care w/AIDS Min 11 Hours | $750.10 | $16.88 | $9.92 | $776.90 |
| 3975 | Continuous Home Care w/AIDS Min 12 Hours | $818.30 | $18.41 | $9.92 | $846.63 |
| 3976 | Continuous Home Care w/AIDS Min 13 Hours | $886.49 | $19.95 | $9.92 | $916.36 |
| 3977 | Continuous Home Care w/AIDS Min 14 Hours | $954.68 | $21.48 | $9.92 | $986.08 |
| 3978 | Continuous Home Care w/AIDS Min 15 Hours | $1,022.87 | $23.01 | $9.92 | $1,055.80 |
| 3979 | Continuous Home Care w/AIDS Min 16 Hours | $1,091.06 | $24.55 | $9.92 | $1,125.53 |
| 3980 | Continuous Home Care w/AIDS Min 17 Hours | $1,159.25 | $26.08 | $9.92 | $1,195.25 |
| 3981 | Continuous Home Care w/AIDS Min 18 Hours | $1,227.44 | $27.62 | $9.92 | $1,264.98 |
| 3982 | Continuous Home Care w/AIDS Min 19 Hours | $1,295.63 | $29.15 | $9.92 | $1,334.70 |
| 3983 | Continuous Home Care w/AIDS Min 20 Hours | $1,363.83 | $30.69 | $9.92 | $1,404.44 |
| 3984 | Continuous Home Care w/AIDS Min 21 Hours | $1,432.02 | $32.22 | $9.92 | $1,474.16 |
| 3985 | Continuous Home Care w/AIDS Min 22 Hours | $1,500.21 | $33.75 | $9.92 | $1,543.88 |
| 3986 | Continuous Home Care w/AIDS Min 23 Hours | $1,568.40 | $35.29 | $9.92 | $1,613.61 |
| 3987 | Continuous Home Care w/AIDS Min 24 Hours | $1,636.59 | $36.82 | $9.92 | $1,683.33 |
| 3988 | General Inpatient w/ AIDS | $1,222.12 | $27.50 | $9.92 | $1,259.54 |
| 3989 | Routine Home Care w/ AIDS Escort | $361.97 | $8.14 | $9.92 | $380.03 |
| 3991 | Service Intensity Add-on | $62.87 | $1.41 | $0.00 | $64.28 |
* WRR =´Worker Recruitment and Retention addon´ if applicable
* RTR =´Recruitment, Training and Retention addon´ if applicable
SMSA: Elmira
Hospice Rate Sheets for the Counties of: CHEMUNG
| Rate Code |
Description | Base Rate | WRP Add-on * |
RTR Add-on * |
Total w/ addons |
|---|---|---|---|---|---|
| 3945 | Routine Home Care | $192.38 | $4.33 | $9.92 | $206.63 |
| 3946 | Inpatient Respite | $450.02 | $10.13 | $9.92 | $470.07 |
| 3947 | General Inpatient Care | $1,012.59 | $22.78 | $9.92 | $1,045.29 |
| 3948 | Continuous Home Care - Min 8 Hours | $457.41 | $10.29 | $9.92 | $477.62 |
| 3949 | Continuous Home Care - Min 9 Hours | $514.58 | $11.58 | $9.92 | $536.08 |
| 3950 | Continuous Home Care - Min 10 Hours | $571.76 | $12.86 | $9.92 | $594.54 |
| 3951 | Continuous Home Care - Min 11 Hours | $628.93 | $14.15 | $9.92 | $653.00 |
| 3952 | Continuous Home Care - Min 12 Hours | $686.11 | $15.44 | $9.92 | $711.47 |
| 3953 | Continuous Home Care - Min 13 Hours | $743.29 | $16.72 | $9.92 | $769.93 |
| 3954 | Continuous Home Care - Min 14 Hours | $800.46 | $18.01 | $9.92 | $828.39 |
| 3955 | Continuous Home Care - Min 15 Hours | $857.64 | $19.30 | $9.92 | $886.86 |
| 3956 | Continuous Home Care - Min 16 Hours | $914.81 | $20.58 | $9.92 | $945.31 |
| 3957 | Continuous Home Care - Min 17 Hours | $971.99 | $21.87 | $9.92 | $1,003.78 |
| 3958 | Continuous Home Care - Min 18 Hours | $1,029.17 | $23.16 | $9.92 | $1,062.25 |
| 3959 | Continuous Home Care - Min 19 Hours | $1,086.34 | $24.44 | $9.92 | $1,120.70 |
| 3960 | Continuous Home Care - Min 20 Hours | $1,143.52 | $25.73 | $9.92 | $1,179.17 |
| 3961 | Continuous Home Care - Min 21 Hours | $1,200.69 | $27.02 | $9.92 | $1,237.63 |
| 3962 | Continuous Home Care - Min 22 Hours | $1,257.87 | $28.30 | $9.92 | $1,296.09 |
| 3963 | Continuous Home Care - Min 23 Hours | $1,315.04 | $29.59 | $9.92 | $1,354.55 |
| 3964 | Continuous Home Care - Min 24 Hours | $1,372.22 | $30.87 | $9.92 | $1,413.01 |
| 3965 | Hospice Inpatient Respite Care Coinsurance Rate - 5% of 3946 | $22.50 | $0.51 | $0.50 | $23.51 |
| 3966 | Drugs Coinsurance Rate | $1.00 | $0.00 | $0.00 | $1.00 |
| 3969 | Routine Home Care w/AIDS | $314.45 | $7.08 | $9.92 | $331.45 |
| 3970 | Routine Home Care w/Escort | $211.74 | $4.76 | $9.92 | $226.42 |
| 3971 | Continuous Home Care w/AIDS Min 8 Hours | $483.61 | $10.88 | $9.92 | $504.41 |
| 3972 | Continuous Home Care w/AIDS Min 9 Hours | $544.06 | $12.24 | $9.92 | $566.22 |
| 3973 | Continuous Home Care w/AIDS Min 10 Hours | $604.51 | $13.60 | $9.92 | $628.03 |
| 3974 | Continuous Home Care w/AIDS Min 11 Hours | $664.96 | $14.96 | $9.92 | $689.84 |
| 3975 | Continuous Home Care w/AIDS Min 12 Hours | $725.42 | $16.32 | $9.92 | $751.66 |
| 3976 | Continuous Home Care w/AIDS Min 13 Hours | $785.87 | $17.68 | $9.92 | $813.47 |
| 3977 | Continuous Home Care w/AIDS Min 14 Hours | $846.32 | $19.04 | $9.92 | $875.28 |
| 3978 | Continuous Home Care w/AIDS Min 15 Hours | $906.77 | $20.40 | $9.92 | $937.09 |
| 3979 | Continuous Home Care w/AIDS Min 16 Hours | $967.22 | $21.76 | $9.92 | $998.90 |
| 3980 | Continuous Home Care w/AIDS Min 17 Hours | $1,027.67 | $23.12 | $9.92 | $1,060.71 |
| 3981 | Continuous Home Care w/AIDS Min 18 Hours | $1,088.12 | $24.48 | $9.92 | $1,122.52 |
| 3982 | Continuous Home Care w/AIDS Min 19 Hours | $1,148.57 | $25.84 | $9.92 | $1,184.33 |
| 3983 | Continuous Home Care w/AIDS Min 20 Hours | $1,209.03 | $27.20 | $9.92 | $1,246.15 |
| 3984 | Continuous Home Care w/AIDS Min 21 Hours | $1,269.48 | $28.56 | $9.92 | $1,307.96 |
| 3985 | Continuous Home Care w/AIDS Min 22 Hours | $1,329.93 | $29.92 | $9.92 | $1,369.77 |
| 3986 | Continuous Home Care w/AIDS Min 23 Hours | $1,390.38 | $31.28 | $9.92 | $1,431.58 |
| 3987 | Continuous Home Care w/AIDS Min 24 Hours | $1,450.83 | $32.64 | $9.92 | $1,493.39 |
| 3988 | General Inpatient w/ AIDS | $1,125.39 | $25.32 | $9.92 | $1,160.63 |
| 3989 | Routine Home Care w/ AIDS Escort | $333.81 | $7.51 | $9.92 | $351.24 |
| 3991 | Service Intensity Add-on | $57.50 | $1.29 | $0.00 | $58.79 |
* WRR =´Worker Recruitment and Retention addon´ if applicable
* RTR =´Recruitment, Training and Retention addon´ if applicable
SMSA: Glens Falls
Hospice Rate Sheets for the Counties of:WARREN, WASHINGTON
| Rate Code |
Description | Base Rate | WRP Add-on * |
RTR Add-on * |
Total w/ addons |
|---|---|---|---|---|---|
| 3945 | Routine Home Care | $176.55 | $3.97 | $9.92 | $190.44 |
| 3946 | Inpatient Respite | $415.95 | $9.36 | $9.92 | $435.23 |
| 3947 | General Inpatient Care | $932.61 | $20.98 | $9.92 | $963.51 |
| 3948 | Continuous Home Care - Min 8 Hours | $414.19 | $9.32 | $9.92 | $433.43 |
| 3949 | Continuous Home Care - Min 9 Hours | $465.96 | $10.48 | $9.92 | $486.36 |
| 3950 | Continuous Home Care - Min 10 Hours | $517.73 | $11.65 | $9.92 | $539.30 |
| 3951 | Continuous Home Care - Min 11 Hours | $569.51 | $12.81 | $9.92 | $592.24 |
| 3952 | Continuous Home Care - Min 12 Hours | $621.28 | $13.98 | $9.92 | $645.18 |
| 3953 | Continuous Home Care - Min 13 Hours | $673.05 | $15.14 | $9.92 | $698.11 |
| 3954 | Continuous Home Care - Min 14 Hours | $724.83 | $16.31 | $9.92 | $751.06 |
| 3955 | Continuous Home Care - Min 15 Hours | $776.60 | $17.47 | $9.92 | $803.99 |
| 3956 | Continuous Home Care - Min 16 Hours | $828.37 | $18.64 | $9.92 | $856.93 |
| 3957 | Continuous Home Care - Min 17 Hours | $880.15 | $19.80 | $9.92 | $909.87 |
| 3958 | Continuous Home Care - Min 18 Hours | $931.92 | $20.97 | $9.92 | $962.81 |
| 3959 | Continuous Home Care - Min 19 Hours | $983.69 | $22.13 | $9.92 | $1,015.74 |
| 3960 | Continuous Home Care - Min 20 Hours | $1,035.47 | $23.30 | $9.92 | $1,068.69 |
| 3961 | Continuous Home Care - Min 21 Hours | $1,087.24 | $24.46 | $9.92 | $1,121.62 |
| 3962 | Continuous Home Care - Min 22 Hours | $1,139.01 | $25.63 | $9.92 | $1,174.56 |
| 3963 | Continuous Home Care - Min 23 Hours | $1,190.79 | $26.79 | $9.92 | $1,227.50 |
| 3964 | Continuous Home Care - Min 24 Hours | $1,242.56 | $27.96 | $9.92 | $1,280.44 |
| 3965 | Hospice Inpatient Respite Care Coinsurance Rate - 5% of 3946 | $20.80 | $0.47 | $0.50 | $21.77 |
| 3966 | Drugs Coinsurance Rate | $1.00 | $0.00 | $0.00 | $1.00 |
| 3969 | Routine Home Care w/AIDS | $288.58 | $6.49 | $9.92 | $304.99 |
| 3970 | Routine Home Care w/Escort | $195.91 | $4.41 | $9.92 | $210.24 |
| 3971 | Continuous Home Care w/AIDS Min 8 Hours | $426.71 | $9.60 | $9.92 | $446.23 |
| 3972 | Continuous Home Care w/AIDS Min 9 Hours | $480.05 | $10.80 | $9.92 | $500.77 |
| 3973 | Continuous Home Care w/AIDS Min 10 Hours | $533.38 | $12.00 | $9.92 | $555.30 |
| 3974 | Continuous Home Care w/AIDS Min 11 Hours | $586.72 | $13.20 | $9.92 | $609.84 |
| 3975 | Continuous Home Care w/AIDS Min 12 Hours | $640.06 | $14.40 | $9.92 | $664.38 |
| 3976 | Continuous Home Care w/AIDS Min 13 Hours | $693.40 | $15.60 | $9.92 | $718.92 |
| 3977 | Continuous Home Care w/AIDS Min 14 Hours | $746.74 | $16.80 | $9.92 | $773.46 |
| 3978 | Continuous Home Care w/AIDS Min 15 Hours | $800.08 | $18.00 | $9.92 | $828.00 |
| 3979 | Continuous Home Care w/AIDS Min 16 Hours | $853.41 | $19.20 | $9.92 | $882.53 |
| 3980 | Continuous Home Care w/AIDS Min 17 Hours | $906.75 | $20.40 | $9.92 | $937.07 |
| 3981 | Continuous Home Care w/AIDS Min 18 Hours | $960.09 | $21.60 | $9.92 | $991.61 |
| 3982 | Continuous Home Care w/AIDS Min 19 Hours | $1,013.43 | $22.80 | $9.92 | $1,046.15 |
| 3983 | Continuous Home Care w/AIDS Min 20 Hours | $1,066.77 | $24.00 | $9.92 | $1,100.69 |
| 3984 | Continuous Home Care w/AIDS Min 21 Hours | $1,120.11 | $25.20 | $9.92 | $1,155.23 |
| 3985 | Continuous Home Care w/AIDS Min 22 Hours | $1,173.44 | $26.40 | $9.92 | $1,209.76 |
| 3986 | Continuous Home Care w/AIDS Min 23 Hours | $1,226.78 | $27.60 | $9.92 | $1,264.30 |
| 3987 | Continuous Home Care w/AIDS Min 24 Hours | $1,280.12 | $28.80 | $9.92 | $1,318.84 |
| 3988 | General Inpatient w/ AIDS | $1,036.50 | $23.32 | $9.92 | $1,069.74 |
| 3989 | Routine Home Care w/ AIDS Escort | $307.94 | $6.93 | $9.92 | $324.79 |
| 3991 | Service Intensity Add-on | $52.57 | $1.18 | $0.00 | $53.75 |
* WRR =´Worker Recruitment and Retention addon´ if applicable
* RTR =´Recruitment, Training and Retention addon´ if applicable
SMSA: Nassau Suffolk
Hospice Rate Sheets for the Counties of: NASSAU, SUFFOLK
| Rate Code |
Description | Base Rate | WRP Add-on * |
RTR Add-on * |
Total w/ addons |
|---|---|---|---|---|---|
| 3945 | Routine Home Care | $241.58 | $5.44 | $9.92 | $256.94 |
| 3946 | Inpatient Respite | $555.94 | $12.51 | $9.92 | $578.37 |
| 3947 | General Inpatient Care | $1,261.21 | $28.38 | $9.92 | $1,299.51 |
| 3948 | Continuous Home Care - Min 8 Hours | $591.77 | $13.31 | $9.92 | $615.00 |
| 3949 | Continuous Home Care - Min 9 Hours | $665.74 | $14.98 | $9.92 | $690.64 |
| 3950 | Continuous Home Care - Min 10 Hours | $739.71 | $16.64 | $9.92 | $766.27 |
| 3951 | Continuous Home Care - Min 11 Hours | $813.68 | $18.31 | $9.92 | $841.91 |
| 3952 | Continuous Home Care - Min 12 Hours | $887.66 | $19.97 | $9.92 | $917.55 |
| 3953 | Continuous Home Care - Min 13 Hours | $961.63 | $21.64 | $9.92 | $993.19 |
| 3954 | Continuous Home Care - Min 14 Hours | $1,035.60 | $23.30 | $9.92 | $1,068.82 |
| 3955 | Continuous Home Care - Min 15 Hours | $1,109.57 | $24.97 | $9.92 | $1,144.46 |
| 3956 | Continuous Home Care - Min 16 Hours | $1,183.54 | $26.63 | $9.92 | $1,220.09 |
| 3957 | Continuous Home Care - Min 17 Hours | $1,257.51 | $28.29 | $9.92 | $1,295.72 |
| 3958 | Continuous Home Care - Min 18 Hours | $1,331.48 | $29.96 | $9.92 | $1,371.36 |
| 3959 | Continuous Home Care - Min 19 Hours | $1,405.45 | $31.62 | $9.92 | $1,446.99 |
| 3960 | Continuous Home Care - Min 20 Hours | $1,479.43 | $33.29 | $9.92 | $1,522.64 |
| 3961 | Continuous Home Care - Min 21 Hours | $1,553.40 | $34.95 | $9.92 | $1,598.27 |
| 3962 | Continuous Home Care - Min 22 Hours | $1,627.37 | $36.62 | $9.92 | $1,673.91 |
| 3963 | Continuous Home Care - Min 23 Hours | $1,701.34 | $38.28 | $9.92 | $1,749.54 |
| 3964 | Continuous Home Care - Min 24 Hours | $1,775.31 | $39.94 | $9.92 | $1,825.17 |
| 3965 | Hospice Inpatient Respite Care Coinsurance Rate - 5% of 3946 | $27.80 | $0.63 | $0.50 | $28.93 |
| 3966 | Drugs Coinsurance Rate | $1.00 | $0.00 | $0.00 | $1.00 |
| 3969 | Routine Home Care w/AIDS | $394.88 | $8.88 | $9.92 | $413.68 |
| 3970 | Routine Home Care w/Escort | $260.94 | $5.87 | $9.92 | $276.73 |
| 3971 | Continuous Home Care w/AIDS Min 8 Hours | $660.49 | $14.86 | $9.92 | $685.27 |
| 3972 | Continuous Home Care w/AIDS Min 9 Hours | $743.06 | $16.72 | $9.92 | $769.70 |
| 3973 | Continuous Home Care w/AIDS Min 10 Hours | $825.62 | $18.58 | $9.92 | $854.12 |
| 3974 | Continuous Home Care w/AIDS Min 11 Hours | $908.18 | $20.43 | $9.92 | $938.53 |
| 3975 | Continuous Home Care w/AIDS Min 12 Hours | $990.74 | $22.29 | $9.92 | $1,022.95 |
| 3976 | Continuous Home Care w/AIDS Min 13 Hours | $1,073.30 | $24.15 | $9.92 | $1,107.37 |
| 3977 | Continuous Home Care w/AIDS Min 14 Hours | $1,155.86 | $26.01 | $9.92 | $1,191.79 |
| 3978 | Continuous Home Care w/AIDS Min 15 Hours | $1,238.43 | $27.86 | $9.92 | $1,276.21 |
| 3979 | Continuous Home Care w/AIDS Min 16 Hours | $1,320.99 | $29.72 | $9.92 | $1,360.63 |
| 3980 | Continuous Home Care w/AIDS Min 17 Hours | $1,403.55 | $31.58 | $9.92 | $1,445.05 |
| 3981 | Continuous Home Care w/AIDS Min 18 Hours | $1,486.11 | $33.44 | $9.92 | $1,529.47 |
| 3982 | Continuous Home Care w/AIDS Min 19 Hours | $1,568.67 | $35.30 | $9.92 | $1,613.89 |
| 3983 | Continuous Home Care w/AIDS Min 20 Hours | $1,651.23 | $37.15 | $9.92 | $1,698.30 |
| 3984 | Continuous Home Care w/AIDS Min 21 Hours | $1,733.80 | $39.01 | $9.92 | $1,782.73 |
| 3985 | Continuous Home Care w/AIDS Min 22 Hours | $1,816.36 | $40.87 | $9.92 | $1,867.15 |
| 3986 | Continuous Home Care w/AIDS Min 23 Hours | $1,898.92 | $42.73 | $9.92 | $1,951.57 |
| 3987 | Continuous Home Care w/AIDS Min 24 Hours | $1,981.48 | $44.58 | $9.92 | $2,035.98 |
| 3988 | General Inpatient w/ AIDS | $1,401.71 | $31.54 | $9.92 | $1,443.17 |
| 3989 | Routine Home Care w/ AIDS Escort | $414.24 | $9.32 | $9.92 | $433.48 |
| 3991 | Service Intensity Add-on | $72.85 | $1.64 | $0.00 | $74.49 |
* WRR =´Worker Recruitment and Retention addon´ if applicable
* RTR =´Recruitment, Training and Retention addon´ if applicable
SMSA: New York City
Hospice Rate Sheets for the Counties of: BRONX, KINGS, NEW YORK, PUTNAM, QUEENS, RICHMOND, ROCKLAND, WESTCHESTER
| Rate Code |
Description | Base Rate | WRP Add-on * |
RTR Add-on * |
Total w/ addons |
|---|---|---|---|---|---|
| 3945 | Routine Home Care | $248.88 | $5.60 | $9.92 | $264.40 |
| 3946 | Inpatient Respite | $571.66 | $12.86 | $9.92 | $594.44 |
| 3947 | General Inpatient Care | $1,298.11 | $29.21 | $9.92 | $1,337.24 |
| 3948 | Continuous Home Care - Min 8 Hours | $611.71 | $13.76 | $9.92 | $635.39 |
| 3949 | Continuous Home Care - Min 9 Hours | $688.18 | $15.48 | $9.92 | $713.58 |
| 3950 | Continuous Home Care - Min 10 Hours | $764.64 | $17.20 | $9.92 | $791.76 |
| 3951 | Continuous Home Care - Min 11 Hours | $841.11 | $18.92 | $9.92 | $869.95 |
| 3952 | Continuous Home Care - Min 12 Hours | $917.57 | $20.65 | $9.92 | $948.14 |
| 3953 | Continuous Home Care - Min 13 Hours | $994.03 | $22.37 | $9.92 | $1,026.32 |
| 3954 | Continuous Home Care - Min 14 Hours | $1,070.50 | $24.09 | $9.92 | $1,104.51 |
| 3955 | Continuous Home Care - Min 15 Hours | $1,146.96 | $25.81 | $9.92 | $1,182.69 |
| 3956 | Continuous Home Care - Min 16 Hours | $1,223.43 | $27.53 | $9.92 | $1,260.88 |
| 3957 | Continuous Home Care - Min 17 Hours | $1,299.89 | $29.25 | $9.92 | $1,339.06 |
| 3958 | Continuous Home Care - Min 18 Hours | $1,376.36 | $30.97 | $9.92 | $1,417.25 |
| 3959 | Continuous Home Care - Min 19 Hours | $1,452.82 | $32.69 | $9.92 | $1,495.43 |
| 3960 | Continuous Home Care - Min 20 Hours | $1,529.28 | $34.41 | $9.92 | $1,573.61 |
| 3961 | Continuous Home Care - Min 21 Hours | $1,605.75 | $36.13 | $9.92 | $1,651.80 |
| 3962 | Continuous Home Care - Min 22 Hours | $1,682.21 | $37.85 | $9.92 | $1,729.98 |
| 3963 | Continuous Home Care - Min 23 Hours | $1,758.68 | $39.57 | $9.92 | $1,808.17 |
| 3964 | Continuous Home Care - Min 24 Hours | $1,835.14 | $41.29 | $9.92 | $1,886.35 |
| 3965 | Hospice Inpatient Respite Care Coinsurance Rate - 5% of 3946 | $28.58 | $0.64 | $0.50 | $29.72 |
| 3966 | Drugs Coinsurance Rate | $1.00 | $0.00 | $0.00 | $1.00 |
| 3969 | Routine Home Care w/AIDS | $406.81 | $9.15 | $9.92 | $425.88 |
| 3970 | Routine Home Care w/Escort | $268.24 | $6.04 | $9.92 | $284.20 |
| 3971 | Continuous Home Care w/AIDS Min 8 Hours | $686.75 | $15.45 | $9.92 | $712.12 |
| 3972 | Continuous Home Care w/AIDS Min 9 Hours | $772.59 | $17.38 | $9.92 | $799.89 |
| 3973 | Continuous Home Care w/AIDS Min 10 Hours | $858.44 | $19.31 | $9.92 | $887.67 |
| 3974 | Continuous Home Care w/AIDS Min 11 Hours | $944.28 | $21.25 | $9.92 | $975.45 |
| 3975 | Continuous Home Care w/AIDS Min 12 Hours | $1,030.13 | $23.18 | $9.92 | $1,063.23 |
| 3976 | Continuous Home Care w/AIDS Min 13 Hours | $1,115.97 | $25.11 | $9.92 | $1,151.00 |
| 3977 | Continuous Home Care w/AIDS Min 14 Hours | $1,201.81 | $27.04 | $9.92 | $1,238.77 |
| 3978 | Continuous Home Care w/AIDS Min 15 Hours | $1,287.66 | $28.97 | $9.92 | $1,326.55 |
| 3979 | Continuous Home Care w/AIDS Min 16 Hours | $1,373.50 | $30.90 | $9.92 | $1,414.32 |
| 3980 | Continuous Home Care w/AIDS Min 17 Hours | $1,459.34 | $32.84 | $9.92 | $1,502.10 |
| 3981 | Continuous Home Care w/AIDS Min 18 Hours | $1,545.19 | $34.77 | $9.92 | $1,589.88 |
| 3982 | Continuous Home Care w/AIDS Min 19 Hours | $1,631.03 | $36.70 | $9.92 | $1,677.65 |
| 3983 | Continuous Home Care w/AIDS Min 20 Hours | $1,716.88 | $38.63 | $9.92 | $1,765.43 |
| 3984 | Continuous Home Care w/AIDS Min 21 Hours | $1,802.72 | $40.56 | $9.92 | $1,853.20 |
| 3985 | Continuous Home Care w/AIDS Min 22 Hours | $1,888.56 | $42.49 | $9.92 | $1,940.97 |
| 3986 | Continuous Home Care w/AIDS Min 23 Hours | $1,974.41 | $44.42 | $9.92 | $2,028.75 |
| 3987 | Continuous Home Care w/AIDS Min 24 Hours | $2,060.25 | $46.36 | $9.92 | $2,116.53 |
| 3988 | General Inpatient w/ AIDS | $1,442.72 | $32.46 | $9.92 | $1,485.10 |
| 3989 | Routine Home Care w/ AIDS Escort | $426.17 | $9.59 | $9.92 | $445.68 |
| 3991 | Service Intensity Add-on | $75.13 | $1.69 | $0.00 | $76.82 |
* WRR =´Worker Recruitment and Retention addon´ if applicable
* RTR =´Recruitment, Training and Retention addon´ if applicable
SMSA: Niagara Falls
Hospice Rate Sheets for the Counties of: NIAGARA
| Rate Code |
Description | Base Rate | WRP Add-on * |
RTR Add-on * |
Total w/ addons |
|---|---|---|---|---|---|
| 3945 | Routine Home Care | $209.60 | $4.72 | $9.92 | $224.24 |
| 3946 | Inpatient Respite | $487.10 | $10.96 | $9.92 | $507.98 |
| 3947 | General Inpatient Care | $1,099.62 | $24.74 | $9.92 | $1,134.28 |
| 3948 | Continuous Home Care - Min 8 Hours | $504.44 | $11.35 | $9.92 | $525.71 |
| 3949 | Continuous Home Care - Min 9 Hours | $567.50 | $12.77 | $9.92 | $590.19 |
| 3950 | Continuous Home Care - Min 10 Hours | $630.55 | $14.19 | $9.92 | $654.66 |
| 3951 | Continuous Home Care - Min 11 Hours | $693.61 | $15.61 | $9.92 | $719.14 |
| 3952 | Continuous Home Care - Min 12 Hours | $756.67 | $17.03 | $9.92 | $783.62 |
| 3953 | Continuous Home Care - Min 13 Hours | $819.72 | $18.44 | $9.92 | $848.08 |
| 3954 | Continuous Home Care - Min 14 Hours | $882.78 | $19.86 | $9.92 | $912.56 |
| 3955 | Continuous Home Care - Min 15 Hours | $945.83 | $21.28 | $9.92 | $977.03 |
| 3956 | Continuous Home Care - Min 16 Hours | $1,008.89 | $22.70 | $9.92 | $1,041.51 |
| 3957 | Continuous Home Care - Min 17 Hours | $1,071.94 | $24.12 | $9.92 | $1,105.98 |
| 3958 | Continuous Home Care - Min 18 Hours | $1,135.00 | $25.54 | $9.92 | $1,170.46 |
| 3959 | Continuous Home Care - Min 19 Hours | $1,198.05 | $26.96 | $9.92 | $1,234.93 |
| 3960 | Continuous Home Care - Min 20 Hours | $1,261.11 | $28.37 | $9.92 | $1,299.40 |
| 3961 | Continuous Home Care - Min 21 Hours | $1,324.16 | $29.79 | $9.92 | $1,363.87 |
| 3962 | Continuous Home Care - Min 22 Hours | $1,387.22 | $31.21 | $9.92 | $1,428.35 |
| 3963 | Continuous Home Care - Min 23 Hours | $1,450.27 | $32.63 | $9.92 | $1,492.82 |
| 3964 | Continuous Home Care - Min 24 Hours | $1,513.33 | $34.05 | $9.92 | $1,557.30 |
| 3965 | Hospice Inpatient Respite Care Coinsurance Rate - | ||||
| 5% of 3946 | $24.36 | $0.55 | $0.50 | $25.41 | |
| 3966 | Drugs Coinsurance Rate | $1.00 | $0.00 | $0.00 | $1.00 |
| 3969 | Routine Home Care w/AIDS | $342.61 | $7.71 | $9.92 | $360.24 |
| 3970 | Routine Home Care w/Escort | $228.96 | $5.15 | $9.92 | $244.03 |
| 3971 | Continuous Home Care w/AIDS Min 8 Hours | $545.53 | $12.27 | $9.92 | $567.72 |
| 3972 | Continuous Home Care w/AIDS Min 9 Hours | $613.72 | $13.81 | $9.92 | $637.45 |
| 3973 | Continuous Home Care w/AIDS Min 10 Hours | $681.91 | $15.34 | $9.92 | $707.17 |
| 3974 | Continuous Home Care w/AIDS Min 11 Hours | $750.10 | $16.88 | $9.92 | $776.90 |
| 3975 | Continuous Home Care w/AIDS Min 12 Hours | $818.30 | $18.41 | $9.92 | $846.63 |
| 3976 | Continuous Home Care w/AIDS Min 13 Hours | $886.49 | $19.95 | $9.92 | $916.36 |
| 3977 | Continuous Home Care w/AIDS Min 14 Hours | $954.68 | $21.48 | $9.92 | $986.08 |
| 3978 | Continuous Home Care w/AIDS Min 15 Hours | $1,022.87 | $23.01 | $9.92 | $1,055.80 |
| 3979 | Continuous Home Care w/AIDS Min 16 Hours | $1,091.06 | $24.55 | $9.92 | $1,125.53 |
| 3980 | Continuous Home Care w/AIDS Min 17 Hours | $1,159.25 | $26.08 | $9.92 | $1,195.25 |
| 3981 | Continuous Home Care w/AIDS Min 18 Hours | $1,227.44 | $27.62 | $9.92 | $1,264.98 |
| 3982 | Continuous Home Care w/AIDS Min 19 Hours | $1,295.63 | $29.15 | $9.92 | $1,334.70 |
| 3983 | Continuous Home Care w/AIDS Min 20 Hours | $1,363.83 | $30.69 | $9.92 | $1,404.44 |
| 3984 | Continuous Home Care w/AIDS Min 21 Hours | $1,432.02 | $32.22 | $9.92 | $1,474.16 |
| 3985 | Continuous Home Care w/AIDS Min 22 Hours | $1,500.21 | $33.75 | $9.92 | $1,543.88 |
| 3986 | Continuous Home Care w/AIDS Min 23 Hours | $1,568.40 | $35.29 | $9.92 | $1,613.61 |
| 3987 | Continuous Home Care w/AIDS Min 24 Hours | $1,636.59 | $36.82 | $9.92 | $1,683.33 |
| 3988 | General Inpatient w/ AIDS | $1,222.12 | $27.50 | $9.92 | $1,259.54 |
| 3989 | Routine Home Care w/ AIDS Escort | $361.97 | $8.14 | $9.92 | $380.03 |
| 3991 | Service Intensity Add-on | $62.87 | $1.41 | $0.00 | $64.28 |
* WRR =´Worker Recruitment and Retention addon´ if applicable
* RTR =´Recruitment, Training and Retention addon´ if applicable
SMSA: Orange
Hospice Rate Sheets for the Counties of: ORANGE
| Rate Code |
Description | Base Rate | WRP Add-on * |
RTR Add-on * |
Total w/ addons |
|---|---|---|---|---|---|
| 3945 | Routine Home Care | $248.88 | $5.60 | $9.92 | $264.40 |
| 3946 | Inpatient Respite | $571.66 | $12.86 | $9.92 | $594.44 |
| 3947 | General Inpatient Care | $1,298.11 | $29.21 | $9.92 | $1,337.24 |
| 3948 | Continuous Home Care - Min 8 Hours | $611.71 | $13.76 | $9.92 | $635.39 |
| 3949 | Continuous Home Care - Min 9 Hours | $688.18 | $15.48 | $9.92 | $713.58 |
| 3950 | Continuous Home Care - Min 10 Hours | $764.64 | $17.20 | $9.92 | $791.76 |
| 3951 | Continuous Home Care - Min 11 Hours | $841.11 | $18.92 | $9.92 | $869.95 |
| 3952 | Continuous Home Care - Min 12 Hours | $917.57 | $20.65 | $9.92 | $948.14 |
| 3953 | Continuous Home Care - Min 13 Hours | $994.03 | $22.37 | $9.92 | $1,026.32 |
| 3954 | Continuous Home Care - Min 14 Hours | $1,070.50 | $24.09 | $9.92 | $1,104.51 |
| 3955 | Continuous Home Care - Min 15 Hours | $1,146.96 | $25.81 | $9.92 | $1,182.69 |
| 3956 | Continuous Home Care - Min 16 Hours | $1,223.43 | $27.53 | $9.92 | $1,260.88 |
| 3957 | Continuous Home Care - Min 17 Hours | $1,299.89 | $29.25 | $9.92 | $1,339.06 |
| 3958 | Continuous Home Care - Min 18 Hours | $1,376.36 | $30.97 | $9.92 | $1,417.25 |
| 3959 | Continuous Home Care - Min 19 Hours | $1,452.82 | $32.69 | $9.92 | $1,495.43 |
| 3960 | Continuous Home Care - Min 20 Hours | $1,529.28 | $34.41 | $9.92 | $1,573.61 |
| 3961 | Continuous Home Care - Min 21 Hours | $1,605.75 | $36.13 | $9.92 | $1,651.80 |
| 3962 | Continuous Home Care - Min 22 Hours | $1,682.21 | $37.85 | $9.92 | $1,729.98 |
| 3963 | Continuous Home Care - Min 23 Hours | $1,758.68 | $39.57 | $9.92 | $1,808.17 |
| 3964 | Continuous Home Care - Min 24 Hours | $1,835.14 | $41.29 | $9.92 | $1,886.35 |
| 3965 | Hospice Inpatient Respite Care Coinsurance Rate - | ||||
| 5% of 3946 | $28.58 | $0.64 | $0.50 | $29.72 | |
| 3966 | Drugs Coinsurance Rate | $1.00 | $0.00 | $0.00 | $1.00 |
| 3969 | Routine Home Care w/AIDS | $406.81 | $9.15 | $9.92 | $425.88 |
| 3970 | Routine Home Care w/Escort | $268.24 | $6.04 | $9.92 | $284.20 |
| 3971 | Continuous Home Care w/AIDS Min 8 Hours | $686.75 | $15.45 | $9.92 | $712.12 |
| 3972 | Continuous Home Care w/AIDS Min 9 Hours | $772.59 | $17.38 | $9.92 | $799.89 |
| 3973 | Continuous Home Care w/AIDS Min 10 Hours | $858.44 | $19.31 | $9.92 | $887.67 |
| 3974 | Continuous Home Care w/AIDS Min 11 Hours | $944.28 | $21.25 | $9.92 | $975.45 |
| 3975 | Continuous Home Care w/AIDS Min 12 Hours | $1,030.13 | $23.18 | $9.92 | $1,063.23 |
| 3976 | Continuous Home Care w/AIDS Min 13 Hours | $1,115.97 | $25.11 | $9.92 | $1,151.00 |
| 3977 | Continuous Home Care w/AIDS Min 14 Hours | $1,201.81 | $27.04 | $9.92 | $1,238.77 |
| 3978 | Continuous Home Care w/AIDS Min 15 Hours | $1,287.66 | $28.97 | $9.92 | $1,326.55 |
| 3979 | Continuous Home Care w/AIDS Min 16 Hours | $1,373.50 | $30.90 | $9.92 | $1,414.32 |
| 3980 | Continuous Home Care w/AIDS Min 17 Hours | $1,459.34 | $32.84 | $9.92 | $1,502.10 |
| 3981 | Continuous Home Care w/AIDS Min 18 Hours | $1,545.19 | $34.77 | $9.92 | $1,589.88 |
| 3982 | Continuous Home Care w/AIDS Min 19 Hours | $1,631.03 | $36.70 | $9.92 | $1,677.65 |
| 3983 | Continuous Home Care w/AIDS Min 20 Hours | $1,716.88 | $38.63 | $9.92 | $1,765.43 |
| 3984 | Continuous Home Care w/AIDS Min 21 Hours | $1,802.72 | $40.56 | $9.92 | $1,853.20 |
| 3985 | Continuous Home Care w/AIDS Min 22 Hours | $1,888.56 | $42.49 | $9.92 | $1,940.97 |
| 3986 | Continuous Home Care w/AIDS Min 23 Hours | $1,974.41 | $44.42 | $9.92 | $2,028.75 |
| 3987 | Continuous Home Care w/AIDS Min 24 Hours | $2,060.25 | $46.36 | $9.92 | $2,116.53 |
| 3988 | General Inpatient w/ AIDS | $1,442.72 | $32.46 | $9.92 | $1,485.10 |
| 3989 | Routine Home Care w/ AIDS Escort | $426.17 | $9.59 | $9.92 | $445.68 |
| 3991 | Service Intensity Add-on | $75.13 | $1.69 | $0.00 | $76.82 |
* WRR =´Worker Recruitment and Retention addon´ if applicable
* RTR =´Recruitment, Training and Retention addon´ if applicable
SMSA: Poughkeepsie
Hospice Rate Sheets for the Counties of: DUTCHESS
| Rate Code |
Description | Base Rate | WRP Add-on * |
RTR Add-on * |
Total w/ addons |
|---|---|---|---|---|---|
| 3945 | Routine Home Care | $234.53 | $5.28 | $9.92 | $249.73 |
| 3946 | Inpatient Respite | $540.77 | $12.17 | $9.92 | $562.86 |
| 3947 | General Inpatient Care | $1,225.59 | $27.58 | $9.92 | $1,263.09 |
| 3948 | Continuous Home Care - Min 8 Hours | $572.52 | $12.88 | $9.92 | $595.32 |
| 3949 | Continuous Home Care - Min 9 Hours | $644.09 | $14.49 | $9.92 | $668.50 |
| 3950 | Continuous Home Care - Min 10 Hours | $715.65 | $16.10 | $9.92 | $741.67 |
| 3951 | Continuous Home Care - Min 11 Hours | $787.22 | $17.71 | $9.92 | $814.85 |
| 3952 | Continuous Home Care - Min 12 Hours | $858.79 | $19.32 | $9.92 | $888.03 |
| 3953 | Continuous Home Care - Min 13 Hours | $930.35 | $20.93 | $9.92 | $961.20 |
| 3954 | Continuous Home Care - Min 14 Hours | $1,001.92 | $22.54 | $9.92 | $1,034.38 |
| 3955 | Continuous Home Care - Min 15 Hours | $1,073.48 | $24.15 | $9.92 | $1,107.55 |
| 3956 | Continuous Home Care - Min 16 Hours | $1,145.05 | $25.76 | $9.92 | $1,180.73 |
| 3957 | Continuous Home Care - Min 17 Hours | $1,216.61 | $27.37 | $9.92 | $1,253.90 |
| 3958 | Continuous Home Care - Min 18 Hours | $1,288.18 | $28.98 | $9.92 | $1,327.08 |
| 3959 | Continuous Home Care - Min 19 Hours | $1,359.74 | $30.59 | $9.92 | $1,400.25 |
| 3960 | Continuous Home Care - Min 20 Hours | $1,431.31 | $32.20 | $9.92 | $1,473.43 |
| 3961 | Continuous Home Care - Min 21 Hours | $1,502.87 | $33.81 | $9.92 | $1,546.60 |
| 3962 | Continuous Home Care - Min 22 Hours | $1,574.44 | $35.42 | $9.92 | $1,619.78 |
| 3963 | Continuous Home Care - Min 23 Hours | $1,646.00 | $37.04 | $9.92 | $1,692.96 |
| 3964 | Continuous Home Care - Min 24 Hours | $1,717.57 | $38.65 | $9.92 | $1,766.14 |
| 3965 | Hospice Inpatient Respite Care Coinsurance Rate - 5% of 3946 | $27.04 | $0.61 | $0.50 | $28.15 |
| 3966 | Drugs Coinsurance Rate | $1.00 | $0.00 | $0.00 | $1.00 |
| 3969 | Routine Home Care w/AIDS | $383.36 | $8.63 | $9.92 | $401.91 |
| 3970 | Routine Home Care w/Escort | $253.89 | $5.71 | $9.92 | $269.52 |
| 3971 | Continuous Home Care w/AIDS Min 8 Hours | $635.16 | $14.29 | $9.92 | $659.37 |
| 3972 | Continuous Home Care w/AIDS Min 9 Hours | $714.55 | $16.08 | $9.92 | $740.55 |
| 3973 | Continuous Home Care w/AIDS Min 10 Hours | $793.95 | $17.86 | $9.92 | $821.73 |
| 3974 | Continuous Home Care w/AIDS Min 11 Hours | $873.34 | $19.65 | $9.92 | $902.91 |
| 3975 | Continuous Home Care w/AIDS Min 12 Hours | $952.74 | $21.44 | $9.92 | $984.10 |
| 3976 | Continuous Home Care w/AIDS Min 13 Hours | $1,032.13 | $23.22 | $9.92 | $1,065.27 |
| 3977 | Continuous Home Care w/AIDS Min 14 Hours | $1,111.52 | $25.01 | $9.92 | $1,146.45 |
| 3978 | Continuous Home Care w/AIDS Min 15 Hours | $1,190.92 | $26.80 | $9.92 | $1,227.64 |
| 3979 | Continuous Home Care w/AIDS Min 16 Hours | $1,270.31 | $28.58 | $9.92 | $1,308.81 |
| 3980 | Continuous Home Care w/AIDS Min 17 Hours | $1,349.71 | $30.37 | $9.92 | $1,390.00 |
| 3981 | Continuous Home Care w/AIDS Min 18 Hours | $1,429.10 | $32.15 | $9.92 | $1,471.17 |
| 3982 | Continuous Home Care w/AIDS Min 19 Hours | $1,508.50 | $33.94 | $9.92 | $1,552.36 |
| 3983 | Continuous Home Care w/AIDS Min 20 Hours | $1,587.89 | $35.73 | $9.92 | $1,633.54 |
| 3984 | Continuous Home Care w/AIDS Min 21 Hours | $1,667.29 | $37.51 | $9.92 | $1,714.72 |
| 3985 | Continuous Home Care w/AIDS Min 22 Hours | $1,746.68 | $39.30 | $9.92 | $1,795.90 |
| 3986 | Continuous Home Care w/AIDS Min 23 Hours | $1,826.08 | $41.09 | $9.92 | $1,877.09 |
| 3987 | Continuous Home Care w/AIDS Min 24 Hours | $1,905.47 | $42.87 | $9.92 | $1,958.26 |
| 3988 | General Inpatient w/ AIDS | $1,362.12 | $30.65 | $9.92 | $1,402.69 |
| 3989 | Routine Home Care w/ AIDS Escort | $402.72 | $9.06 | $9.92 | $421.70 |
| 3991 | Service Intensity Add-on | $70.65 | $1.59 | $0.00 | $72.24 |
* WRR =´Worker Recruitment and Retention addon´ if applicable
* RTR =´Recruitment, Training and Retention addon´ if applicable
SMSA: Rochester
Hospice Rate Sheets for the Counties of: LIVINGSTON, MONROE, ONTARIO, ORLEANS, WAYNE
| Rate Code |
Description | Base Rate | WRP Add-on * |
RTR Add-on * |
Total w/ addons |
|---|---|---|---|---|---|
| 3945 | Routine Home Care | $189.77 | $4.27 | $9.92 | $203.96 |
| 3946 | Inpatient Respite | $444.42 | $10.00 | $9.92 | $464.34 |
| 3947 | General Inpatient Care | $999.43 | $22.49 | $9.92 | $1,031.84 |
| 3948 | Continuous Home Care - Min 8 Hours | $450.30 | $10.13 | $9.92 | $470.35 |
| 3949 | Continuous Home Care - Min 9 Hours | $506.58 | $11.40 | $9.92 | $527.90 |
| 3950 | Continuous Home Care - Min 10 Hours | $562.87 | $12.66 | $9.92 | $585.45 |
| 3951 | Continuous Home Care - Min 11 Hours | $619.16 | $13.93 | $9.92 | $643.01 |
| 3952 | Continuous Home Care - Min 12 Hours | $675.45 | $15.20 | $9.92 | $700.57 |
| 3953 | Continuous Home Care - Min 13 Hours | $731.73 | $16.46 | $9.92 | $758.11 |
| 3954 | Continuous Home Care - Min 14 Hours | $788.02 | $17.73 | $9.92 | $815.67 |
| 3955 | Continuous Home Care - Min 15 Hours | $844.31 | $19.00 | $9.92 | $873.23 |
| 3956 | Continuous Home Care - Min 16 Hours | $900.59 | $20.26 | $9.92 | $930.77 |
| 3957 | Continuous Home Care - Min 17 Hours | $956.88 | $21.53 | $9.92 | $988.33 |
| 3958 | Continuous Home Care - Min 18 Hours | $1,013.17 | $22.80 | $9.92 | $1,045.89 |
| 3959 | Continuous Home Care - Min 19 Hours | $1,069.45 | $24.06 | $9.92 | $1,103.43 |
| 3960 | Continuous Home Care - Min 20 Hours | $1,125.74 | $25.33 | $9.92 | $1,160.99 |
| 3961 | Continuous Home Care - Min 21 Hours | $1,182.03 | $26.60 | $9.92 | $1,218.55 |
| 3962 | Continuous Home Care - Min 22 Hours | $1,238.32 | $27.86 | $9.92 | $1,276.10 |
| 3963 | Continuous Home Care - Min 23 Hours | $1,294.60 | $29.13 | $9.92 | $1,333.65 |
| 3964 | Continuous Home Care - Min 24 Hours | $1,350.89 | $30.40 | $9.92 | $1,391.21 |
| 3965 | Hospice Inpatient Respite Care Coinsurance Rate - 5% of 3946 | $22.22 | $0.50 | $0.50 | $23.22 |
| 3966 | Drugs Coinsurance Rate | $1.00 | $0.00 | $0.00 | $1.00 |
| 3969 | Routine Home Care w/AIDS | $310.20 | $6.98 | $9.92 | $327.10 |
| 3970 | Routine Home Care w/Escort | $209.13 | $4.71 | $9.92 | $223.76 |
| 3971 | Continuous Home Care w/AIDS Min 8 Hours | $474.25 | $10.67 | $9.92 | $494.84 |
| 3972 | Continuous Home Care w/AIDS Min 9 Hours | $533.53 | $12.00 | $9.92 | $555.45 |
| 3973 | Continuous Home Care w/AIDS Min 10 Hours | $592.81 | $13.34 | $9.92 | $616.07 |
| 3974 | Continuous Home Care w/AIDS Min 11 Hours | $652.09 | $14.67 | $9.92 | $676.68 |
| 3975 | Continuous Home Care w/AIDS Min 12 Hours | $711.37 | $16.01 | $9.92 | $737.30 |
| 3976 | Continuous Home Care w/AIDS Min 13 Hours | $770.65 | $17.34 | $9.92 | $797.91 |
| 3977 | Continuous Home Care w/AIDS Min 14 Hours | $829.93 | $18.67 | $9.92 | $858.52 |
| 3978 | Continuous Home Care w/AIDS Min 15 Hours | $889.21 | $20.01 | $9.92 | $919.14 |
| 3979 | Continuous Home Care w/AIDS Min 16 Hours | $948.49 | $21.34 | $9.92 | $979.75 |
| 3980 | Continuous Home Care w/AIDS Min 17 Hours | $1,007.77 | $22.67 | $9.92 | $1,040.36 |
| 3981 | Continuous Home Care w/AIDS Min 18 Hours | $1,067.06 | $24.01 | $9.92 | $1,100.99 |
| 3982 | Continuous Home Care w/AIDS Min 19 Hours | $1,126.34 | $25.34 | $9.92 | $1,161.60 |
| 3983 | Continuous Home Care w/AIDS Min 20 Hours | $1,185.62 | $26.68 | $9.92 | $1,222.22 |
| 3984 | Continuous Home Care w/AIDS Min 21 Hours | $1,244.90 | $28.01 | $9.92 | $1,282.83 |
| 3985 | Continuous Home Care w/AIDS Min 22 Hours | $1,304.18 | $29.34 | $9.92 | $1,343.44 |
| 3986 | Continuous Home Care w/AIDS Min 23 Hours | $1,363.46 | $30.68 | $9.92 | $1,404.06 |
| 3987 | Continuous Home Care w/AIDS Min 24 Hours | $1,422.74 | $32.01 | $9.92 | $1,464.67 |
| 3988 | General Inpatient w/ AIDS | $1,110.77 | $24.99 | $9.92 | $1,145.68 |
| 3989 | Routine Home Care w/ AIDS Escort | $329.56 | $7.42 | $9.92 | $346.90 |
| 3991 | Service Intensity Add-on | $56.69 | $1.28 | $0.00 | $57.97 |
* WRR =´Worker Recruitment and Retention addon´ if applicable
* RTR =´Recruitment, Training and Retention addon´ if applicable
SMSA: Syracuse
Hospice Rate Sheets for the Counties of: MADISON, ONONDAGA, OSWEGO
| Rate Code |
Description | Base Rate | WRP Add-on * |
RTR Add-on * |
Total w/ addons |
|---|---|---|---|---|---|
| 3945 | Routine Home Care | $205.83 | $4.63 | $9.92 | $220.38 |
| 3946 | Inpatient Respite | $478.98 | $10.78 | $9.92 | $499.68 |
| 3947 | General Inpatient Care | $1,080.56 | $24.31 | $9.92 | $1,114.79 |
| 3948 | Continuous Home Care - Min 8 Hours | $494.14 | $11.12 | $9.92 | $515.18 |
| 3949 | Continuous Home Care - Min 9 Hours | $555.91 | $12.51 | $9.92 | $578.34 |
| 3950 | Continuous Home Care - Min 10 Hours | $617.68 | $13.90 | $9.92 | $641.50 |
| 3951 | Continuous Home Care - Min 11 Hours | $679.45 | $15.29 | $9.92 | $704.66 |
| 3952 | Continuous Home Care - Min 12 Hours | $741.22 | $16.68 | $9.92 | $767.82 |
| 3953 | Continuous Home Care - Min 13 Hours | $802.98 | $18.07 | $9.92 | $830.97 |
| 3954 | Continuous Home Care - Min 14 Hours | $864.75 | $19.46 | $9.92 | $894.13 |
| 3955 | Continuous Home Care - Min 15 Hours | $926.52 | $20.85 | $9.92 | $957.29 |
| 3956 | Continuous Home Care - Min 16 Hours | $988.29 | $22.24 | $9.92 | $1,020.45 |
| 3957 | Continuous Home Care - Min 17 Hours | $1,050.05 | $23.63 | $9.92 | $1,083.60 |
| 3958 | Continuous Home Care - Min 18 Hours | $1,111.82 | $25.02 | $9.92 | $1,146.76 |
| 3959 | Continuous Home Care - Min 19 Hours | $1,173.59 | $26.41 | $9.92 | $1,209.92 |
| 3960 | Continuous Home Care - Min 20 Hours | $1,235.36 | $27.80 | $9.92 | $1,273.08 |
| 3961 | Continuous Home Care - Min 21 Hours | $1,297.13 | $29.19 | $9.92 | $1,336.24 |
| 3962 | Continuous Home Care - Min 22 Hours | $1,358.89 | $30.58 | $9.92 | $1,399.39 |
| 3963 | Continuous Home Care - Min 23 Hours | $1,420.66 | $31.96 | $9.92 | $1,462.54 |
| 3964 | Continuous Home Care - Min 24 Hours | $1,482.43 | $33.35 | $9.92 | $1,525.70 |
| 3965 | Hospice Inpatient Respite Care Coinsurance Rate - | ||||
| 5% of 3946 | $23.95 | $0.54 | $0.50 | $24.99 | |
| 3966 | Drugs Coinsurance Rate | $1.00 | $0.00 | $0.00 | $1.00 |
| 3969 | Routine Home Care w/AIDS | $336.44 | $7.57 | $9.92 | $353.93 |
| 3970 | Routine Home Care w/Escort | $225.19 | $5.07 | $9.92 | $240.18 |
| 3971 | Continuous Home Care w/AIDS Min 8 Hours | $531.97 | $11.97 | $9.92 | $553.86 |
| 3972 | Continuous Home Care w/AIDS Min 9 Hours | $598.47 | $13.47 | $9.92 | $621.86 |
| 3973 | Continuous Home Care w/AIDS Min 10 Hours | $664.96 | $14.96 | $9.92 | $689.84 |
| 3974 | Continuous Home Care w/AIDS Min 11 Hours | $731.46 | $16.46 | $9.92 | $757.84 |
| 3975 | Continuous Home Care w/AIDS Min 12 Hours | $797.96 | $17.95 | $9.92 | $825.83 |
| 3976 | Continuous Home Care w/AIDS Min 13 Hours | $864.45 | $19.45 | $9.92 | $893.82 |
| 3977 | Continuous Home Care w/AIDS Min 14 Hours | $930.95 | $20.95 | $9.92 | $961.82 |
| 3978 | Continuous Home Care w/AIDS Min 15 Hours | $997.44 | $22.44 | $9.92 | $1,029.80 |
| 3979 | Continuous Home Care w/AIDS Min 16 Hours | $1,063.94 | $23.94 | $9.92 | $1,097.80 |
| 3980 | Continuous Home Care w/AIDS Min 17 Hours | $1,130.44 | $25.43 | $9.92 | $1,165.79 |
| 3981 | Continuous Home Care w/AIDS Min 18 Hours | $1,196.93 | $26.93 | $9.92 | $1,233.78 |
| 3982 | Continuous Home Care w/AIDS Min 19 Hours | $1,263.43 | $28.43 | $9.92 | $1,301.78 |
| 3983 | Continuous Home Care w/AIDS Min 20 Hours | $1,329.93 | $29.92 | $9.92 | $1,369.77 |
| 3984 | Continuous Home Care w/AIDS Min 21 Hours | $1,396.42 | $31.42 | $9.92 | $1,437.76 |
| 3985 | Continuous Home Care w/AIDS Min 22 Hours | $1,462.92 | $32.92 | $9.92 | $1,505.76 |
| 3986 | Continuous Home Care w/AIDS Min 23 Hours | $1,529.41 | $34.41 | $9.92 | $1,573.74 |
| 3987 | Continuous Home Care w/AIDS Min 24 Hours | $1,595.91 | $35.91 | $9.92 | $1,641.74 |
| 3988 | General Inpatient w/ AIDS | $1,200.93 | $27.02 | $9.92 | $1,237.87 |
| 3989 | Routine Home Care w/ AIDS Escort | $355.80 | $8.01 | $9.92 | $373.73 |
| 3991 | Service Intensity Add-on | $61.70 | $1.39 | $0.00 | $63.09 |
* WRR =´Worker Recruitment and Retention addon´ if applicable
* RTR =´Recruitment, Training and Retention addon´ if applicable
SMSA: Utica-Rome
Hospice Rate Sheets for the Counties of: HERKIMER, ONEIDA
| Rate Code |
Description | Base Rate | WRP Add-on * |
RTR Add-on * |
Total w/ addons |
|---|---|---|---|---|---|
| 3945 | Routine Home Care | $189.26 | $4.26 | $9.92 | $203.44 |
| 3946 | Inpatient Respite | $443.32 | $9.97 | $9.92 | $463.21 |
| 3947 | General Inpatient Care | $996.85 | $22.43 | $9.92 | $1,029.20 |
| 3948 | Continuous Home Care - Min 8 Hours | $448.90 | $10.10 | $9.92 | $468.92 |
| 3949 | Continuous Home Care - Min 9 Hours | $505.02 | $11.36 | $9.92 | $526.30 |
| 3950 | Continuous Home Care - Min 10 Hours | $561.13 | $12.63 | $9.92 | $583.68 |
| 3951 | Continuous Home Care - Min 11 Hours | $617.24 | $13.89 | $9.92 | $641.05 |
| 3952 | Continuous Home Care - Min 12 Hours | $673.36 | $15.15 | $9.92 | $698.43 |
| 3953 | Continuous Home Care - Min 13 Hours | $729.47 | $16.41 | $9.92 | $755.80 |
| 3954 | Continuous Home Care - Min 14 Hours | $785.58 | $17.68 | $9.92 | $813.18 |
| 3955 | Continuous Home Care - Min 15 Hours | $841.69 | $18.94 | $9.92 | $870.55 |
| 3956 | Continuous Home Care - Min 16 Hours | $897.81 | $20.20 | $9.92 | $927.93 |
| 3957 | Continuous Home Care - Min 17 Hours | $953.92 | $21.46 | $9.92 | $985.30 |
| 3958 | Continuous Home Care - Min 18 Hours | $1,010.03 | $22.73 | $9.92 | $1,042.68 |
| 3959 | Continuous Home Care - Min 19 Hours | $1,066.15 | $23.99 | $9.92 | $1,100.06 |
| 3960 | Continuous Home Care - Min 20 Hours | $1,122.26 | $25.25 | $9.92 | $1,157.43 |
| 3961 | Continuous Home Care - Min 21 Hours | $1,178.37 | $26.51 | $9.92 | $1,214.80 |
| 3962 | Continuous Home Care - Min 22 Hours | $1,234.48 | $27.78 | $9.92 | $1,272.18 |
| 3963 | Continuous Home Care - Min 23 Hours | $1,290.60 | $29.04 | $9.92 | $1,329.56 |
| 3964 | Continuous Home Care - Min 24 Hours | $1,346.71 | $30.30 | $9.92 | $1,386.93 |
| 3965 | Hospice Inpatient Respite Care Coinsurance Rate - 5% of 3946 | $22.17 | $0.50 | $0.50 | $23.17 |
| 3966 | Drugs Coinsurance Rate | $1.00 | $0.00 | $0.00 | $1.00 |
| 3969 | Routine Home Care w/AIDS | $309.36 | $6.96 | $9.92 | $326.24 |
| 3970 | Routine Home Care w/Escort | $208.62 | $4.69 | $9.92 | $223.23 |
| 3971 | Continuous Home Care w/AIDS Min 8 Hours | $472.41 | $10.63 | $9.92 | $492.96 |
| 3972 | Continuous Home Care w/AIDS Min 9 Hours | $531.47 | $11.96 | $9.92 | $553.35 |
| 3973 | Continuous Home Care w/AIDS Min 10 Hours | $590.52 | $13.29 | $9.92 | $613.73 |
| 3974 | Continuous Home Care w/AIDS Min 11 Hours | $649.57 | $14.62 | $9.92 | $674.11 |
| 3975 | Continuous Home Care w/AIDS Min 12 Hours | $708.62 | $15.94 | $9.92 | $734.48 |
| 3976 | Continuous Home Care w/AIDS Min 13 Hours | $767.67 | $17.27 | $9.92 | $794.86 |
| 3977 | Continuous Home Care w/AIDS Min 14 Hours | $826.72 | $18.60 | $9.92 | $855.24 |
| 3978 | Continuous Home Care w/AIDS Min 15 Hours | $885.78 | $19.93 | $9.92 | $915.63 |
| 3979 | Continuous Home Care w/AIDS Min 16 Hours | $944.83 | $21.26 | $9.92 | $976.01 |
| 3980 | Continuous Home Care w/AIDS Min 17 Hours | $1,003.88 | $22.59 | $9.92 | $1,036.39 |
| 3981 | Continuous Home Care w/AIDS Min 18 Hours | $1,062.93 | $23.92 | $9.92 | $1,096.77 |
| 3982 | Continuous Home Care w/AIDS Min 19 Hours | $1,121.98 | $25.24 | $9.92 | $1,157.14 |
| 3983 | Continuous Home Care w/AIDS Min 20 Hours | $1,181.03 | $26.57 | $9.92 | $1,217.52 |
| 3984 | Continuous Home Care w/AIDS Min 21 Hours | $1,240.09 | $27.90 | $9.92 | $1,277.91 |
| 3985 | Continuous Home Care w/AIDS Min 22 Hours | $1,299.14 | $29.23 | $9.92 | $1,338.29 |
| 3986 | Continuous Home Care w/AIDS Min 23 Hours | $1,358.19 | $30.56 | $9.92 | $1,398.67 |
| 3987 | Continuous Home Care w/AIDS Min 24 Hours | $1,417.24 | $31.89 | $9.92 | $1,459.05 |
| 3988 | General Inpatient w/ AIDS | $1,107.90 | $24.93 | $9.92 | $1,142.75 |
| 3989 | Routine Home Care w/ AIDS Escort | $328.72 | $7.40 | $9.92 | $346.04 |
| 3991 | Service Intensity Add-on | $56.53 | $1.27 | $0.00 | $57.80 |
* WRR =´Worker Recruitment and Retention addon´ if applicable
* RTR =´Recruitment, Training and Retention addon´ if applicable
SMSA: Rural
Hospice Rate Sheets for the Counties of: ALLEGANY, CATTARAUGUS, CAYUGA, CHAUTAUQUA, CHENANGO, CLINTON, COLUMBIA, CORTLAND, DELAWARE, ESSEX, FRANKLIN, FULTON, GENESEE, HAMILTON, JEFFERSON, LEWIS, OTSEGO, SCHOHARIE, SCHUYLER, SENECA, ST. LAWRENCE, STEUBEN, SULLIVAN, TOMPKINS, ULSTER, WYOMING, YATES
| Rate Code |
Description | Base Rate | WRP Add-on * |
RTR Add-on * |
Total w/ addons |
|---|---|---|---|---|---|
| 3945 | Routine Home Care | $183.47 | $4.13 | $9.92 | $197.52 |
| 3946 | Inpatient Respite | $430.83 | $9.69 | $9.92 | $450.44 |
| 3947 | General Inpatient Care | $967.54 | $21.77 | $9.92 | $999.23 |
| 3948 | Continuous Home Care - Min 8 Hours | $433.07 | $9.74 | $9.92 | $452.73 |
| 3949 | Continuous Home Care - Min 9 Hours | $487.20 | $10.96 | $9.92 | $508.08 |
| 3950 | Continuous Home Care - Min 10 Hours | $541.33 | $12.18 | $9.92 | $563.43 |
| 3951 | Continuous Home Care - Min 11 Hours | $595.47 | $13.40 | $9.92 | $618.79 |
| 3952 | Continuous Home Care - Min 12 Hours | $649.60 | $14.62 | $9.92 | $674.14 |
| 3953 | Continuous Home Care - Min 13 Hours | $703.73 | $15.83 | $9.92 | $729.48 |
| 3954 | Continuous Home Care - Min 14 Hours | $757.87 | $17.05 | $9.92 | $784.84 |
| 3955 | Continuous Home Care - Min 15 Hours | $812.00 | $18.27 | $9.92 | $840.19 |
| 3956 | Continuous Home Care - Min 16 Hours | $866.13 | $19.49 | $9.92 | $895.54 |
| 3957 | Continuous Home Care - Min 17 Hours | $920.27 | $20.71 | $9.92 | $950.90 |
| 3958 | Continuous Home Care - Min 18 Hours | $974.40 | $21.92 | $9.92 | $1,006.24 |
| 3959 | Continuous Home Care - Min 19 Hours | $1,028.53 | $23.14 | $9.92 | $1,061.59 |
| 3960 | Continuous Home Care - Min 20 Hours | $1,082.67 | $24.36 | $9.92 | $1,116.95 |
| 3961 | Continuous Home Care - Min 21 Hours | $1,136.80 | $25.58 | $9.92 | $1,172.30 |
| 3962 | Continuous Home Care - Min 22 Hours | $1,190.93 | $26.80 | $9.92 | $1,227.65 |
| 3963 | Continuous Home Care - Min 23 Hours | $1,245.07 | $28.01 | $9.92 | $1,283.00 |
| 3964 | Continuous Home Care - Min 24 Hours | $1,299.20 | $29.23 | $9.92 | $1,338.35 |
| 3965 | Hospice Inpatient Respite Care Coinsurance Rate - 5% of 3946 | $21.54 | $0.48 | $0.50 | $22.52 |
| 3966 | Drugs Coinsurance Rate | $1.00 | $0.00 | $0.00 | $1.00 |
| 3969 | Routine Home Care w/AIDS | $299.88 | $6.75 | $9.92 | $316.55 |
| 3970 | Routine Home Care w/Escort | $202.83 | $4.56 | $9.92 | $217.31 |
| 3971 | Continuous Home Care w/AIDS Min 8 Hours | $451.56 | $10.16 | $9.92 | $471.64 |
| 3972 | Continuous Home Care w/AIDS Min 9 Hours | $508.01 | $11.43 | $9.92 | $529.36 |
| 3973 | Continuous Home Care w/AIDS Min 10 Hours | $564.45 | $12.70 | $9.92 | $587.07 |
| 3974 | Continuous Home Care w/AIDS Min 11 Hours | $620.90 | $13.97 | $9.92 | $644.79 |
| 3975 | Continuous Home Care w/AIDS Min 12 Hours | $677.35 | $15.24 | $9.92 | $702.51 |
| 3976 | Continuous Home Care w/AIDS Min 13 Hours | $733.79 | $16.51 | $9.92 | $760.22 |
| 3977 | Continuous Home Care w/AIDS Min 14 Hours | $790.24 | $17.78 | $9.92 | $817.94 |
| 3978 | Continuous Home Care w/AIDS Min 15 Hours | $846.68 | $19.05 | $9.92 | $875.65 |
| 3979 | Continuous Home Care w/AIDS Min 16 Hours | $903.13 | $20.32 | $9.92 | $933.37 |
| 3980 | Continuous Home Care w/AIDS Min 17 Hours | $959.57 | $21.59 | $9.92 | $991.08 |
| 3981 | Continuous Home Care w/AIDS Min 18 Hours | $1,016.02 | $22.86 | $9.92 | $1,048.80 |
| 3982 | Continuous Home Care w/AIDS Min 19 Hours | $1,072.46 | $24.13 | $9.92 | $1,106.51 |
| 3983 | Continuous Home Care w/AIDS Min 20 Hours | $1,128.91 | $25.40 | $9.92 | $1,164.23 |
| 3984 | Continuous Home Care w/AIDS Min 21 Hours | $1,185.35 | $26.67 | $9.92 | $1,221.94 |
| 3985 | Continuous Home Care w/AIDS Min 22 Hours | $1,241.80 | $27.94 | $9.92 | $1,279.66 |
| 3986 | Continuous Home Care w/AIDS Min 23 Hours | $1,298.24 | $29.21 | $9.92 | $1,337.37 |
| 3987 | Continuous Home Care w/AIDS Min 24 Hours | $1,354.69 | $30.48 | $9.92 | $1,395.09 |
| 3988 | General Inpatient w/ AIDS | $1,075.32 | $24.19 | $9.92 | $1,109.43 |
| 3989 | Routine Home Care w/ AIDS Escort | $319.24 | $7.18 | $9.92 | $336.34 |
| 3991 | Service Intensity Add-on | $54.72 | $1.23 | $0.00 | $55.95 |
* WRR =´Worker Recruitment and Retention addon´ if applicable
* RTR =´Recruitment, Training and Retention addon´ if applicable
