Certified Hospice Program
Medicaid Rate Sheet
Effective: 10/01/2024 - 09/30/2025
- Rates also available in Excel Format (XLSM)
| 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 | 1% Add-on |
|---|---|---|---|---|---|---|
| 3945 | Routine Home Care | $197.64 | $4.45 | $9.92 | $212.01 | $214.13 |
| 3946 | Inpatient Respite | $484.89 | $10.91 | $9.92 | $505.72 | $510.78 |
| 3947 | General Inpatient Care | $1,033.55 | $23.25 | $9.92 | $1,066.72 | $1,077.39 |
| 3948 | Continuous Home Care - Min 8 Hours | $465.18 | $10.47 | $9.92 | $485.57 | $490.43 |
| 3949 | Continuous Home Care - Min 9 Hours | $523.33 | $11.77 | $9.92 | $545.02 | $550.47 |
| 3950 | Continuous Home Care - Min 10 Hours | $581.48 | $13.08 | $9.92 | $604.48 | $610.52 |
| 3951 | Continuous Home Care - Min 11 Hours | $639.62 | $14.39 | $9.92 | $663.93 | $670.57 |
| 3952 | Continuous Home Care - Min 12 Hours | $697.77 | $15.70 | $9.92 | $723.39 | $730.62 |
| 3953 | Continuous Home Care - Min 13 Hours | $755.92 | $17.01 | $9.92 | $782.85 | $790.68 |
| 3954 | Continuous Home Care - Min 14 Hours | $814.07 | $18.32 | $9.92 | $842.31 | $850.73 |
| 3955 | Continuous Home Care - Min 15 Hours | $872.21 | $19.62 | $9.92 | $901.75 | $910.77 |
| 3956 | Continuous Home Care - Min 16 Hours | $930.36 | $20.93 | $9.92 | $961.21 | $970.82 |
| 3957 | Continuous Home Care - Min 17 Hours | $988.51 | $22.24 | $9.92 | $1,020.67 | $1,030.88 |
| 3958 | Continuous Home Care - Min 18 Hours | $1,046.66 | $23.55 | $9.92 | $1,080.13 | $1,090.93 |
| 3959 | Continuous Home Care - Min 19 Hours | $1,104.80 | $24.86 | $9.92 | $1,139.58 | $1,150.98 |
| 3960 | Continuous Home Care - Min 20 Hours | $1,162.95 | $26.17 | $9.92 | $1,199.04 | $1,211.03 |
| 3961 | Continuous Home Care - Min 21 Hours | $1,221.10 | $27.47 | $9.92 | $1,258.49 | $1,271.07 |
| 3962 | Continuous Home Care - Min 22 Hours | $1,279.25 | $28.78 | $9.92 | $1,317.95 | $1,331.13 |
| 3963 | Continuous Home Care - Min 23 Hours | $1,337.39 | $30.09 | $9.92 | $1,377.40 | $1,391.17 |
| 3964 | Continuous Home Care - Min 24 Hours | $1,395.54 | $31.40 | $9.92 | $1,436.86 | $1,451.23 |
| 3965 | Hospice Inpatient Respite Care Coinsurance Rate - 5% of 3946 | $24.24 | $0.55 | $0.50 | $25.29 | $25.54 |
| 3966 | Drugs Coinsurance Rate | $1.00 | $0.00 | $0.00 | $1.00 | $1.01 |
| 3969 | Routine Home Care w/AIDS | $321.70 | $7.24 | $9.92 | $338.86 | $342.25 |
| 3970 | Routine Home Care w/Escort | $218.82 | $4.92 | $9.92 | $233.66 | $236.00 |
| 3971 | Continuous Home Care w/AIDS Min 8 Hours | $480.74 | $10.82 | $9.92 | $501.48 | $506.49 |
| 3972 | Continuous Home Care w/AIDS Min 9 Hours | $540.83 | $12.17 | $9.92 | $562.92 | $568.55 |
| 3973 | Continuous Home Care w/AIDS Min 10 Hours | $600.93 | $13.52 | $9.92 | $624.37 | $630.61 |
| 3974 | Continuous Home Care w/AIDS Min 11 Hours | $661.02 | $14.87 | $9.92 | $685.81 | $692.67 |
| 3975 | Continuous Home Care w/AIDS Min 12 Hours | $721.11 | $16.22 | $9.92 | $747.25 | $754.72 |
| 3976 | Continuous Home Care w/AIDS Min 13 Hours | $781.20 | $17.58 | $9.92 | $808.70 | $816.79 |
| 3977 | Continuous Home Care w/AIDS Min 14 Hours | $841.30 | $18.93 | $9.92 | $870.15 | $878.85 |
| 3978 | Continuous Home Care w/AIDS Min 15 Hours | $901.39 | $20.28 | $9.92 | $931.59 | $940.91 |
| 3979 | Continuous Home Care w/AIDS Min 16 Hours | $961.48 | $21.63 | $9.92 | $993.03 | $1,002.96 |
| 3980 | Continuous Home Care w/AIDS Min 17 Hours | $1,021.57 | $22.99 | $9.92 | $1,054.48 | $1,065.02 |
| 3981 | Continuous Home Care w/AIDS Min 18 Hours | $1,081.67 | $24.34 | $9.92 | $1,115.93 | $1,127.09 |
| 3982 | Continuous Home Care w/AIDS Min 19 Hours | $1,141.76 | $25.69 | $9.92 | $1,177.37 | $1,189.14 |
| 3983 | Continuous Home Care w/AIDS Min 20 Hours | $1,201.85 | $27.04 | $9.92 | $1,238.81 | $1,251.20 |
| 3984 | Continuous Home Care w/AIDS Min 21 Hours | $1,261.94 | $28.39 | $9.92 | $1,300.25 | $1,313.25 |
| 3985 | Continuous Home Care w/AIDS Min 22 Hours | $1,322.04 | $29.75 | $9.92 | $1,361.71 | $1,375.33 |
| 3986 | Continuous Home Care w/AIDS Min 23 Hours | $1,382.13 | $31.10 | $9.92 | $1,423.15 | $1,437.38 |
| 3987 | Continuous Home Care w/AIDS Min 24 Hours | $1,442.22 | $32.45 | $9.92 | $1,484.59 | $1,499.44 |
| 3988 | General Inpatient w/ AIDS | $1,148.69 | $25.85 | $9.92 | $1,184.46 | $1,196.30 |
| 3989 | Routine Home Care w/ AIDS Escort | $342.88 | $7.71 | $9.92 | $360.51 | $364.12 |
| 3991 | Service Intensity Add-on | $59.29 | $1.33 | $0.00 | $60.62 | $61.23 |
* 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 | 1% Add-on |
|---|---|---|---|---|---|---|
| 3945 | Routine Home Care | $195.86 | $4.41 | $9.92 | $210.19 | $212.29 |
| 3946 | Inpatient Respite | $480.89 | $10.82 | $9.92 | $501.63 | $506.65 |
| 3947 | General Inpatient Care | $1,024.64 | $23.05 | $9.92 | $1,057.61 | $1,068.19 |
| 3948 | Continuous Home Care - Min 8 Hours | $460.31 | $10.36 | $9.92 | $480.59 | $485.40 |
| 3949 | Continuous Home Care - Min 9 Hours | $517.85 | $11.65 | $9.92 | $539.42 | $544.81 |
| 3950 | Continuous Home Care - Min 10 Hours | $575.39 | $12.95 | $9.92 | $598.26 | $604.24 |
| 3951 | Continuous Home Care - Min 11 Hours | $632.93 | $14.24 | $9.92 | $657.09 | $663.66 |
| 3952 | Continuous Home Care - Min 12 Hours | $690.47 | $15.54 | $9.92 | $715.93 | $723.09 |
| 3953 | Continuous Home Care - Min 13 Hours | $748.00 | $16.83 | $9.92 | $774.75 | $782.50 |
| 3954 | Continuous Home Care - Min 14 Hours | $805.54 | $18.12 | $9.92 | $833.58 | $841.92 |
| 3955 | Continuous Home Care - Min 15 Hours | $863.08 | $19.42 | $9.92 | $892.42 | $901.34 |
| 3956 | Continuous Home Care - Min 16 Hours | $920.62 | $20.71 | $9.92 | $951.25 | $960.76 |
| 3957 | Continuous Home Care - Min 17 Hours | $978.16 | $22.01 | $9.92 | $1,010.09 | $1,020.19 |
| 3958 | Continuous Home Care - Min 18 Hours | $1,035.70 | $23.30 | $9.92 | $1,068.92 | $1,079.61 |
| 3959 | Continuous Home Care - Min 19 Hours | $1,093.24 | $24.60 | $9.92 | $1,127.76 | $1,139.04 |
| 3960 | Continuous Home Care - Min 20 Hours | $1,150.78 | $25.89 | $9.92 | $1,186.59 | $1,198.46 |
| 3961 | Continuous Home Care - Min 21 Hours | $1,208.31 | $27.19 | $9.92 | $1,245.42 | $1,257.87 |
| 3962 | Continuous Home Care - Min 22 Hours | $1,265.85 | $28.48 | $9.92 | $1,304.25 | $1,317.29 |
| 3963 | Continuous Home Care - Min 23 Hours | $1,323.39 | $29.78 | $9.92 | $1,363.09 | $1,376.72 |
| 3964 | Continuous Home Care - Min 24 Hours | $1,380.93 | $31.07 | $9.92 | $1,421.92 | $1,436.14 |
| 3965 | Hospice Inpatient Respite Care Coinsurance Rate - 5% of 3946 | $24.04 | $0.54 | $0.50 | $25.08 | $25.33 |
| 3966 | Drugs Coinsurance Rate | $1.00 | $0.00 | $0.00 | $1.00 | $1.01 |
| 3969 | Routine Home Care w/AIDS | $318.80 | $7.17 | $9.92 | $335.89 | $339.25 |
| 3970 | Routine Home Care w/Escort | $217.04 | $4.88 | $9.92 | $231.84 | $234.16 |
| 3971 | Continuous Home Care w/AIDS Min 8 Hours | $474.33 | $10.67 | $9.92 | $494.92 | $499.87 |
| 3972 | Continuous Home Care w/AIDS Min 9 Hours | $533.63 | $12.01 | $9.92 | $555.56 | $561.12 |
| 3973 | Continuous Home Care w/AIDS Min 10 Hours | $592.92 | $13.34 | $9.92 | $616.18 | $622.34 |
| 3974 | Continuous Home Care w/AIDS Min 11 Hours | $652.21 | $14.67 | $9.92 | $676.80 | $683.57 |
| 3975 | Continuous Home Care w/AIDS Min 12 Hours | $711.50 | $16.01 | $9.92 | $737.43 | $744.80 |
| 3976 | Continuous Home Care w/AIDS Min 13 Hours | $770.79 | $17.34 | $9.92 | $798.05 | $806.03 |
| 3977 | Continuous Home Care w/AIDS Min 14 Hours | $830.08 | $18.68 | $9.92 | $858.68 | $867.27 |
| 3978 | Continuous Home Care w/AIDS Min 15 Hours | $889.38 | $20.01 | $9.92 | $919.31 | $928.50 |
| 3979 | Continuous Home Care w/AIDS Min 16 Hours | $948.67 | $21.35 | $9.92 | $979.94 | $989.74 |
| 3980 | Continuous Home Care w/AIDS Min 17 Hours | $1,007.96 | $22.68 | $9.92 | $1,040.56 | $1,050.97 |
| 3981 | Continuous Home Care w/AIDS Min 18 Hours | $1,067.25 | $24.01 | $9.92 | $1,101.18 | $1,112.19 |
| 3982 | Continuous Home Care w/AIDS Min 19 Hours | $1,126.54 | $25.35 | $9.92 | $1,161.81 | $1,173.43 |
| 3983 | Continuous Home Care w/AIDS Min 20 Hours | $1,185.83 | $26.68 | $9.92 | $1,222.43 | $1,234.65 |
| 3984 | Continuous Home Care w/AIDS Min 21 Hours | $1,245.13 | $28.02 | $9.92 | $1,283.07 | $1,295.90 |
| 3985 | Continuous Home Care w/AIDS Min 22 Hours | $1,304.42 | $29.35 | $9.92 | $1,343.69 | $1,357.13 |
| 3986 | Continuous Home Care w/AIDS Min 23 Hours | $1,363.71 | $30.68 | $9.92 | $1,404.31 | $1,418.35 |
| 3987 | Continuous Home Care w/AIDS Min 24 Hours | $1,423.00 | $32.02 | $9.92 | $1,464.94 | $1,479.59 |
| 3988 | General Inpatient w/ AIDS | $1,138.78 | $25.62 | $9.92 | $1,174.32 | $1,186.06 |
| 3989 | Routine Home Care w/ AIDS Escort | $339.98 | $7.65 | $9.92 | $357.55 | $361.13 |
| 3991 | Service Intensity Add-on | $58.76 | $1.32 | $0.00 | $60.08 | $60.68 |
* 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 | 1% Add-on |
|---|---|---|---|---|---|---|
| 3945 | Routine Home Care | $230.82 | $5.19 | $9.92 | $245.93 | $248.39 |
| 3946 | Inpatient Respite | $559.34 | $12.59 | $9.92 | $581.85 | $587.67 |
| 3947 | General Inpatient Care | $1,199.61 | $26.99 | $9.92 | $1,236.52 | $1,248.89 |
| 3948 | Continuous Home Care - Min 8 Hours | $555.89 | $12.51 | $9.92 | $578.32 | $584.10 |
| 3949 | Continuous Home Care - Min 9 Hours | $625.38 | $14.07 | $9.92 | $649.37 | $655.86 |
| 3950 | Continuous Home Care - Min 10 Hours | $694.87 | $15.63 | $9.92 | $720.42 | $727.62 |
| 3951 | Continuous Home Care - Min 11 Hours | $764.35 | $17.20 | $9.92 | $791.47 | $799.38 |
| 3952 | Continuous Home Care - Min 12 Hours | $833.84 | $18.76 | $9.92 | $862.52 | $871.15 |
| 3953 | Continuous Home Care - Min 13 Hours | $903.33 | $20.32 | $9.92 | $933.57 | $942.91 |
| 3954 | Continuous Home Care - Min 14 Hours | $972.81 | $21.89 | $9.92 | $1,004.62 | $1,014.67 |
| 3955 | Continuous Home Care - Min 15 Hours | $1,042.30 | $23.45 | $9.92 | $1,075.67 | $1,086.43 |
| 3956 | Continuous Home Care - Min 16 Hours | $1,111.79 | $25.02 | $9.92 | $1,146.73 | $1,158.20 |
| 3957 | Continuous Home Care - Min 17 Hours | $1,181.27 | $26.58 | $9.92 | $1,217.77 | $1,229.95 |
| 3958 | Continuous Home Care - Min 18 Hours | $1,250.76 | $28.14 | $9.92 | $1,288.82 | $1,301.71 |
| 3959 | Continuous Home Care - Min 19 Hours | $1,320.25 | $29.71 | $9.92 | $1,359.88 | $1,373.48 |
| 3960 | Continuous Home Care - Min 20 Hours | $1,389.73 | $31.27 | $9.92 | $1,430.92 | $1,445.23 |
| 3961 | Continuous Home Care - Min 21 Hours | $1,459.22 | $32.83 | $9.92 | $1,501.97 | $1,516.99 |
| 3962 | Continuous Home Care - Min 22 Hours | $1,528.71 | $34.40 | $9.92 | $1,573.03 | $1,588.76 |
| 3963 | Continuous Home Care - Min 23 Hours | $1,598.19 | $35.96 | $9.92 | $1,644.07 | $1,660.51 |
| 3964 | Continuous Home Care - Min 24 Hours | $1,667.68 | $37.52 | $9.92 | $1,715.12 | $1,732.27 |
| 3965 | Hospice Inpatient Respite Care Coinsurance Rate - 5% of 3946 | $27.97 | $0.63 | $0.50 | $29.10 | $29.39 |
| 3966 | Drugs Coinsurance Rate | $1.00 | $0.00 | $0.00 | $1.00 | $1.01 |
| 3969 | Routine Home Care w/AIDS | $375.70 | $8.45 | $9.92 | $394.07 | $398.01 |
| 3970 | Routine Home Care w/Escort | $252.00 | $5.67 | $9.92 | $267.59 | $270.27 |
| 3971 | Continuous Home Care w/AIDS Min 8 Hours | $600.07 | $13.50 | $9.92 | $623.49 | $629.72 |
| 3972 | Continuous Home Care w/AIDS Min 9 Hours | $675.08 | $15.19 | $9.92 | $700.19 | $707.19 |
| 3973 | Continuous Home Care w/AIDS Min 10 Hours | $750.08 | $16.88 | $9.92 | $776.88 | $784.65 |
| 3974 | Continuous Home Care w/AIDS Min 11 Hours | $825.09 | $18.56 | $9.92 | $853.57 | $862.11 |
| 3975 | Continuous Home Care w/AIDS Min 12 Hours | $900.10 | $20.25 | $9.92 | $930.27 | $939.57 |
| 3976 | Continuous Home Care w/AIDS Min 13 Hours | $975.11 | $21.94 | $9.92 | $1,006.97 | $1,017.04 |
| 3977 | Continuous Home Care w/AIDS Min 14 Hours | $1,050.12 | $23.63 | $9.92 | $1,083.67 | $1,094.51 |
| 3978 | Continuous Home Care w/AIDS Min 15 Hours | $1,125.13 | $25.32 | $9.92 | $1,160.37 | $1,171.97 |
| 3979 | Continuous Home Care w/AIDS Min 16 Hours | $1,200.13 | $27.00 | $9.92 | $1,237.05 | $1,249.42 |
| 3980 | Continuous Home Care w/AIDS Min 17 Hours | $1,275.14 | $28.69 | $9.92 | $1,313.75 | $1,326.89 |
| 3981 | Continuous Home Care w/AIDS Min 18 Hours | $1,350.15 | $30.38 | $9.92 | $1,390.45 | $1,404.35 |
| 3982 | Continuous Home Care w/AIDS Min 19 Hours | $1,425.16 | $32.07 | $9.92 | $1,467.15 | $1,481.82 |
| 3983 | Continuous Home Care w/AIDS Min 20 Hours | $1,500.17 | $33.75 | $9.92 | $1,543.84 | $1,559.28 |
| 3984 | Continuous Home Care w/AIDS Min 21 Hours | $1,575.18 | $35.44 | $9.92 | $1,620.54 | $1,636.75 |
| 3985 | Continuous Home Care w/AIDS Min 22 Hours | $1,650.18 | $37.13 | $9.92 | $1,697.23 | $1,714.20 |
| 3986 | Continuous Home Care w/AIDS Min 23 Hours | $1,725.19 | $38.82 | $9.92 | $1,773.93 | $1,791.67 |
| 3987 | Continuous Home Care w/AIDS Min 24 Hours | $1,800.20 | $40.50 | $9.92 | $1,850.62 | $1,869.13 |
| 3988 | General Inpatient w/ AIDS | $1,333.25 | $30.00 | $9.92 | $1,373.17 | $1,386.90 |
| 3989 | Routine Home Care w/ AIDS Escort | $396.88 | $8.93 | $9.92 | $415.73 | $419.89 |
| 3991 | Service Intensity Add-on | $69.24 | $1.56 | $0.00 | $70.80 | $71.51 |
* 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 | 1% Add-on |
|---|---|---|---|---|---|---|
| 3945 | Routine Home Care | $199.87 | $4.50 | $9.92 | $214.29 | $216.43 |
| 3946 | Inpatient Respite | $489.88 | $11.02 | $9.92 | $510.82 | $515.93 |
| 3947 | General Inpatient Care | $1,044.70 | $23.51 | $9.92 | $1,078.13 | $1,088.91 |
| 3948 | Continuous Home Care - Min 8 Hours | $471.27 | $10.60 | $9.92 | $491.79 | $496.71 |
| 3949 | Continuous Home Care - Min 9 Hours | $530.18 | $11.93 | $9.92 | $552.03 | $557.55 |
| 3950 | Continuous Home Care - Min 10 Hours | $589.08 | $13.25 | $9.92 | $612.25 | $618.37 |
| 3951 | Continuous Home Care - Min 11 Hours | $647.99 | $14.58 | $9.92 | $672.49 | $679.21 |
| 3952 | Continuous Home Care - Min 12 Hours | $706.90 | $15.91 | $9.92 | $732.73 | $740.06 |
| 3953 | Continuous Home Care - Min 13 Hours | $765.81 | $17.23 | $9.92 | $792.96 | $800.89 |
| 3954 | Continuous Home Care - Min 14 Hours | $824.72 | $18.56 | $9.92 | $853.20 | $861.73 |
| 3955 | Continuous Home Care - Min 15 Hours | $883.63 | $19.88 | $9.92 | $913.43 | $922.56 |
| 3956 | Continuous Home Care - Min 16 Hours | $942.53 | $21.21 | $9.92 | $973.66 | $983.40 |
| 3957 | Continuous Home Care - Min 17 Hours | $1,001.44 | $22.53 | $9.92 | $1,033.89 | $1,044.23 |
| 3958 | Continuous Home Care - Min 18 Hours | $1,060.35 | $23.86 | $9.92 | $1,094.13 | $1,105.07 |
| 3959 | Continuous Home Care - Min 19 Hours | $1,119.26 | $25.18 | $9.92 | $1,154.36 | $1,165.90 |
| 3960 | Continuous Home Care - Min 20 Hours | $1,178.17 | $26.51 | $9.92 | $1,214.60 | $1,226.75 |
| 3961 | Continuous Home Care - Min 21 Hours | $1,237.08 | $27.83 | $9.92 | $1,274.83 | $1,287.58 |
| 3962 | Continuous Home Care - Min 22 Hours | $1,295.98 | $29.16 | $9.92 | $1,335.06 | $1,348.41 |
| 3963 | Continuous Home Care - Min 23 Hours | $1,354.89 | $30.49 | $9.92 | $1,395.30 | $1,409.25 |
| 3964 | Continuous Home Care - Min 24 Hours | $1,413.80 | $31.81 | $9.92 | $1,455.53 | $1,470.09 |
| 3965 | Hospice Inpatient Respite Care Coinsurance Rate - 5% of 3946 | $24.49 | $0.55 | $0.50 | $25.54 | $25.80 |
| 3966 | Drugs Coinsurance Rate | $1.00 | $0.00 | $0.00 | $1.00 | $1.01 |
| 3969 | Routine Home Care w/AIDS | $325.32 | $7.32 | $9.92 | $342.56 | $345.99 |
| 3970 | Routine Home Care w/Escort | $221.05 | $4.97 | $9.92 | $235.94 | $238.30 |
| 3971 | Continuous Home Care w/AIDS Min 8 Hours | $488.75 | $11.00 | $9.92 | $509.67 | $514.77 |
| 3972 | Continuous Home Care w/AIDS Min 9 Hours | $549.84 | $12.37 | $9.92 | $572.13 | $577.85 |
| 3973 | Continuous Home Care w/AIDS Min 10 Hours | $610.93 | $13.75 | $9.92 | $634.60 | $640.95 |
| 3974 | Continuous Home Care w/AIDS Min 11 Hours | $672.03 | $15.12 | $9.92 | $697.07 | $704.04 |
| 3975 | Continuous Home Care w/AIDS Min 12 Hours | $733.12 | $16.50 | $9.92 | $759.54 | $767.14 |
| 3976 | Continuous Home Care w/AIDS Min 13 Hours | $794.21 | $17.87 | $9.92 | $822.00 | $830.22 |
| 3977 | Continuous Home Care w/AIDS Min 14 Hours | $855.31 | $19.24 | $9.92 | $884.47 | $893.31 |
| 3978 | Continuous Home Care w/AIDS Min 15 Hours | $916.40 | $20.62 | $9.92 | $946.94 | $956.41 |
| 3979 | Continuous Home Care w/AIDS Min 16 Hours | $977.49 | $21.99 | $9.92 | $1,009.40 | $1,019.49 |
| 3980 | Continuous Home Care w/AIDS Min 17 Hours | $1,038.59 | $23.37 | $9.92 | $1,071.88 | $1,082.60 |
| 3981 | Continuous Home Care w/AIDS Min 18 Hours | $1,099.68 | $24.74 | $9.92 | $1,134.34 | $1,145.68 |
| 3982 | Continuous Home Care w/AIDS Min 19 Hours | $1,160.77 | $26.12 | $9.92 | $1,196.81 | $1,208.78 |
| 3983 | Continuous Home Care w/AIDS Min 20 Hours | $1,221.87 | $27.49 | $9.92 | $1,259.28 | $1,271.87 |
| 3984 | Continuous Home Care w/AIDS Min 21 Hours | $1,282.96 | $28.87 | $9.92 | $1,321.75 | $1,334.97 |
| 3985 | Continuous Home Care w/AIDS Min 22 Hours | $1,344.05 | $30.24 | $9.92 | $1,384.21 | $1,398.05 |
| 3986 | Continuous Home Care w/AIDS Min 23 Hours | $1,405.15 | $31.62 | $9.92 | $1,446.69 | $1,461.16 |
| 3987 | Continuous Home Care w/AIDS Min 24 Hours | $1,466.24 | $32.99 | $9.92 | $1,509.15 | $1,524.24 |
| 3988 | General Inpatient w/ AIDS | $1,161.08 | $26.12 | $9.92 | $1,197.12 | $1,209.09 |
| 3989 | Routine Home Care w/ AIDS Escort | $346.50 | $7.80 | $9.92 | $364.22 | $367.86 |
| 3991 | Service Intensity Add-on | $59.96 | $1.35 | $0.00 | $61.31 | $61.92 |
* 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 | 1% Add-on |
|---|---|---|---|---|---|---|
| 3945 | Routine Home Care | $202.33 | $4.55 | $9.92 | $216.80 | $218.97 |
| 3946 | Inpatient Respite | $495.41 | $11.15 | $9.92 | $516.48 | $521.64 |
| 3947 | General Inpatient Care | $1,057.03 | $23.78 | $9.92 | $1,090.73 | $1,101.64 |
| 3948 | Continuous Home Care - Min 8 Hours | $478.01 | $10.76 | $9.92 | $498.69 | $503.68 |
| 3949 | Continuous Home Care - Min 9 Hours | $537.76 | $12.10 | $9.92 | $559.78 | $565.38 |
| 3950 | Continuous Home Care - Min 10 Hours | $597.51 | $13.44 | $9.92 | $620.87 | $627.08 |
| 3951 | Continuous Home Care - Min 11 Hours | $657.26 | $14.79 | $9.92 | $681.97 | $688.79 |
| 3952 | Continuous Home Care - Min 12 Hours | $717.01 | $16.13 | $9.92 | $743.06 | $750.49 |
| 3953 | Continuous Home Care - Min 13 Hours | $776.76 | $17.48 | $9.92 | $804.16 | $812.20 |
| 3954 | Continuous Home Care - Min 14 Hours | $836.51 | $18.82 | $9.92 | $865.25 | $873.90 |
| 3955 | Continuous Home Care - Min 15 Hours | $896.26 | $20.17 | $9.92 | $926.35 | $935.61 |
| 3956 | Continuous Home Care - Min 16 Hours | $956.01 | $21.51 | $9.92 | $987.44 | $997.31 |
| 3957 | Continuous Home Care - Min 17 Hours | $1,015.76 | $22.85 | $9.92 | $1,048.53 | $1,059.02 |
| 3958 | Continuous Home Care - Min 18 Hours | $1,075.52 | $24.20 | $9.92 | $1,109.64 | $1,120.74 |
| 3959 | Continuous Home Care - Min 19 Hours | $1,135.27 | $25.54 | $9.92 | $1,170.73 | $1,182.44 |
| 3960 | Continuous Home Care - Min 20 Hours | $1,195.02 | $26.89 | $9.92 | $1,231.83 | $1,244.15 |
| 3961 | Continuous Home Care - Min 21 Hours | $1,254.77 | $28.23 | $9.92 | $1,292.92 | $1,305.85 |
| 3962 | Continuous Home Care - Min 22 Hours | $1,314.52 | $29.58 | $9.92 | $1,354.02 | $1,367.56 |
| 3963 | Continuous Home Care - Min 23 Hours | $1,374.27 | $30.92 | $9.92 | $1,415.11 | $1,429.26 |
| 3964 | Continuous Home Care - Min 24 Hours | $1,434.02 | $32.27 | $9.92 | $1,476.21 | $1,490.97 |
| 3965 | Hospice Inpatient Respite Care Coinsurance Rate - 5% of 3946 | $24.77 | $0.56 | $0.50 | $25.83 | $26.09 |
| 3966 | Drugs Coinsurance Rate | $1.00 | $0.00 | $0.00 | $1.00 | $1.01 |
| 3969 | Routine Home Care w/AIDS | $329.33 | $7.41 | $9.92 | $346.66 | $350.13 |
| 3970 | Routine Home Care w/Escort | $223.51 | $5.03 | $9.92 | $238.46 | $240.84 |
| 3971 | Continuous Home Care w/AIDS Min 8 Hours | $497.61 | $11.20 | $9.92 | $518.73 | $523.92 |
| 3972 | Continuous Home Care w/AIDS Min 9 Hours | $559.81 | $12.60 | $9.92 | $582.33 | $588.15 |
| 3973 | Continuous Home Care w/AIDS Min 10 Hours | $622.01 | $14.00 | $9.92 | $645.93 | $652.39 |
| 3974 | Continuous Home Care w/AIDS Min 11 Hours | $684.21 | $15.39 | $9.92 | $709.52 | $716.62 |
| 3975 | Continuous Home Care w/AIDS Min 12 Hours | $746.42 | $16.79 | $9.92 | $773.13 | $780.86 |
| 3976 | Continuous Home Care w/AIDS Min 13 Hours | $808.62 | $18.19 | $9.92 | $836.73 | $845.10 |
| 3977 | Continuous Home Care w/AIDS Min 14 Hours | $870.82 | $19.59 | $9.92 | $900.33 | $909.33 |
| 3978 | Continuous Home Care w/AIDS Min 15 Hours | $933.02 | $20.99 | $9.92 | $963.93 | $973.57 |
| 3979 | Continuous Home Care w/AIDS Min 16 Hours | $995.22 | $22.39 | $9.92 | $1,027.53 | $1,037.81 |
| 3980 | Continuous Home Care w/AIDS Min 17 Hours | $1,057.42 | $23.79 | $9.92 | $1,091.13 | $1,102.04 |
| 3981 | Continuous Home Care w/AIDS Min 18 Hours | $1,119.62 | $25.19 | $9.92 | $1,154.73 | $1,166.28 |
| 3982 | Continuous Home Care w/AIDS Min 19 Hours | $1,181.82 | $26.59 | $9.92 | $1,218.33 | $1,230.51 |
| 3983 | Continuous Home Care w/AIDS Min 20 Hours | $1,244.03 | $27.99 | $9.92 | $1,281.94 | $1,294.76 |
| 3984 | Continuous Home Care w/AIDS Min 21 Hours | $1,306.23 | $29.39 | $9.92 | $1,345.54 | $1,359.00 |
| 3985 | Continuous Home Care w/AIDS Min 22 Hours | $1,368.43 | $30.79 | $9.92 | $1,409.14 | $1,423.23 |
| 3986 | Continuous Home Care w/AIDS Min 23 Hours | $1,430.63 | $32.19 | $9.92 | $1,472.74 | $1,487.47 |
| 3987 | Continuous Home Care w/AIDS Min 24 Hours | $1,492.83 | $33.59 | $9.92 | $1,536.34 | $1,551.70 |
| 3988 | General Inpatient w/ AIDS | $1,174.78 | $26.43 | $9.92 | $1,211.13 | $1,223.24 |
| 3989 | Routine Home Care w/ AIDS Escort | $350.51 | $7.89 | $9.92 | $368.32 | $372.00 |
| 3991 | Service Intensity Add-on | $60.70 | $1.37 | $0.00 | $62.07 | $62.69 |
* 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 | 1% Add-on |
|---|---|---|---|---|---|---|
| 3945 | Routine Home Care | $264.56 | $5.95 | $9.92 | $280.43 | $283.23 |
| 3946 | Inpatient Respite | $635.05 | $14.29 | $9.92 | $659.26 | $665.85 |
| 3947 | General Inpatient Care | $1,368.49 | $30.79 | $9.92 | $1,409.20 | $1,423.29 |
| 3948 | Continuous Home Care - Min 8 Hours | $648.15 | $14.58 | $9.92 | $672.65 | $679.38 |
| 3949 | Continuous Home Care - Min 9 Hours | $729.17 | $16.41 | $9.92 | $755.50 | $763.06 |
| 3950 | Continuous Home Care - Min 10 Hours | $810.19 | $18.23 | $9.92 | $838.34 | $846.72 |
| 3951 | Continuous Home Care - Min 11 Hours | $891.21 | $20.05 | $9.92 | $921.18 | $930.39 |
| 3952 | Continuous Home Care - Min 12 Hours | $972.23 | $21.88 | $9.92 | $1,004.03 | $1,014.07 |
| 3953 | Continuous Home Care - Min 13 Hours | $1,053.24 | $23.70 | $9.92 | $1,086.86 | $1,097.73 |
| 3954 | Continuous Home Care - Min 14 Hours | $1,134.26 | $25.52 | $9.92 | $1,169.70 | $1,181.40 |
| 3955 | Continuous Home Care - Min 15 Hours | $1,215.28 | $27.34 | $9.92 | $1,252.54 | $1,265.07 |
| 3956 | Continuous Home Care - Min 16 Hours | $1,296.30 | $29.17 | $9.92 | $1,335.39 | $1,348.74 |
| 3957 | Continuous Home Care - Min 17 Hours | $1,377.32 | $30.99 | $9.92 | $1,418.23 | $1,432.41 |
| 3958 | Continuous Home Care - Min 18 Hours | $1,458.34 | $32.81 | $9.92 | $1,501.07 | $1,516.08 |
| 3959 | Continuous Home Care - Min 19 Hours | $1,539.36 | $34.64 | $9.92 | $1,583.92 | $1,599.76 |
| 3960 | Continuous Home Care - Min 20 Hours | $1,620.38 | $36.46 | $9.92 | $1,666.76 | $1,683.43 |
| 3961 | Continuous Home Care - Min 21 Hours | $1,701.39 | $38.28 | $9.92 | $1,749.59 | $1,767.09 |
| 3962 | Continuous Home Care - Min 22 Hours | $1,782.41 | $40.10 | $9.92 | $1,832.43 | $1,850.75 |
| 3963 | Continuous Home Care - Min 23 Hours | $1,863.43 | $41.93 | $9.92 | $1,915.28 | $1,934.43 |
| 3964 | Continuous Home Care - Min 24 Hours | $1,944.45 | $43.75 | $9.92 | $1,998.12 | $2,018.10 |
| 3965 | Hospice Inpatient Respite Care Coinsurance Rate - 5% of 3946 | $31.75 | $0.71 | $0.50 | $32.96 | $33.29 |
| 3966 | Drugs Coinsurance Rate | $1.00 | $0.00 | $0.00 | $1.00 | $1.01 |
| 3969 | Routine Home Care w/AIDS | $430.61 | $9.69 | $9.92 | $450.22 | $454.72 |
| 3970 | Routine Home Care w/Escort | $285.74 | $6.43 | $9.92 | $302.09 | $305.11 |
| 3971 | Continuous Home Care w/AIDS Min 8 Hours | $721.42 | $16.23 | $9.92 | $747.57 | $755.05 |
| 3972 | Continuous Home Care w/AIDS Min 9 Hours | $811.60 | $18.26 | $9.92 | $839.78 | $848.18 |
| 3973 | Continuous Home Care w/AIDS Min 10 Hours | $901.78 | $20.29 | $9.92 | $931.99 | $941.31 |
| 3974 | Continuous Home Care w/AIDS Min 11 Hours | $991.95 | $22.32 | $9.92 | $1,024.19 | $1,034.43 |
| 3975 | Continuous Home Care w/AIDS Min 12 Hours | $1,082.13 | $24.35 | $9.92 | $1,116.40 | $1,127.56 |
| 3976 | Continuous Home Care w/AIDS Min 13 Hours | $1,172.31 | $26.38 | $9.92 | $1,208.61 | $1,220.70 |
| 3977 | Continuous Home Care w/AIDS Min 14 Hours | $1,262.49 | $28.41 | $9.92 | $1,300.82 | $1,313.83 |
| 3978 | Continuous Home Care w/AIDS Min 15 Hours | $1,352.66 | $30.43 | $9.92 | $1,393.01 | $1,406.94 |
| 3979 | Continuous Home Care w/AIDS Min 16 Hours | $1,442.84 | $32.46 | $9.92 | $1,485.22 | $1,500.07 |
| 3980 | Continuous Home Care w/AIDS Min 17 Hours | $1,533.02 | $34.49 | $9.92 | $1,577.43 | $1,593.20 |
| 3981 | Continuous Home Care w/AIDS Min 18 Hours | $1,623.20 | $36.52 | $9.92 | $1,669.64 | $1,686.34 |
| 3982 | Continuous Home Care w/AIDS Min 19 Hours | $1,713.37 | $38.55 | $9.92 | $1,761.84 | $1,779.46 |
| 3983 | Continuous Home Care w/AIDS Min 20 Hours | $1,803.55 | $40.58 | $9.92 | $1,854.05 | $1,872.59 |
| 3984 | Continuous Home Care w/AIDS Min 21 Hours | $1,893.73 | $42.61 | $9.92 | $1,946.26 | $1,965.72 |
| 3985 | Continuous Home Care w/AIDS Min 22 Hours | $1,983.91 | $44.64 | $9.92 | $2,038.47 | $2,058.85 |
| 3986 | Continuous Home Care w/AIDS Min 23 Hours | $2,074.08 | $46.67 | $9.92 | $2,130.67 | $2,151.98 |
| 3987 | Continuous Home Care w/AIDS Min 24 Hours | $2,164.26 | $48.70 | $9.92 | $2,222.88 | $2,245.11 |
| 3988 | General Inpatient w/ AIDS | $1,520.94 | $34.22 | $9.92 | $1,565.08 | $1,580.73 |
| 3989 | Routine Home Care w/ AIDS Escort | $451.79 | $10.17 | $9.92 | $471.88 | $476.60 |
| 3991 | Service Intensity Add-on | $79.36 | $1.79 | $0.00 | $81.15 | $81.96 |
* 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 | 1% Add-on |
|---|---|---|---|---|---|---|
| 3945 | Routine Home Care | $271.49 | $6.11 | $9.92 | $287.52 | $290.40 |
| 3946 | Inpatient Respite | $650.61 | $14.64 | $9.92 | $675.17 | $681.92 |
| 3947 | General Inpatient Care | $1,403.19 | $31.57 | $9.92 | $1,444.68 | $1,459.13 |
| 3948 | Continuous Home Care - Min 8 Hours | $667.11 | $15.01 | $9.92 | $692.04 | $698.96 |
| 3949 | Continuous Home Care - Min 9 Hours | $750.50 | $16.89 | $9.92 | $777.31 | $785.08 |
| 3950 | Continuous Home Care - Min 10 Hours | $833.88 | $18.76 | $9.92 | $862.56 | $871.19 |
| 3951 | Continuous Home Care - Min 11 Hours | $917.27 | $20.64 | $9.92 | $947.83 | $957.31 |
| 3952 | Continuous Home Care - Min 12 Hours | $1,000.66 | $22.51 | $9.92 | $1,033.09 | $1,043.42 |
| 3953 | Continuous Home Care - Min 13 Hours | $1,084.05 | $24.39 | $9.92 | $1,118.36 | $1,129.54 |
| 3954 | Continuous Home Care - Min 14 Hours | $1,167.44 | $26.27 | $9.92 | $1,203.63 | $1,215.67 |
| 3955 | Continuous Home Care - Min 15 Hours | $1,250.83 | $28.14 | $9.92 | $1,288.89 | $1,301.78 |
| 3956 | Continuous Home Care - Min 16 Hours | $1,334.21 | $30.02 | $9.92 | $1,374.15 | $1,387.89 |
| 3957 | Continuous Home Care - Min 17 Hours | $1,417.60 | $31.90 | $9.92 | $1,459.42 | $1,474.01 |
| 3958 | Continuous Home Care - Min 18 Hours | $1,500.99 | $33.77 | $9.92 | $1,544.68 | $1,560.13 |
| 3959 | Continuous Home Care - Min 19 Hours | $1,584.38 | $35.65 | $9.92 | $1,629.95 | $1,646.25 |
| 3960 | Continuous Home Care - Min 20 Hours | $1,667.77 | $37.52 | $9.92 | $1,715.21 | $1,732.36 |
| 3961 | Continuous Home Care - Min 21 Hours | $1,751.16 | $39.40 | $9.92 | $1,800.48 | $1,818.48 |
| 3962 | Continuous Home Care - Min 22 Hours | $1,834.54 | $41.28 | $9.92 | $1,885.74 | $1,904.60 |
| 3963 | Continuous Home Care - Min 23 Hours | $1,917.93 | $43.15 | $9.92 | $1,971.00 | $1,990.71 |
| 3964 | Continuous Home Care - Min 24 Hours | $2,001.32 | $45.03 | $9.92 | $2,056.27 | $2,076.83 |
| 3965 | Hospice Inpatient Respite Care Coinsurance Rate - 5% of 3946 | $32.53 | $0.73 | $0.50 | $33.76 | $34.10 |
| 3966 | Drugs Coinsurance Rate | $1.00 | $0.00 | $0.00 | $1.00 | $1.01 |
| 3969 | Routine Home Care w/AIDS | $441.90 | $9.94 | $9.92 | $461.76 | $466.38 |
| 3970 | Routine Home Care w/Escort | $292.67 | $6.59 | $9.92 | $309.18 | $312.27 |
| 3971 | Continuous Home Care w/AIDS Min 8 Hours | $746.35 | $16.79 | $9.92 | $773.06 | $780.79 |
| 3972 | Continuous Home Care w/AIDS Min 9 Hours | $839.65 | $18.89 | $9.92 | $868.46 | $877.14 |
| 3973 | Continuous Home Care w/AIDS Min 10 Hours | $932.94 | $20.99 | $9.92 | $963.85 | $973.49 |
| 3974 | Continuous Home Care w/AIDS Min 11 Hours | $1,026.24 | $23.09 | $9.92 | $1,059.25 | $1,069.84 |
| 3975 | Continuous Home Care w/AIDS Min 12 Hours | $1,119.53 | $25.19 | $9.92 | $1,154.64 | $1,166.19 |
| 3976 | Continuous Home Care w/AIDS Min 13 Hours | $1,212.82 | $27.29 | $9.92 | $1,250.03 | $1,262.53 |
| 3977 | Continuous Home Care w/AIDS Min 14 Hours | $1,306.12 | $29.39 | $9.92 | $1,345.43 | $1,358.88 |
| 3978 | Continuous Home Care w/AIDS Min 15 Hours | $1,399.41 | $31.49 | $9.92 | $1,440.82 | $1,455.23 |
| 3979 | Continuous Home Care w/AIDS Min 16 Hours | $1,492.71 | $33.59 | $9.92 | $1,536.22 | $1,551.58 |
| 3980 | Continuous Home Care w/AIDS Min 17 Hours | $1,586.00 | $35.69 | $9.92 | $1,631.61 | $1,647.93 |
| 3981 | Continuous Home Care w/AIDS Min 18 Hours | $1,679.30 | $37.78 | $9.92 | $1,727.00 | $1,744.27 |
| 3982 | Continuous Home Care w/AIDS Min 19 Hours | $1,772.59 | $39.88 | $9.92 | $1,822.39 | $1,840.61 |
| 3983 | Continuous Home Care w/AIDS Min 20 Hours | $1,865.88 | $41.98 | $9.92 | $1,917.78 | $1,936.96 |
| 3984 | Continuous Home Care w/AIDS Min 21 Hours | $1,959.18 | $44.08 | $9.92 | $2,013.18 | $2,033.31 |
| 3985 | Continuous Home Care w/AIDS Min 22 Hours | $2,052.47 | $46.18 | $9.92 | $2,108.57 | $2,129.66 |
| 3986 | Continuous Home Care w/AIDS Min 23 Hours | $2,145.77 | $48.28 | $9.92 | $2,203.97 | $2,226.01 |
| 3987 | Continuous Home Care w/AIDS Min 24 Hours | $2,239.06 | $50.38 | $9.92 | $2,299.36 | $2,322.35 |
| 3988 | General Inpatient w/ AIDS | $1,559.51 | $35.09 | $9.92 | $1,604.52 | $1,620.57 |
| 3989 | Routine Home Care w/ AIDS Escort | $463.08 | $10.42 | $9.92 | $483.42 | $488.25 |
| 3991 | Service Intensity Add-on | $81.44 | $1.83 | $0.00 | $83.27 | $84.10 |
* 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 | 1% Add-on |
|---|---|---|---|---|---|---|
| 3945 | Routine Home Care | $230.82 | $5.19 | $9.92 | $245.93 | $248.39 |
| 3946 | Inpatient Respite | $559.34 | $12.59 | $9.92 | $581.85 | $587.67 |
| 3947 | General Inpatient Care | $1,199.61 | $26.99 | $9.92 | $1,236.52 | $1,248.89 |
| 3948 | Continuous Home Care - Min 8 Hours | $555.89 | $12.51 | $9.92 | $578.32 | $584.10 |
| 3949 | Continuous Home Care - Min 9 Hours | $625.38 | $14.07 | $9.92 | $649.37 | $655.86 |
| 3950 | Continuous Home Care - Min 10 Hours | $694.87 | $15.63 | $9.92 | $720.42 | $727.62 |
| 3951 | Continuous Home Care - Min 11 Hours | $764.35 | $17.20 | $9.92 | $791.47 | $799.38 |
| 3952 | Continuous Home Care - Min 12 Hours | $833.84 | $18.76 | $9.92 | $862.52 | $871.15 |
| 3953 | Continuous Home Care - Min 13 Hours | $903.33 | $20.32 | $9.92 | $933.57 | $942.91 |
| 3954 | Continuous Home Care - Min 14 Hours | $972.81 | $21.89 | $9.92 | $1,004.62 | $1,014.67 |
| 3955 | Continuous Home Care - Min 15 Hours | $1,042.30 | $23.45 | $9.92 | $1,075.67 | $1,086.43 |
| 3956 | Continuous Home Care - Min 16 Hours | $1,111.79 | $25.02 | $9.92 | $1,146.73 | $1,158.20 |
| 3957 | Continuous Home Care - Min 17 Hours | $1,181.27 | $26.58 | $9.92 | $1,217.77 | $1,229.95 |
| 3958 | Continuous Home Care - Min 18 Hours | $1,250.76 | $28.14 | $9.92 | $1,288.82 | $1,301.71 |
| 3959 | Continuous Home Care - Min 19 Hours | $1,320.25 | $29.71 | $9.92 | $1,359.88 | $1,373.48 |
| 3960 | Continuous Home Care - Min 20 Hours | $1,389.73 | $31.27 | $9.92 | $1,430.92 | $1,445.23 |
| 3961 | Continuous Home Care - Min 21 Hours | $1,459.22 | $32.83 | $9.92 | $1,501.97 | $1,516.99 |
| 3962 | Continuous Home Care - Min 22 Hours | $1,528.71 | $34.40 | $9.92 | $1,573.03 | $1,588.76 |
| 3963 | Continuous Home Care - Min 23 Hours | $1,598.19 | $35.96 | $9.92 | $1,644.07 | $1,660.51 |
| 3964 | Continuous Home Care - Min 24 Hours | $1,667.68 | $37.52 | $9.92 | $1,715.12 | $1,732.27 |
| 3965 | Hospice Inpatient Respite Care Coinsurance Rate - 5% of 3946 | $27.97 | $0.63 | $0.50 | $29.10 | $29.39 |
| 3966 | Drugs Coinsurance Rate | $1.00 | $0.00 | $0.00 | $1.00 | $1.01 |
| 3969 | Routine Home Care w/AIDS | $375.70 | $8.45 | $9.92 | $394.07 | $398.01 |
| 3970 | Routine Home Care w/Escort | $252.00 | $5.67 | $9.92 | $267.59 | $270.27 |
| 3971 | Continuous Home Care w/AIDS Min 8 Hours | $600.07 | $13.50 | $9.92 | $623.49 | $629.72 |
| 3972 | Continuous Home Care w/AIDS Min 9 Hours | $675.08 | $15.19 | $9.92 | $700.19 | $707.19 |
| 3973 | Continuous Home Care w/AIDS Min 10 Hours | $750.08 | $16.88 | $9.92 | $776.88 | $784.65 |
| 3974 | Continuous Home Care w/AIDS Min 11 Hours | $825.09 | $18.56 | $9.92 | $853.57 | $862.11 |
| 3975 | Continuous Home Care w/AIDS Min 12 Hours | $900.10 | $20.25 | $9.92 | $930.27 | $939.57 |
| 3976 | Continuous Home Care w/AIDS Min 13 Hours | $975.11 | $21.94 | $9.92 | $1,006.97 | $1,017.04 |
| 3977 | Continuous Home Care w/AIDS Min 14 Hours | $1,050.12 | $23.63 | $9.92 | $1,083.67 | $1,094.51 |
| 3978 | Continuous Home Care w/AIDS Min 15 Hours | $1,125.13 | $25.32 | $9.92 | $1,160.37 | $1,171.97 |
| 3979 | Continuous Home Care w/AIDS Min 16 Hours | $1,200.13 | $27.00 | $9.92 | $1,237.05 | $1,249.42 |
| 3980 | Continuous Home Care w/AIDS Min 17 Hours | $1,275.14 | $28.69 | $9.92 | $1,313.75 | $1,326.89 |
| 3981 | Continuous Home Care w/AIDS Min 18 Hours | $1,350.15 | $30.38 | $9.92 | $1,390.45 | $1,404.35 |
| 3982 | Continuous Home Care w/AIDS Min 19 Hours | $1,425.16 | $32.07 | $9.92 | $1,467.15 | $1,481.82 |
| 3983 | Continuous Home Care w/AIDS Min 20 Hours | $1,500.17 | $33.75 | $9.92 | $1,543.84 | $1,559.28 |
| 3984 | Continuous Home Care w/AIDS Min 21 Hours | $1,575.18 | $35.44 | $9.92 | $1,620.54 | $1,636.75 |
| 3985 | Continuous Home Care w/AIDS Min 22 Hours | $1,650.18 | $37.13 | $9.92 | $1,697.23 | $1,714.20 |
| 3986 | Continuous Home Care w/AIDS Min 23 Hours | $1,725.19 | $38.82 | $9.92 | $1,773.93 | $1,791.67 |
| 3987 | Continuous Home Care w/AIDS Min 24 Hours | $1,800.20 | $40.50 | $9.92 | $1,850.62 | $1,869.13 |
| 3988 | General Inpatient w/ AIDS | $1,333.25 | $30.00 | $9.92 | $1,373.17 | $1,386.90 |
| 3989 | Routine Home Care w/ AIDS Escort | $396.88 | $8.93 | $9.92 | $415.73 | $419.89 |
| 3991 | Service Intensity Add-on | $69.24 | $1.56 | $0.00 | $70.80 | $71.51 |
* 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 | 1% Add-on |
|---|---|---|---|---|---|---|
| 3945 | Routine Home Care | $271.49 | $6.11 | $9.92 | $287.52 | $290.40 |
| 3946 | Inpatient Respite | $650.61 | $14.64 | $9.92 | $675.17 | $681.92 |
| 3947 | General Inpatient Care | $1,403.19 | $31.57 | $9.92 | $1,444.68 | $1,459.13 |
| 3948 | Continuous Home Care - Min 8 Hours | $667.11 | $15.01 | $9.92 | $692.04 | $698.96 |
| 3949 | Continuous Home Care - Min 9 Hours | $750.50 | $16.89 | $9.92 | $777.31 | $785.08 |
| 3950 | Continuous Home Care - Min 10 Hours | $833.88 | $18.76 | $9.92 | $862.56 | $871.19 |
| 3951 | Continuous Home Care - Min 11 Hours | $917.27 | $20.64 | $9.92 | $947.83 | $957.31 |
| 3952 | Continuous Home Care - Min 12 Hours | $1,000.66 | $22.51 | $9.92 | $1,033.09 | $1,043.42 |
| 3953 | Continuous Home Care - Min 13 Hours | $1,084.05 | $24.39 | $9.92 | $1,118.36 | $1,129.54 |
| 3954 | Continuous Home Care - Min 14 Hours | $1,167.44 | $26.27 | $9.92 | $1,203.63 | $1,215.67 |
| 3955 | Continuous Home Care - Min 15 Hours | $1,250.83 | $28.14 | $9.92 | $1,288.89 | $1,301.78 |
| 3956 | Continuous Home Care - Min 16 Hours | $1,334.21 | $30.02 | $9.92 | $1,374.15 | $1,387.89 |
| 3957 | Continuous Home Care - Min 17 Hours | $1,417.60 | $31.90 | $9.92 | $1,459.42 | $1,474.01 |
| 3958 | Continuous Home Care - Min 18 Hours | $1,500.99 | $33.77 | $9.92 | $1,544.68 | $1,560.13 |
| 3959 | Continuous Home Care - Min 19 Hours | $1,584.38 | $35.65 | $9.92 | $1,629.95 | $1,646.25 |
| 3960 | Continuous Home Care - Min 20 Hours | $1,667.77 | $37.52 | $9.92 | $1,715.21 | $1,732.36 |
| 3961 | Continuous Home Care - Min 21 Hours | $1,751.16 | $39.40 | $9.92 | $1,800.48 | $1,818.48 |
| 3962 | Continuous Home Care - Min 22 Hours | $1,834.54 | $41.28 | $9.92 | $1,885.74 | $1,904.60 |
| 3963 | Continuous Home Care - Min 23 Hours | $1,917.93 | $43.15 | $9.92 | $1,971.00 | $1,990.71 |
| 3964 | Continuous Home Care - Min 24 Hours | $2,001.32 | $45.03 | $9.92 | $2,056.27 | $2,076.83 |
| 3965 | Hospice Inpatient Respite Care Coinsurance Rate - 5% of 3946 | $32.53 | $0.73 | $0.50 | $33.76 | $34.10 |
| 3966 | Drugs Coinsurance Rate | $1.00 | $0.00 | $0.00 | $1.00 | $1.01 |
| 3969 | Routine Home Care w/AIDS | $441.90 | $9.94 | $9.92 | $461.76 | $466.38 |
| 3970 | Routine Home Care w/Escort | $292.67 | $6.59 | $9.92 | $309.18 | $312.27 |
| 3971 | Continuous Home Care w/AIDS Min 8 Hours | $746.35 | $16.79 | $9.92 | $773.06 | $780.79 |
| 3972 | Continuous Home Care w/AIDS Min 9 Hours | $839.65 | $18.89 | $9.92 | $868.46 | $877.14 |
| 3973 | Continuous Home Care w/AIDS Min 10 Hours | $932.94 | $20.99 | $9.92 | $963.85 | $973.49 |
| 3974 | Continuous Home Care w/AIDS Min 11 Hours | $1,026.24 | $23.09 | $9.92 | $1,059.25 | $1,069.84 |
| 3975 | Continuous Home Care w/AIDS Min 12 Hours | $1,119.53 | $25.19 | $9.92 | $1,154.64 | $1,166.19 |
| 3976 | Continuous Home Care w/AIDS Min 13 Hours | $1,212.82 | $27.29 | $9.92 | $1,250.03 | $1,262.53 |
| 3977 | Continuous Home Care w/AIDS Min 14 Hours | $1,306.12 | $29.39 | $9.92 | $1,345.43 | $1,358.88 |
| 3978 | Continuous Home Care w/AIDS Min 15 Hours | $1,399.41 | $31.49 | $9.92 | $1,440.82 | $1,455.23 |
| 3979 | Continuous Home Care w/AIDS Min 16 Hours | $1,492.71 | $33.59 | $9.92 | $1,536.22 | $1,551.58 |
| 3980 | Continuous Home Care w/AIDS Min 17 Hours | $1,586.00 | $35.69 | $9.92 | $1,631.61 | $1,647.93 |
| 3981 | Continuous Home Care w/AIDS Min 18 Hours | $1,679.30 | $37.78 | $9.92 | $1,727.00 | $1,744.27 |
| 3982 | Continuous Home Care w/AIDS Min 19 Hours | $1,772.59 | $39.88 | $9.92 | $1,822.39 | $1,840.61 |
| 3983 | Continuous Home Care w/AIDS Min 20 Hours | $1,865.88 | $41.98 | $9.92 | $1,917.78 | $1,936.96 |
| 3984 | Continuous Home Care w/AIDS Min 21 Hours | $1,959.18 | $44.08 | $9.92 | $2,013.18 | $2,033.31 |
| 3985 | Continuous Home Care w/AIDS Min 22 Hours | $2,052.47 | $46.18 | $9.92 | $2,108.57 | $2,129.66 |
| 3986 | Continuous Home Care w/AIDS Min 23 Hours | $2,145.77 | $48.28 | $9.92 | $2,203.97 | $2,226.01 |
| 3987 | Continuous Home Care w/AIDS Min 24 Hours | $2,239.06 | $50.38 | $9.92 | $2,299.36 | $2,322.35 |
| 3988 | General Inpatient w/ AIDS | $1,559.51 | $35.09 | $9.92 | $1,604.52 | $1,620.57 |
| 3989 | Routine Home Care w/ AIDS Escort | $463.08 | $10.42 | $9.92 | $483.42 | $488.25 |
| 3991 | Service Intensity Add-on | $81.44 | $1.83 | $0.00 | $83.27 | $84.10 |
* 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 | 1% Add-on |
|---|---|---|---|---|---|---|
| 3945 | Routine Home Care | $258.13 | $5.81 | $9.92 | $273.86 | $276.60 |
| 3946 | Inpatient Respite | $620.63 | $13.96 | $9.92 | $644.51 | $650.96 |
| 3947 | General Inpatient Care | $1,336.32 | $30.07 | $9.92 | $1,376.31 | $1,390.07 |
| 3948 | Continuous Home Care - Min 8 Hours | $630.58 | $14.19 | $9.92 | $654.69 | $661.24 |
| 3949 | Continuous Home Care - Min 9 Hours | $709.40 | $15.96 | $9.92 | $735.28 | $742.63 |
| 3950 | Continuous Home Care - Min 10 Hours | $788.22 | $17.73 | $9.92 | $815.87 | $824.03 |
| 3951 | Continuous Home Care - Min 11 Hours | $867.04 | $19.51 | $9.92 | $896.47 | $905.43 |
| 3952 | Continuous Home Care - Min 12 Hours | $945.87 | $21.28 | $9.92 | $977.07 | $986.84 |
| 3953 | Continuous Home Care - Min 13 Hours | $1,024.69 | $23.06 | $9.92 | $1,057.67 | $1,068.25 |
| 3954 | Continuous Home Care - Min 14 Hours | $1,103.51 | $24.83 | $9.92 | $1,138.26 | $1,149.64 |
| 3955 | Continuous Home Care - Min 15 Hours | $1,182.33 | $26.60 | $9.92 | $1,218.85 | $1,231.04 |
| 3956 | Continuous Home Care - Min 16 Hours | $1,261.15 | $28.38 | $9.92 | $1,299.45 | $1,312.44 |
| 3957 | Continuous Home Care - Min 17 Hours | $1,339.98 | $30.15 | $9.92 | $1,380.05 | $1,393.85 |
| 3958 | Continuous Home Care - Min 18 Hours | $1,418.80 | $31.92 | $9.92 | $1,460.64 | $1,475.25 |
| 3959 | Continuous Home Care - Min 19 Hours | $1,497.62 | $33.70 | $9.92 | $1,541.24 | $1,556.65 |
| 3960 | Continuous Home Care - Min 20 Hours | $1,576.44 | $35.47 | $9.92 | $1,621.83 | $1,638.05 |
| 3961 | Continuous Home Care - Min 21 Hours | $1,655.26 | $37.24 | $9.92 | $1,702.42 | $1,719.44 |
| 3962 | Continuous Home Care - Min 22 Hours | $1,734.09 | $39.02 | $9.92 | $1,783.03 | $1,800.86 |
| 3963 | Continuous Home Care - Min 23 Hours | $1,812.91 | $40.79 | $9.92 | $1,863.62 | $1,882.26 |
| 3964 | Continuous Home Care - Min 24 Hours | $1,891.73 | $42.56 | $9.92 | $1,944.21 | $1,963.65 |
| 3965 | Hospice Inpatient Respite Care Coinsurance Rate - 5% of 3946 | $31.03 | $0.70 | $0.50 | $32.23 | $32.55 |
| 3966 | Drugs Coinsurance Rate | $1.00 | $0.00 | $0.00 | $1.00 | $1.01 |
| 3969 | Routine Home Care w/AIDS | $420.15 | $9.45 | $9.92 | $439.52 | $443.92 |
| 3970 | Routine Home Care w/Escort | $279.31 | $6.28 | $9.92 | $295.51 | $298.47 |
| 3971 | Continuous Home Care w/AIDS Min 8 Hours | $698.30 | $15.71 | $9.92 | $723.93 | $731.17 |
| 3972 | Continuous Home Care w/AIDS Min 9 Hours | $785.59 | $17.68 | $9.92 | $813.19 | $821.32 |
| 3973 | Continuous Home Care w/AIDS Min 10 Hours | $872.88 | $19.64 | $9.92 | $902.44 | $911.46 |
| 3974 | Continuous Home Care w/AIDS Min 11 Hours | $960.17 | $21.60 | $9.92 | $991.69 | $1,001.61 |
| 3975 | Continuous Home Care w/AIDS Min 12 Hours | $1,047.46 | $23.57 | $9.92 | $1,080.95 | $1,091.76 |
| 3976 | Continuous Home Care w/AIDS Min 13 Hours | $1,134.74 | $25.53 | $9.92 | $1,170.19 | $1,181.89 |
| 3977 | Continuous Home Care w/AIDS Min 14 Hours | $1,222.03 | $27.50 | $9.92 | $1,259.45 | $1,272.04 |
| 3978 | Continuous Home Care w/AIDS Min 15 Hours | $1,309.32 | $29.46 | $9.92 | $1,348.70 | $1,362.19 |
| 3979 | Continuous Home Care w/AIDS Min 16 Hours | $1,396.61 | $31.42 | $9.92 | $1,437.95 | $1,452.33 |
| 3980 | Continuous Home Care w/AIDS Min 17 Hours | $1,483.89 | $33.39 | $9.92 | $1,527.20 | $1,542.47 |
| 3981 | Continuous Home Care w/AIDS Min 18 Hours | $1,571.18 | $35.35 | $9.92 | $1,616.45 | $1,632.61 |
| 3982 | Continuous Home Care w/AIDS Min 19 Hours | $1,658.47 | $37.32 | $9.92 | $1,705.71 | $1,722.77 |
| 3983 | Continuous Home Care w/AIDS Min 20 Hours | $1,745.76 | $39.28 | $9.92 | $1,794.96 | $1,812.91 |
| 3984 | Continuous Home Care w/AIDS Min 21 Hours | $1,833.05 | $41.24 | $9.92 | $1,884.21 | $1,903.05 |
| 3985 | Continuous Home Care w/AIDS Min 22 Hours | $1,920.33 | $43.21 | $9.92 | $1,973.46 | $1,993.19 |
| 3986 | Continuous Home Care w/AIDS Min 23 Hours | $2,007.62 | $45.17 | $9.92 | $2,062.71 | $2,083.34 |
| 3987 | Continuous Home Care w/AIDS Min 24 Hours | $2,094.91 | $47.14 | $9.92 | $2,151.97 | $2,173.49 |
| 3988 | General Inpatient w/ AIDS | $1,485.19 | $33.42 | $9.92 | $1,528.53 | $1,543.82 |
| 3989 | Routine Home Care w/ AIDS Escort | $441.33 | $9.93 | $9.92 | $461.18 | $465.79 |
| 3991 | Service Intensity Add-on | $77.44 | $1.74 | $0.00 | $79.18 | $79.97 |
* 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 | 1% Add-on |
|---|---|---|---|---|---|---|
| 3945 | Routine Home Care | $211.15 | $4.75 | $9.92 | $225.82 | $228.08 |
| 3946 | Inpatient Respite | $515.20 | $11.59 | $9.92 | $536.71 | $542.08 |
| 3947 | General Inpatient Care | $1,101.17 | $24.78 | $9.92 | $1,135.87 | $1,147.23 |
| 3948 | Continuous Home Care - Min 8 Hours | $502.11 | $11.30 | $9.92 | $523.33 | $528.56 |
| 3949 | Continuous Home Care - Min 9 Hours | $564.88 | $12.71 | $9.92 | $587.51 | $593.39 |
| 3950 | Continuous Home Care - Min 10 Hours | $627.64 | $14.12 | $9.92 | $651.68 | $658.20 |
| 3951 | Continuous Home Care - Min 11 Hours | $690.41 | $15.53 | $9.92 | $715.86 | $723.02 |
| 3952 | Continuous Home Care - Min 12 Hours | $753.17 | $16.95 | $9.92 | $780.04 | $787.84 |
| 3953 | Continuous Home Care - Min 13 Hours | $815.93 | $18.36 | $9.92 | $844.21 | $852.65 |
| 3954 | Continuous Home Care - Min 14 Hours | $878.70 | $19.77 | $9.92 | $908.39 | $917.47 |
| 3955 | Continuous Home Care - Min 15 Hours | $941.46 | $21.18 | $9.92 | $972.56 | $982.29 |
| 3956 | Continuous Home Care - Min 16 Hours | $1,004.23 | $22.60 | $9.92 | $1,036.75 | $1,047.12 |
| 3957 | Continuous Home Care - Min 17 Hours | $1,066.99 | $24.01 | $9.92 | $1,100.92 | $1,111.93 |
| 3958 | Continuous Home Care - Min 18 Hours | $1,129.76 | $25.42 | $9.92 | $1,165.10 | $1,176.75 |
| 3959 | Continuous Home Care - Min 19 Hours | $1,192.52 | $26.83 | $9.92 | $1,229.27 | $1,241.56 |
| 3960 | Continuous Home Care - Min 20 Hours | $1,255.28 | $28.24 | $9.92 | $1,293.44 | $1,306.37 |
| 3961 | Continuous Home Care - Min 21 Hours | $1,318.05 | $29.66 | $9.92 | $1,357.63 | $1,371.21 |
| 3962 | Continuous Home Care - Min 22 Hours | $1,380.81 | $31.07 | $9.92 | $1,421.80 | $1,436.02 |
| 3963 | Continuous Home Care - Min 23 Hours | $1,443.58 | $32.48 | $9.92 | $1,485.98 | $1,500.84 |
| 3964 | Continuous Home Care - Min 24 Hours | $1,506.34 | $33.89 | $9.92 | $1,550.15 | $1,565.65 |
| 3965 | Hospice Inpatient Respite Care Coinsurance Rate - 5% of 3946 | $25.76 | $0.58 | $0.50 | $26.84 | $27.11 |
| 3966 | Drugs Coinsurance Rate | $1.00 | $0.00 | $0.00 | $1.00 | $1.01 |
| 3969 | Routine Home Care w/AIDS | $343.68 | $7.73 | $9.92 | $361.33 | $364.94 |
| 3970 | Routine Home Care w/Escort | $232.33 | $5.23 | $9.92 | $247.48 | $249.95 |
| 3971 | Continuous Home Care w/AIDS Min 8 Hours | $529.32 | $11.91 | $9.92 | $551.15 | $556.66 |
| 3972 | Continuous Home Care w/AIDS Min 9 Hours | $595.49 | $13.40 | $9.92 | $618.81 | $625.00 |
| 3973 | Continuous Home Care w/AIDS Min 10 Hours | $661.65 | $14.89 | $9.92 | $686.46 | $693.32 |
| 3974 | Continuous Home Care w/AIDS Min 11 Hours | $727.82 | $16.38 | $9.92 | $754.12 | $761.66 |
| 3975 | Continuous Home Care w/AIDS Min 12 Hours | $793.99 | $17.86 | $9.92 | $821.77 | $829.99 |
| 3976 | Continuous Home Care w/AIDS Min 13 Hours | $860.15 | $19.35 | $9.92 | $889.42 | $898.31 |
| 3977 | Continuous Home Care w/AIDS Min 14 Hours | $926.32 | $20.84 | $9.92 | $957.08 | $966.65 |
| 3978 | Continuous Home Care w/AIDS Min 15 Hours | $992.48 | $22.33 | $9.92 | $1,024.73 | $1,034.98 |
| 3979 | Continuous Home Care w/AIDS Min 16 Hours | $1,058.65 | $23.82 | $9.92 | $1,092.39 | $1,103.31 |
| 3980 | Continuous Home Care w/AIDS Min 17 Hours | $1,124.81 | $25.31 | $9.92 | $1,160.04 | $1,171.64 |
| 3981 | Continuous Home Care w/AIDS Min 18 Hours | $1,190.98 | $26.80 | $9.92 | $1,227.70 | $1,239.98 |
| 3982 | Continuous Home Care w/AIDS Min 19 Hours | $1,257.14 | $28.29 | $9.92 | $1,295.35 | $1,308.30 |
| 3983 | Continuous Home Care w/AIDS Min 20 Hours | $1,323.31 | $29.77 | $9.92 | $1,363.00 | $1,376.63 |
| 3984 | Continuous Home Care w/AIDS Min 21 Hours | $1,389.47 | $31.26 | $9.92 | $1,430.65 | $1,444.96 |
| 3985 | Continuous Home Care w/AIDS Min 22 Hours | $1,455.64 | $32.75 | $9.92 | $1,498.31 | $1,513.29 |
| 3986 | Continuous Home Care w/AIDS Min 23 Hours | $1,521.80 | $34.24 | $9.92 | $1,565.96 | $1,581.62 |
| 3987 | Continuous Home Care w/AIDS Min 24 Hours | $1,587.97 | $35.73 | $9.92 | $1,633.62 | $1,649.96 |
| 3988 | General Inpatient w/ AIDS | $1,223.84 | $27.54 | $9.92 | $1,261.30 | $1,273.91 |
| 3989 | Routine Home Care w/ AIDS Escort | $364.86 | $8.21 | $9.92 | $382.99 | $386.82 |
| 3991 | Service Intensity Add-on | $63.34 | $1.43 | $0.00 | $64.77 | $65.42 |
* 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 | 1% Add-on |
|---|---|---|---|---|---|---|
| 3945 | Routine Home Care | $218.04 | $4.91 | $9.92 | $232.87 | $235.20 |
| 3946 | Inpatient Respite | $530.66 | $11.94 | $9.92 | $552.52 | $558.05 |
| 3947 | General Inpatient Care | $1,135.64 | $25.55 | $9.92 | $1,171.11 | $1,182.82 |
| 3948 | Continuous Home Care - Min 8 Hours | $520.95 | $11.72 | $9.92 | $542.59 | $548.02 |
| 3949 | Continuous Home Care - Min 9 Hours | $586.07 | $13.19 | $9.92 | $609.18 | $615.27 |
| 3950 | Continuous Home Care - Min 10 Hours | $651.18 | $14.65 | $9.92 | $675.75 | $682.51 |
| 3951 | Continuous Home Care - Min 11 Hours | $716.30 | $16.12 | $9.92 | $742.34 | $749.76 |
| 3952 | Continuous Home Care - Min 12 Hours | $781.42 | $17.58 | $9.92 | $808.92 | $817.01 |
| 3953 | Continuous Home Care - Min 13 Hours | $846.54 | $19.05 | $9.92 | $875.51 | $884.27 |
| 3954 | Continuous Home Care - Min 14 Hours | $911.66 | $20.51 | $9.92 | $942.09 | $951.51 |
| 3955 | Continuous Home Care - Min 15 Hours | $976.78 | $21.98 | $9.92 | $1,008.68 | $1,018.77 |
| 3956 | Continuous Home Care - Min 16 Hours | $1,041.89 | $23.44 | $9.92 | $1,075.25 | $1,086.00 |
| 3957 | Continuous Home Care - Min 17 Hours | $1,107.01 | $24.91 | $9.92 | $1,141.84 | $1,153.26 |
| 3958 | Continuous Home Care - Min 18 Hours | $1,172.13 | $26.37 | $9.92 | $1,208.42 | $1,220.50 |
| 3959 | Continuous Home Care - Min 19 Hours | $1,237.25 | $27.84 | $9.92 | $1,275.01 | $1,287.76 |
| 3960 | Continuous Home Care - Min 20 Hours | $1,302.37 | $29.30 | $9.92 | $1,341.59 | $1,355.01 |
| 3961 | Continuous Home Care - Min 21 Hours | $1,367.49 | $30.77 | $9.92 | $1,408.18 | $1,422.26 |
| 3962 | Continuous Home Care - Min 22 Hours | $1,432.60 | $32.23 | $9.92 | $1,474.75 | $1,489.50 |
| 3963 | Continuous Home Care - Min 23 Hours | $1,497.72 | $33.70 | $9.92 | $1,541.34 | $1,556.75 |
| 3964 | Continuous Home Care - Min 24 Hours | $1,562.84 | $35.16 | $9.92 | $1,607.92 | $1,624.00 |
| 3965 | Hospice Inpatient Respite Care Coinsurance Rate - 5% of 3946 | $26.53 | $0.60 | $0.50 | $27.63 | $27.91 |
| 3966 | Drugs Coinsurance Rate | $1.00 | $0.00 | $0.00 | $1.00 | $1.01 |
| 3969 | Routine Home Care w/AIDS | $354.89 | $7.99 | $9.92 | $372.80 | $376.53 |
| 3970 | Routine Home Care w/Escort | $239.22 | $5.38 | $9.92 | $254.52 | $257.07 |
| 3971 | Continuous Home Care w/AIDS Min 8 Hours | $554.10 | $12.47 | $9.92 | $576.49 | $582.25 |
| 3972 | Continuous Home Care w/AIDS Min 9 Hours | $623.36 | $14.03 | $9.92 | $647.31 | $653.78 |
| 3973 | Continuous Home Care w/AIDS Min 10 Hours | $692.62 | $15.58 | $9.92 | $718.12 | $725.30 |
| 3974 | Continuous Home Care w/AIDS Min 11 Hours | $761.88 | $17.14 | $9.92 | $788.94 | $796.83 |
| 3975 | Continuous Home Care w/AIDS Min 12 Hours | $831.15 | $18.70 | $9.92 | $859.77 | $868.37 |
| 3976 | Continuous Home Care w/AIDS Min 13 Hours | $900.41 | $20.26 | $9.92 | $930.59 | $939.90 |
| 3977 | Continuous Home Care w/AIDS Min 14 Hours | $969.67 | $21.82 | $9.92 | $1,001.41 | $1,011.42 |
| 3978 | Continuous Home Care w/AIDS Min 15 Hours | $1,038.93 | $23.38 | $9.92 | $1,072.23 | $1,082.95 |
| 3979 | Continuous Home Care w/AIDS Min 16 Hours | $1,108.19 | $24.93 | $9.92 | $1,143.04 | $1,154.47 |
| 3980 | Continuous Home Care w/AIDS Min 17 Hours | $1,177.46 | $26.49 | $9.92 | $1,213.87 | $1,226.01 |
| 3981 | Continuous Home Care w/AIDS Min 18 Hours | $1,246.72 | $28.05 | $9.92 | $1,284.69 | $1,297.54 |
| 3982 | Continuous Home Care w/AIDS Min 19 Hours | $1,315.98 | $29.61 | $9.92 | $1,355.51 | $1,369.07 |
| 3983 | Continuous Home Care w/AIDS Min 20 Hours | $1,385.24 | $31.17 | $9.92 | $1,426.33 | $1,440.59 |
| 3984 | Continuous Home Care w/AIDS Min 21 Hours | $1,454.50 | $32.73 | $9.92 | $1,497.15 | $1,512.12 |
| 3985 | Continuous Home Care w/AIDS Min 22 Hours | $1,523.77 | $34.28 | $9.92 | $1,567.97 | $1,583.65 |
| 3986 | Continuous Home Care w/AIDS Min 23 Hours | $1,593.03 | $35.84 | $9.92 | $1,638.79 | $1,655.18 |
| 3987 | Continuous Home Care w/AIDS Min 24 Hours | $1,662.29 | $37.40 | $9.92 | $1,709.61 | $1,726.71 |
| 3988 | General Inpatient w/ AIDS | $1,262.15 | $28.40 | $9.92 | $1,300.47 | $1,313.47 |
| 3989 | Routine Home Care w/ AIDS Escort | $376.07 | $8.46 | $9.92 | $394.45 | $398.39 |
| 3991 | Service Intensity Add-on | $65.41 | $1.47 | $0.00 | $66.88 | $67.55 |
* 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 | 1% Add-on |
|---|---|---|---|---|---|---|
| 3945 | Routine Home Care | $208.05 | $4.68 | $9.92 | $222.65 | $224.88 |
| 3946 | Inpatient Respite | $508.24 | $11.44 | $9.92 | $529.60 | $534.90 |
| 3947 | General Inpatient Care | $1,085.64 | $24.43 | $9.92 | $1,119.99 | $1,131.19 |
| 3948 | Continuous Home Care - Min 8 Hours | $493.63 | $11.11 | $9.92 | $514.66 | $519.81 |
| 3949 | Continuous Home Care - Min 9 Hours | $555.33 | $12.49 | $9.92 | $577.74 | $583.52 |
| 3950 | Continuous Home Care - Min 10 Hours | $617.04 | $13.88 | $9.92 | $640.84 | $647.25 |
| 3951 | Continuous Home Care - Min 11 Hours | $678.74 | $15.27 | $9.92 | $703.93 | $710.97 |
| 3952 | Continuous Home Care - Min 12 Hours | $740.45 | $16.66 | $9.92 | $767.03 | $774.70 |
| 3953 | Continuous Home Care - Min 13 Hours | $802.15 | $18.05 | $9.92 | $830.12 | $838.42 |
| 3954 | Continuous Home Care - Min 14 Hours | $863.85 | $19.44 | $9.92 | $893.21 | $902.14 |
| 3955 | Continuous Home Care - Min 15 Hours | $925.56 | $20.83 | $9.92 | $956.31 | $965.87 |
| 3956 | Continuous Home Care - Min 16 Hours | $987.26 | $22.21 | $9.92 | $1,019.39 | $1,029.58 |
| 3957 | Continuous Home Care - Min 17 Hours | $1,048.96 | $23.60 | $9.92 | $1,082.48 | $1,093.30 |
| 3958 | Continuous Home Care - Min 18 Hours | $1,110.67 | $24.99 | $9.92 | $1,145.58 | $1,157.04 |
| 3959 | Continuous Home Care - Min 19 Hours | $1,172.37 | $26.38 | $9.92 | $1,208.67 | $1,220.76 |
| 3960 | Continuous Home Care - Min 20 Hours | $1,234.08 | $27.77 | $9.92 | $1,271.77 | $1,284.49 |
| 3961 | Continuous Home Care - Min 21 Hours | $1,295.78 | $29.16 | $9.92 | $1,334.86 | $1,348.21 |
| 3962 | Continuous Home Care - Min 22 Hours | $1,357.48 | $30.54 | $9.92 | $1,397.94 | $1,411.92 |
| 3963 | Continuous Home Care - Min 23 Hours | $1,419.19 | $31.93 | $9.92 | $1,461.04 | $1,475.65 |
| 3964 | Continuous Home Care - Min 24 Hours | $1,480.89 | $33.32 | $9.92 | $1,524.13 | $1,539.37 |
| 3965 | Hospice Inpatient Respite Care Coinsurance Rate - 5% of 3946 | $25.41 | $0.57 | $0.50 | $26.48 | $26.74 |
| 3966 | Drugs Coinsurance Rate | $1.00 | $0.00 | $0.00 | $1.00 | $1.01 |
| 3969 | Routine Home Care w/AIDS | $338.63 | $7.62 | $9.92 | $356.17 | $359.73 |
| 3970 | Routine Home Care w/Escort | $229.23 | $5.16 | $9.92 | $244.31 | $246.75 |
| 3971 | Continuous Home Care w/AIDS Min 8 Hours | $518.17 | $11.66 | $9.92 | $539.75 | $545.15 |
| 3972 | Continuous Home Care w/AIDS Min 9 Hours | $582.94 | $13.12 | $9.92 | $605.98 | $612.04 |
| 3973 | Continuous Home Care w/AIDS Min 10 Hours | $647.71 | $14.57 | $9.92 | $672.20 | $678.92 |
| 3974 | Continuous Home Care w/AIDS Min 11 Hours | $712.48 | $16.03 | $9.92 | $738.43 | $745.81 |
| 3975 | Continuous Home Care w/AIDS Min 12 Hours | $777.25 | $17.49 | $9.92 | $804.66 | $812.71 |
| 3976 | Continuous Home Care w/AIDS Min 13 Hours | $842.02 | $18.95 | $9.92 | $870.89 | $879.60 |
| 3977 | Continuous Home Care w/AIDS Min 14 Hours | $906.79 | $20.40 | $9.92 | $937.11 | $946.48 |
| 3978 | Continuous Home Care w/AIDS Min 15 Hours | $971.56 | $21.86 | $9.92 | $1,003.34 | $1,013.37 |
| 3979 | Continuous Home Care w/AIDS Min 16 Hours | $1,036.33 | $23.32 | $9.92 | $1,069.57 | $1,080.27 |
| 3980 | Continuous Home Care w/AIDS Min 17 Hours | $1,101.10 | $24.77 | $9.92 | $1,135.79 | $1,147.15 |
| 3981 | Continuous Home Care w/AIDS Min 18 Hours | $1,165.88 | $26.23 | $9.92 | $1,202.03 | $1,214.05 |
| 3982 | Continuous Home Care w/AIDS Min 19 Hours | $1,230.65 | $27.69 | $9.92 | $1,268.26 | $1,280.94 |
| 3983 | Continuous Home Care w/AIDS Min 20 Hours | $1,295.42 | $29.15 | $9.92 | $1,334.49 | $1,347.83 |
| 3984 | Continuous Home Care w/AIDS Min 21 Hours | $1,360.19 | $30.60 | $9.92 | $1,400.71 | $1,414.72 |
| 3985 | Continuous Home Care w/AIDS Min 22 Hours | $1,424.96 | $32.06 | $9.92 | $1,466.94 | $1,481.61 |
| 3986 | Continuous Home Care w/AIDS Min 23 Hours | $1,489.73 | $33.52 | $9.92 | $1,533.17 | $1,548.50 |
| 3987 | Continuous Home Care w/AIDS Min 24 Hours | $1,554.50 | $34.98 | $9.92 | $1,599.40 | $1,615.39 |
| 3988 | General Inpatient w/ AIDS | $1,206.58 | $27.15 | $9.92 | $1,243.65 | $1,256.09 |
| 3989 | Routine Home Care w/ AIDS Escort | $359.81 | $8.10 | $9.92 | $377.83 | $381.61 |
| 3991 | Service Intensity Add-on | $62.41 | $1.40 | $0.00 | $63.81 | $64.45 |
* 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 |
1% Add-on |
|---|---|---|---|---|---|---|
| 3945 | Routine Home Care | $204.92 | $4.61 | $9.92 | $219.45 | $221.64 |
| 3946 | Inpatient Respite | $501.21 | $11.28 | $9.92 | $522.41 | $527.63 |
| 3947 | General Inpatient Care | $1,069.96 | $24.07 | $9.92 | $1,103.95 | $1,114.99 |
| 3948 | Continuous Home Care - Min 8 Hours | $485.07 | $10.91 | $9.92 | $505.90 | $510.96 |
| 3949 | Continuous Home Care - Min 9 Hours | $545.70 | $12.28 | $9.92 | $567.90 | $573.58 |
| 3950 | Continuous Home Care - Min 10 Hours | $606.33 | $13.64 | $9.92 | $629.89 | $636.19 |
| 3951 | Continuous Home Care - Min 11 Hours | $666.97 | $15.01 | $9.92 | $691.90 | $698.82 |
| 3952 | Continuous Home Care - Min 12 Hours | $727.60 | $16.37 | $9.92 | $753.89 | $761.43 |
| 3953 | Continuous Home Care - Min 13 Hours | $788.23 | $17.74 | $9.92 | $815.89 | $824.05 |
| 3954 | Continuous Home Care - Min 14 Hours | $848.87 | $19.10 | $9.92 | $877.89 | $886.67 |
| 3955 | Continuous Home Care - Min 15 Hours | $909.50 | $20.46 | $9.92 | $939.88 | $949.28 |
| 3956 | Continuous Home Care - Min 16 Hours | $970.13 | $21.83 | $9.92 | $1,001.88 | $1,011.90 |
| 3957 | Continuous Home Care - Min 17 Hours | $1,030.77 | $23.19 | $9.92 | $1,063.88 | $1,074.52 |
| 3958 | Continuous Home Care - Min 18 Hours | $1,091.40 | $24.56 | $9.92 | $1,125.88 | $1,137.14 |
| 3959 | Continuous Home Care - Min 19 Hours | $1,152.03 | $25.92 | $9.92 | $1,187.87 | $1,199.75 |
| 3960 | Continuous Home Care - Min 20 Hours | $1,212.67 | $27.29 | $9.92 | $1,249.88 | $1,262.38 |
| 3961 | Continuous Home Care - Min 21 Hours | $1,273.30 | $28.65 | $9.92 | $1,311.87 | $1,324.99 |
| 3962 | Continuous Home Care - Min 22 Hours | $1,333.93 | $30.01 | $9.92 | $1,373.86 | $1,387.60 |
| 3963 | Continuous Home Care - Min 23 Hours | $1,394.57 | $31.38 | $9.92 | $1,435.87 | $1,450.23 |
| 3964 | Continuous Home Care - Min 24 Hours | $1,455.20 | $32.74 | $9.92 | $1,497.86 | $1,512.84 |
| 3965 | Hospice Inpatient Respite Care Coinsurance Rate - 5% of 3946 | $25.06 | $0.56 | $0.50 | $26.12 | $26.38 |
| 3966 | Drugs Coinsurance Rate | $1.00 | $0.00 | $0.00 | $1.00 | $1.01 |
| 3969 | Routine Home Care w/AIDS | $333.54 | $7.50 | $9.92 | $350.96 | $354.47 |
| 3970 | Routine Home Care w/Escort | $226.10 | $5.09 | $9.92 | $241.11 | $243.52 |
| 3971 | Continuous Home Care w/AIDS Min 8 Hours | $506.90 | $11.41 | $9.92 | $528.23 | $533.51 |
| 3972 | Continuous Home Care w/AIDS Min 9 Hours | $570.26 | $12.83 | $9.92 | $593.01 | $598.94 |
| 3973 | Continuous Home Care w/AIDS Min 10 Hours | $633.63 | $14.26 | $9.92 | $657.81 | $664.39 |
| 3974 | Continuous Home Care w/AIDS Min 11 Hours | $696.99 | $15.68 | $9.92 | $722.59 | $729.82 |
| 3975 | Continuous Home Care w/AIDS Min 12 Hours | $760.35 | $17.11 | $9.92 | $787.38 | $795.25 |
| 3976 | Continuous Home Care w/AIDS Min 13 Hours | $823.71 | $18.53 | $9.92 | $852.16 | $860.68 |
| 3977 | Continuous Home Care w/AIDS Min 14 Hours | $887.08 | $19.96 | $9.92 | $916.96 | $926.13 |
| 3978 | Continuous Home Care w/AIDS Min 15 Hours | $950.44 | $21.38 | $9.92 | $981.74 | $991.56 |
| 3979 | Continuous Home Care w/AIDS Min 16 Hours | $1,013.80 | $22.81 | $9.92 | $1,046.53 | $1,057.00 |
| 3980 | Continuous Home Care w/AIDS Min 17 Hours | $1,077.16 | $24.24 | $9.92 | $1,111.32 | $1,122.43 |
| 3981 | Continuous Home Care w/AIDS Min 18 Hours | $1,140.53 | $25.66 | $9.92 | $1,176.11 | $1,187.87 |
| 3982 | Continuous Home Care w/AIDS Min 19 Hours | $1,203.89 | $27.09 | $9.92 | $1,240.90 | $1,253.31 |
| 3983 | Continuous Home Care w/AIDS Min 20 Hours | $1,267.25 | $28.51 | $9.92 | $1,305.68 | $1,318.74 |
| 3984 | Continuous Home Care w/AIDS Min 21 Hours | $1,330.61 | $29.94 | $9.92 | $1,370.47 | $1,384.17 |
| 3985 | Continuous Home Care w/AIDS Min 22 Hours | $1,393.98 | $31.36 | $9.92 | $1,435.26 | $1,449.61 |
| 3986 | Continuous Home Care w/AIDS Min 23 Hours | $1,457.34 | $32.79 | $9.92 | $1,500.05 | $1,515.05 |
| 3987 | Continuous Home Care w/AIDS Min 24 Hours | $1,520.70 | $34.22 | $9.92 | $1,564.84 | $1,580.49 |
| 3988 | General Inpatient w/ AIDS | $1,189.15 | $26.76 | $9.92 | $1,225.83 | $1,238.09 |
| 3989 | Routine Home Care w/ AIDS Escort | $354.72 | $7.98 | $9.92 | $372.62 | $376.35 |
| 3991 | Service Intensity Add-on | $61.47 | $1.38 | $0.00 | $62.85 | $63.48 |
* WRR ='Worker Recruitment and Retention addon' if applicable
* RTR ='Recruitment, Training and Retention addon' if applicable
