Certified Hospice Program
Medicaid Rate Sheet
Effective: 10/01/2025 - 09/30/2026
- 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 | 1% Add-on |
|---|---|---|---|---|---|---|
| 3945 | Routine Home Care | $209.03 | $4.70 | $9.92 | $223.65 | 225.89 |
| 3946 | Inpatient Respite | $510.97 | $11.50 | $9.92 | $532.39 | 537.71 |
| 3947 | General Inpatient Care | $1,089.46 | $24.51 | $9.92 | $1,123.89 | 1135.13 |
| 3948 | Continuous Home Care - Min 8 Hours | $497.48 | $11.19 | $9.92 | $518.59 | 523.78 |
| 3949 | Continuous Home Care - Min 9 Hours | $559.66 | $12.59 | $9.92 | $582.17 | 587.99 |
| 3950 | Continuous Home Care - Min 10 Hours | $621.85 | $13.99 | $9.92 | $645.76 | 652.22 |
| 3951 | Continuous Home Care - Min 11 Hours | $684.03 | $15.39 | $9.92 | $709.34 | 716.43 |
| 3952 | Continuous Home Care - Min 12 Hours | $746.22 | $16.79 | $9.92 | $772.93 | 780.66 |
| 3953 | Continuous Home Care - Min 13 Hours | $808.40 | $18.19 | $9.92 | $836.51 | 844.88 |
| 3954 | Continuous Home Care - Min 14 Hours | $870.58 | $19.59 | $9.92 | $900.09 | 909.09 |
| 3955 | Continuous Home Care - Min 15 Hours | $932.77 | $20.99 | $9.92 | $963.68 | 973.32 |
| 3956 | Continuous Home Care - Min 16 Hours | $994.95 | $22.39 | $9.92 | $1,027.26 | 1037.53 |
| 3957 | Continuous Home Care - Min 17 Hours | $1,057.14 | $23.79 | $9.92 | $1,090.85 | 1101.76 |
| 3958 | Continuous Home Care - Min 18 Hours | $1,119.32 | $25.18 | $9.92 | $1,154.42 | 1165.96 |
| 3959 | Continuous Home Care - Min 19 Hours | $1,181.51 | $26.58 | $9.92 | $1,218.01 | 1230.19 |
| 3960 | Continuous Home Care - Min 20 Hours | $1,243.69 | $27.98 | $9.92 | $1,281.59 | 1294.41 |
| 3961 | Continuous Home Care - Min 21 Hours | $1,305.88 | $29.38 | $9.92 | $1,345.18 | 1358.63 |
| 3962 | Continuous Home Care - Min 22 Hours | $1,368.06 | $30.78 | $9.92 | $1,408.76 | 1422.85 |
| 3963 | Continuous Home Care - Min 23 Hours | $1,430.25 | $32.18 | $9.92 | $1,472.35 | 1487.07 |
| 3964 | Continuous Home Care - Min 24 Hours | $1,492.43 | $33.58 | $9.92 | $1,535.93 | 1551.29 |
| 3965 | Hospice Inpatient Respite Care Coinsurance Rate - 5% of 3946 | $25.55 | $0.57 | $0.50 | $26.62 | 26.89 |
| 3966 | Drugs Coinsurance Rate | $1.00 | $0.00 | $0.00 | $1.00 | 1.01 |
| 3969 | Routine Home Care w/AIDS | $339.76 | $7.64 | $9.92 | $357.32 | 360.89 |
| 3970 | Routine Home Care w/Escort | $230.72 | $5.19 | $9.92 | $245.83 | 248.29 |
| 3971 | Continuous Home Care w/AIDS Min 8 Hours | $518.36 | $11.66 | $9.92 | $539.94 | 545.34 |
| 3972 | Continuous Home Care w/AIDS Min 9 Hours | $583.15 | $13.12 | $9.92 | $606.19 | 612.25 |
| 3973 | Continuous Home Care w/AIDS Min 10 Hours | $647.95 | $14.58 | $9.92 | $672.45 | 679.17 |
| 3974 | Continuous Home Care w/AIDS Min 11 Hours | $712.74 | $16.04 | $9.92 | $738.70 | 746.09 |
| 3975 | Continuous Home Care w/AIDS Min 12 Hours | $777.54 | $17.49 | $9.92 | $804.95 | 813 |
| 3976 | Continuous Home Care w/AIDS Min 13 Hours | $842.33 | $18.95 | $9.92 | $871.20 | 879.91 |
| 3977 | Continuous Home Care w/AIDS Min 14 Hours | $907.12 | $20.41 | $9.92 | $937.45 | 946.82 |
| 3978 | Continuous Home Care w/AIDS Min 15 Hours | $971.92 | $21.87 | $9.92 | $1,003.71 | 1013.75 |
| 3979 | Continuous Home Care w/AIDS Min 16 Hours | $1,036.71 | $23.33 | $9.92 | $1,069.96 | 1080.66 |
| 3980 | Continuous Home Care w/AIDS Min 17 Hours | $1,101.51 | $24.78 | $9.92 | $1,136.21 | 1147.57 |
| 3981 | Continuous Home Care w/AIDS Min 18 Hours | $1,166.30 | $26.24 | $9.92 | $1,202.46 | 1214.48 |
| 3982 | Continuous Home Care w/AIDS Min 19 Hours | $1,231.10 | $27.70 | $9.92 | $1,268.72 | 1281.41 |
| 3983 | Continuous Home Care w/AIDS Min 20 Hours | $1,295.89 | $29.16 | $9.92 | $1,334.97 | 1348.32 |
| 3984 | Continuous Home Care w/AIDS Min 21 Hours | $1,360.69 | $30.62 | $9.92 | $1,401.23 | 1415.24 |
| 3985 | Continuous Home Care w/AIDS Min 22 Hours | $1,425.48 | $32.07 | $9.92 | $1,467.47 | 1482.14 |
| 3986 | Continuous Home Care w/AIDS Min 23 Hours | $1,490.28 | $33.53 | $9.92 | $1,533.73 | 1549.07 |
| 3987 | Continuous Home Care w/AIDS Min 24 Hours | $1,555.07 | $34.99 | $9.92 | $1,599.98 | 1615.98 |
| 3988 | General Inpatient w/ AIDS | $1,210.83 | $27.24 | $9.92 | $1,247.99 | 1260.47 |
| 3989 | Routine Home Care w/ AIDS Escort | $361.45 | $8.13 | $9.92 | $379.50 | 383.3 |
| 3991 | Service Intensity Add-on | $62.19 | $1.40 | $0.00 | $63.59 | 64.23 |
* 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 | $205.39 | $4.62 | $9.92 | $219.93 | 222.13 |
| 3946 | Inpatient Respite | $502.83 | $11.31 | $9.92 | $524.06 | 529.3 |
| 3947 | General Inpatient Care | $1,071.33 | $24.10 | $9.92 | $1,105.35 | 1116.4 |
| 3948 | Continuous Home Care - Min 8 Hours | $487.48 | $10.97 | $9.92 | $508.37 | 513.45 |
| 3949 | Continuous Home Care - Min 9 Hours | $548.42 | $12.34 | $9.92 | $570.68 | 576.39 |
| 3950 | Continuous Home Care - Min 10 Hours | $609.35 | $13.71 | $9.92 | $632.98 | 639.31 |
| 3951 | Continuous Home Care - Min 11 Hours | $670.29 | $15.08 | $9.92 | $695.29 | 702.24 |
| 3952 | Continuous Home Care - Min 12 Hours | $731.23 | $16.45 | $9.92 | $757.60 | 765.18 |
| 3953 | Continuous Home Care - Min 13 Hours | $792.16 | $17.82 | $9.92 | $819.90 | 828.1 |
| 3954 | Continuous Home Care - Min 14 Hours | $853.10 | $19.19 | $9.92 | $882.21 | 891.03 |
| 3955 | Continuous Home Care - Min 15 Hours | $914.03 | $20.57 | $9.92 | $944.52 | 953.97 |
| 3956 | Continuous Home Care - Min 16 Hours | $974.97 | $21.94 | $9.92 | $1,006.83 | 1016.9 |
| 3957 | Continuous Home Care - Min 17 Hours | $1,035.90 | $23.31 | $9.92 | $1,069.13 | 1079.82 |
| 3958 | Continuous Home Care - Min 18 Hours | $1,096.84 | $24.68 | $9.92 | $1,131.44 | 1142.75 |
| 3959 | Continuous Home Care - Min 19 Hours | $1,157.77 | $26.05 | $9.92 | $1,193.74 | 1205.68 |
| 3960 | Continuous Home Care - Min 20 Hours | $1,218.71 | $27.42 | $9.92 | $1,256.05 | 1268.61 |
| 3961 | Continuous Home Care - Min 21 Hours | $1,279.64 | $28.79 | $9.92 | $1,318.35 | 1331.53 |
| 3962 | Continuous Home Care - Min 22 Hours | $1,340.58 | $30.16 | $9.92 | $1,380.66 | 1394.47 |
| 3963 | Continuous Home Care - Min 23 Hours | $1,401.51 | $31.53 | $9.92 | $1,442.96 | 1457.39 |
| 3964 | Continuous Home Care - Min 24 Hours | $1,462.45 | $32.91 | $9.92 | $1,505.28 | 1520.33 |
| 3965 | Hospice Inpatient Respite Care Coinsurance Rate - 5% of 3946 | $25.14 | $0.57 | $0.50 | $26.21 | 26.47 |
| 3966 | Drugs Coinsurance Rate | $1.00 | $0.00 | $0.00 | $1.00 | 1.01 |
| 3969 | Routine Home Care w/AIDS | $333.86 | $7.51 | $9.92 | $351.29 | 354.8 |
| 3970 | Routine Home Care w/Escort | $227.08 | $5.11 | $9.92 | $242.11 | 244.53 |
| 3971 | Continuous Home Care w/AIDS Min 8 Hours | $505.22 | $11.37 | $9.92 | $526.51 | 531.78 |
| 3972 | Continuous Home Care w/AIDS Min 9 Hours | $568.38 | $12.79 | $9.92 | $591.09 | 597 |
| 3973 | Continuous Home Care w/AIDS Min 10 Hours | $631.53 | $14.21 | $9.92 | $655.66 | 662.22 |
| 3974 | Continuous Home Care w/AIDS Min 11 Hours | $694.68 | $15.63 | $9.92 | $720.23 | 727.43 |
| 3975 | Continuous Home Care w/AIDS Min 12 Hours | $757.84 | $17.05 | $9.92 | $784.81 | 792.66 |
| 3976 | Continuous Home Care w/AIDS Min 13 Hours | $820.99 | $18.47 | $9.92 | $849.38 | 857.87 |
| 3977 | Continuous Home Care w/AIDS Min 14 Hours | $884.14 | $19.89 | $9.92 | $913.95 | 923.09 |
| 3978 | Continuous Home Care w/AIDS Min 15 Hours | $947.29 | $21.31 | $9.92 | $978.52 | 988.31 |
| 3979 | Continuous Home Care w/AIDS Min 16 Hours | $1,010.45 | $22.74 | $9.92 | $1,043.11 | 1053.54 |
| 3980 | Continuous Home Care w/AIDS Min 17 Hours | $1,073.60 | $24.16 | $9.92 | $1,107.68 | 1118.76 |
| 3981 | Continuous Home Care w/AIDS Min 18 Hours | $1,136.75 | $25.58 | $9.92 | $1,172.25 | 1183.97 |
| 3982 | Continuous Home Care w/AIDS Min 19 Hours | $1,199.91 | $27.00 | $9.92 | $1,236.83 | 1249.2 |
| 3983 | Continuous Home Care w/AIDS Min 20 Hours | $1,263.06 | $28.42 | $9.92 | $1,301.40 | 1314.41 |
| 3984 | Continuous Home Care w/AIDS Min 21 Hours | $1,326.21 | $29.84 | $9.92 | $1,365.97 | 1379.63 |
| 3985 | Continuous Home Care w/AIDS Min 22 Hours | $1,389.36 | $31.26 | $9.92 | $1,430.54 | 1444.85 |
| 3986 | Continuous Home Care w/AIDS Min 23 Hours | $1,452.52 | $32.68 | $9.92 | $1,495.12 | 1510.07 |
| 3987 | Continuous Home Care w/AIDS Min 24 Hours | $1,515.67 | $34.10 | $9.92 | $1,559.69 | 1575.29 |
| 3988 | General Inpatient w/ AIDS | $1,190.68 | $26.79 | $9.92 | $1,227.39 | 1239.66 |
| 3989 | Routine Home Care w/ AIDS Escort | $355.55 | $8.00 | $9.92 | $373.47 | 377.2 |
| 3991 | Service Intensity Add-on | $60.94 | $1.37 | $0.00 | $62.31 | 62.93 |
* 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 | $240.98 | $5.42 | $9.92 | $256.32 | 258.88 |
| 3946 | Inpatient Respite | $582.60 | $13.11 | $9.92 | $605.63 | 611.69 |
| 3947 | General Inpatient Care | $1,249.08 | $28.10 | $9.92 | $1,287.10 | 1299.97 |
| 3948 | Continuous Home Care - Min 8 Hours | $585.44 | $13.17 | $9.92 | $608.53 | 614.62 |
| 3949 | Continuous Home Care - Min 9 Hours | $658.62 | $14.82 | $9.92 | $683.36 | 690.19 |
| 3950 | Continuous Home Care - Min 10 Hours | $731.80 | $16.47 | $9.92 | $758.19 | 765.77 |
| 3951 | Continuous Home Care - Min 11 Hours | $804.98 | $18.11 | $9.92 | $833.01 | 841.34 |
| 3952 | Continuous Home Care - Min 12 Hours | $878.16 | $19.76 | $9.92 | $907.84 | 916.92 |
| 3953 | Continuous Home Care - Min 13 Hours | $951.33 | $21.40 | $9.92 | $982.65 | 992.48 |
| 3954 | Continuous Home Care - Min 14 Hours | $1,024.51 | $23.05 | $9.92 | $1,057.48 | 1068.05 |
| 3955 | Continuous Home Care - Min 15 Hours | $1,097.69 | $24.70 | $9.92 | $1,132.31 | 1143.63 |
| 3956 | Continuous Home Care - Min 16 Hours | $1,170.87 | $26.34 | $9.92 | $1,207.13 | 1219.2 |
| 3957 | Continuous Home Care - Min 17 Hours | $1,244.05 | $27.99 | $9.92 | $1,281.96 | 1294.78 |
| 3958 | Continuous Home Care - Min 18 Hours | $1,317.23 | $29.64 | $9.92 | $1,356.79 | 1370.36 |
| 3959 | Continuous Home Care - Min 19 Hours | $1,390.41 | $31.28 | $9.92 | $1,431.61 | 1445.93 |
| 3960 | Continuous Home Care - Min 20 Hours | $1,463.59 | $32.93 | $9.92 | $1,506.44 | 1521.5 |
| 3961 | Continuous Home Care - Min 21 Hours | $1,536.77 | $34.58 | $9.92 | $1,581.27 | 1597.08 |
| 3962 | Continuous Home Care - Min 22 Hours | $1,609.95 | $36.22 | $9.92 | $1,656.09 | 1672.65 |
| 3963 | Continuous Home Care - Min 23 Hours | $1,683.13 | $37.87 | $9.92 | $1,730.92 | 1748.23 |
| 3964 | Continuous Home Care - Min 24 Hours | $1,756.31 | $39.52 | $9.92 | $1,805.75 | 1823.81 |
| 3965 | Hospice Inpatient Respite Care Coinsurance Rate - 5% of 3946 | $29.13 | $0.66 | $0.50 | $30.29 | 30.59 |
| 3966 | Drugs Coinsurance Rate | $1.00 | $0.00 | $0.00 | $1.00 | 1.01 |
| 3969 | Routine Home Care w/AIDS | $391.71 | $8.81 | $9.92 | $410.44 | 414.54 |
| 3970 | Routine Home Care w/Escort | $262.67 | $5.91 | $9.92 | $278.50 | 281.29 |
| 3971 | Continuous Home Care w/AIDS Min 8 Hours | $633.98 | $14.26 | $9.92 | $658.16 | 664.74 |
| 3972 | Continuous Home Care w/AIDS Min 9 Hours | $713.23 | $16.05 | $9.92 | $739.20 | 746.59 |
| 3973 | Continuous Home Care w/AIDS Min 10 Hours | $792.48 | $17.83 | $9.92 | $820.23 | 828.43 |
| 3974 | Continuous Home Care w/AIDS Min 11 Hours | $871.72 | $19.61 | $9.92 | $901.25 | 910.26 |
| 3975 | Continuous Home Care w/AIDS Min 12 Hours | $950.97 | $21.40 | $9.92 | $982.29 | 992.11 |
| 3976 | Continuous Home Care w/AIDS Min 13 Hours | $1,030.22 | $23.18 | $9.92 | $1,063.32 | 1073.95 |
| 3977 | Continuous Home Care w/AIDS Min 14 Hours | $1,109.47 | $24.96 | $9.92 | $1,144.35 | 1155.79 |
| 3978 | Continuous Home Care w/AIDS Min 15 Hours | $1,188.71 | $26.75 | $9.92 | $1,225.38 | 1237.63 |
| 3979 | Continuous Home Care w/AIDS Min 16 Hours | $1,267.96 | $28.53 | $9.92 | $1,306.41 | 1319.47 |
| 3980 | Continuous Home Care w/AIDS Min 17 Hours | $1,347.21 | $30.31 | $9.92 | $1,387.44 | 1401.31 |
| 3981 | Continuous Home Care w/AIDS Min 18 Hours | $1,426.46 | $32.10 | $9.92 | $1,468.48 | 1483.16 |
| 3982 | Continuous Home Care w/AIDS Min 19 Hours | $1,505.70 | $33.88 | $9.92 | $1,549.50 | 1565 |
| 3983 | Continuous Home Care w/AIDS Min 20 Hours | $1,584.95 | $35.66 | $9.92 | $1,630.53 | 1646.84 |
| 3984 | Continuous Home Care w/AIDS Min 21 Hours | $1,664.20 | $37.44 | $9.92 | $1,711.56 | 1728.68 |
| 3985 | Continuous Home Care w/AIDS Min 22 Hours | $1,743.45 | $39.23 | $9.92 | $1,792.60 | 1810.53 |
| 3986 | Continuous Home Care w/AIDS Min 23 Hours | $1,822.69 | $41.01 | $9.92 | $1,873.62 | 1892.36 |
| 3987 | Continuous Home Care w/AIDS Min 24 Hours | $1,901.94 | $42.79 | $9.92 | $1,954.65 | 1974.2 |
| 3988 | General Inpatient w/ AIDS | $1,388.23 | $31.24 | $9.92 | $1,429.39 | 1443.68 |
| 3989 | Routine Home Care w/ AIDS Escort | $413.40 | $9.30 | $9.92 | $432.62 | 436.95 |
| 3991 | Service Intensity Add-on | $73.18 | $1.65 | $0.00 | $74.83 | 75.58 |
* 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 | $207.67 | $4.67 | $9.92 | $222.26 | 224.48 |
| 3946 | Inpatient Respite | $507.92 | $11.43 | $9.92 | $529.27 | 534.56 |
| 3947 | General Inpatient Care | $1,082.68 | $24.36 | $9.92 | $1,116.96 | 1128.13 |
| 3948 | Continuous Home Care - Min 8 Hours | $493.74 | $11.11 | $9.92 | $514.77 | 519.92 |
| 3949 | Continuous Home Care - Min 9 Hours | $555.46 | $12.50 | $9.92 | $577.88 | 583.66 |
| 3950 | Continuous Home Care - Min 10 Hours | $617.18 | $13.89 | $9.92 | $640.99 | 647.4 |
| 3951 | Continuous Home Care - Min 11 Hours | $678.89 | $15.28 | $9.92 | $704.09 | 711.13 |
| 3952 | Continuous Home Care - Min 12 Hours | $740.61 | $16.66 | $9.92 | $767.19 | 774.86 |
| 3953 | Continuous Home Care - Min 13 Hours | $802.33 | $18.05 | $9.92 | $830.30 | 838.6 |
| 3954 | Continuous Home Care - Min 14 Hours | $864.05 | $19.44 | $9.92 | $893.41 | 902.34 |
| 3955 | Continuous Home Care - Min 15 Hours | $925.76 | $20.83 | $9.92 | $956.51 | 966.08 |
| 3956 | Continuous Home Care - Min 16 Hours | $987.48 | $22.22 | $9.92 | $1,019.62 | 1029.82 |
| 3957 | Continuous Home Care - Min 17 Hours | $1,049.20 | $23.61 | $9.92 | $1,082.73 | 1093.56 |
| 3958 | Continuous Home Care - Min 18 Hours | $1,110.92 | $25.00 | $9.92 | $1,145.84 | 1157.3 |
| 3959 | Continuous Home Care - Min 19 Hours | $1,172.63 | $26.38 | $9.92 | $1,208.93 | 1221.02 |
| 3960 | Continuous Home Care - Min 20 Hours | $1,234.35 | $27.77 | $9.92 | $1,272.04 | 1284.76 |
| 3961 | Continuous Home Care - Min 21 Hours | $1,296.07 | $29.16 | $9.92 | $1,335.15 | 1348.5 |
| 3962 | Continuous Home Care - Min 22 Hours | $1,357.79 | $30.55 | $9.92 | $1,398.26 | 1412.24 |
| 3963 | Continuous Home Care - Min 23 Hours | $1,419.50 | $31.94 | $9.92 | $1,461.36 | 1475.97 |
| 3964 | Continuous Home Care - Min 24 Hours | $1,481.22 | $33.33 | $9.92 | $1,524.47 | 1539.71 |
| 3965 | Hospice Inpatient Respite Care Coinsurance Rate - 5% of 3946 | $25.40 | $0.57 | $0.50 | $26.47 | 26.73 |
| 3966 | Drugs Coinsurance Rate | $1.00 | $0.00 | $0.00 | $1.00 | 1.01 |
| 3969 | Routine Home Care w/AIDS | $337.55 | $7.59 | $9.92 | $355.06 | 358.61 |
| 3970 | Routine Home Care w/Escort | $229.36 | $5.16 | $9.92 | $244.44 | 246.88 |
| 3971 | Continuous Home Care w/AIDS Min 8 Hours | $513.44 | $11.55 | $9.92 | $534.91 | 540.26 |
| 3972 | Continuous Home Care w/AIDS Min 9 Hours | $577.62 | $13.00 | $9.92 | $600.54 | 606.55 |
| 3973 | Continuous Home Care w/AIDS Min 10 Hours | $641.80 | $14.44 | $9.92 | $666.16 | 672.82 |
| 3974 | Continuous Home Care w/AIDS Min 11 Hours | $705.98 | $15.88 | $9.92 | $731.78 | 739.1 |
| 3975 | Continuous Home Care w/AIDS Min 12 Hours | $770.17 | $17.33 | $9.92 | $797.42 | 805.39 |
| 3976 | Continuous Home Care w/AIDS Min 13 Hours | $834.35 | $18.77 | $9.92 | $863.04 | 871.67 |
| 3977 | Continuous Home Care w/AIDS Min 14 Hours | $898.53 | $20.22 | $9.92 | $928.67 | 937.96 |
| 3978 | Continuous Home Care w/AIDS Min 15 Hours | $962.71 | $21.66 | $9.92 | $994.29 | 1004.23 |
| 3979 | Continuous Home Care w/AIDS Min 16 Hours | $1,026.89 | $23.11 | $9.92 | $1,059.92 | 1070.52 |
| 3980 | Continuous Home Care w/AIDS Min 17 Hours | $1,091.07 | $24.55 | $9.92 | $1,125.54 | 1136.8 |
| 3981 | Continuous Home Care w/AIDS Min 18 Hours | $1,155.25 | $25.99 | $9.92 | $1,191.16 | 1203.07 |
| 3982 | Continuous Home Care w/AIDS Min 19 Hours | $1,219.43 | $27.44 | $9.92 | $1,256.79 | 1269.36 |
| 3983 | Continuous Home Care w/AIDS Min 20 Hours | $1,283.61 | $28.88 | $9.92 | $1,322.41 | 1335.63 |
| 3984 | Continuous Home Care w/AIDS Min 21 Hours | $1,347.79 | $30.33 | $9.92 | $1,388.04 | 1401.92 |
| 3985 | Continuous Home Care w/AIDS Min 22 Hours | $1,411.97 | $31.77 | $9.92 | $1,453.66 | 1468.2 |
| 3986 | Continuous Home Care w/AIDS Min 23 Hours | $1,476.15 | $33.21 | $9.92 | $1,519.28 | 1534.47 |
| 3987 | Continuous Home Care w/AIDS Min 24 Hours | $1,540.33 | $34.66 | $9.92 | $1,584.91 | 1600.76 |
| 3988 | General Inpatient w/ AIDS | $1,203.29 | $27.07 | $9.92 | $1,240.28 | 1252.68 |
| 3989 | Routine Home Care w/ AIDS Escort | $359.24 | $8.08 | $9.92 | $377.24 | 381.01 |
| 3991 | Service Intensity Add-on | $61.72 | $1.39 | $0.00 | $63.11 | 63.74 |
* 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 | $220.44 | $4.96 | $9.92 | $235.32 | 237.67 |
| 3946 | Inpatient Respite | $536.54 | $12.07 | $9.92 | $558.53 | 564.12 |
| 3947 | General Inpatient Care | $1,146.45 | $25.80 | $9.92 | $1,182.17 | 1193.99 |
| 3948 | Continuous Home Care - Min 8 Hours | $528.88 | $11.90 | $9.92 | $550.70 | 556.21 |
| 3949 | Continuous Home Care - Min 9 Hours | $594.99 | $13.39 | $9.92 | $618.30 | 624.48 |
| 3950 | Continuous Home Care - Min 10 Hours | $661.10 | $14.87 | $9.92 | $685.89 | 692.75 |
| 3951 | Continuous Home Care - Min 11 Hours | $727.21 | $16.36 | $9.92 | $753.49 | 761.02 |
| 3952 | Continuous Home Care - Min 12 Hours | $793.33 | $17.85 | $9.92 | $821.10 | 829.31 |
| 3953 | Continuous Home Care - Min 13 Hours | $859.44 | $19.34 | $9.92 | $888.70 | 897.59 |
| 3954 | Continuous Home Care - Min 14 Hours | $925.55 | $20.82 | $9.92 | $956.29 | 965.85 |
| 3955 | Continuous Home Care - Min 15 Hours | $991.66 | $22.31 | $9.92 | $1,023.89 | 1034.13 |
| 3956 | Continuous Home Care - Min 16 Hours | $1,057.77 | $23.80 | $9.92 | $1,091.49 | 1102.4 |
| 3957 | Continuous Home Care - Min 17 Hours | $1,123.88 | $25.29 | $9.92 | $1,159.09 | 1170.68 |
| 3958 | Continuous Home Care - Min 18 Hours | $1,189.99 | $26.77 | $9.92 | $1,226.68 | 1238.95 |
| 3959 | Continuous Home Care - Min 19 Hours | $1,256.10 | $28.26 | $9.92 | $1,294.28 | 1307.22 |
| 3960 | Continuous Home Care - Min 20 Hours | $1,322.21 | $29.75 | $9.92 | $1,361.88 | 1375.5 |
| 3961 | Continuous Home Care - Min 21 Hours | $1,388.32 | $31.24 | $9.92 | $1,429.48 | 1443.77 |
| 3962 | Continuous Home Care - Min 22 Hours | $1,454.43 | $32.72 | $9.92 | $1,497.07 | 1512.04 |
| 3963 | Continuous Home Care - Min 23 Hours | $1,520.54 | $34.21 | $9.92 | $1,564.67 | 1580.32 |
| 3964 | Continuous Home Care - Min 24 Hours | $1,586.65 | $35.70 | $9.92 | $1,632.27 | 1648.59 |
| 3965 | Hospice Inpatient Respite Care Coinsurance Rate - 5% of 3946 | $26.83 | $0.60 | $0.50 | $27.93 | 28.21 |
| 3966 | Drugs Coinsurance Rate | $1.00 | $0.00 | $0.00 | $1.00 | 1.01 |
| 3969 | Routine Home Care w/AIDS | $358.31 | $8.06 | $9.92 | $376.29 | 380.05 |
| 3970 | Routine Home Care w/Escort | $242.13 | $5.45 | $9.92 | $257.50 | 260.08 |
| 3971 | Continuous Home Care w/AIDS Min 8 Hours | $559.64 | $12.59 | $9.92 | $582.15 | 587.97 |
| 3972 | Continuous Home Care w/AIDS Min 9 Hours | $629.60 | $14.17 | $9.92 | $653.69 | 660.23 |
| 3973 | Continuous Home Care w/AIDS Min 10 Hours | $699.55 | $15.74 | $9.92 | $725.21 | 732.46 |
| 3974 | Continuous Home Care w/AIDS Min 11 Hours | $769.51 | $17.31 | $9.92 | $796.74 | 804.71 |
| 3975 | Continuous Home Care w/AIDS Min 12 Hours | $839.46 | $18.89 | $9.92 | $868.27 | 876.95 |
| 3976 | Continuous Home Care w/AIDS Min 13 Hours | $909.42 | $20.46 | $9.92 | $939.80 | 949.2 |
| 3977 | Continuous Home Care w/AIDS Min 14 Hours | $979.37 | $22.04 | $9.92 | $1,011.33 | 1021.44 |
| 3978 | Continuous Home Care w/AIDS Min 15 Hours | $1,049.33 | $23.61 | $9.92 | $1,082.86 | 1093.69 |
| 3979 | Continuous Home Care w/AIDS Min 16 Hours | $1,119.28 | $25.18 | $9.92 | $1,154.38 | 1165.92 |
| 3980 | Continuous Home Care w/AIDS Min 17 Hours | $1,189.24 | $26.76 | $9.92 | $1,225.92 | 1238.18 |
| 3981 | Continuous Home Care w/AIDS Min 18 Hours | $1,259.19 | $28.33 | $9.92 | $1,297.44 | 1310.41 |
| 3982 | Continuous Home Care w/AIDS Min 19 Hours | $1,329.15 | $29.91 | $9.92 | $1,368.98 | 1382.67 |
| 3983 | Continuous Home Care w/AIDS Min 20 Hours | $1,399.10 | $31.48 | $9.92 | $1,440.50 | 1454.91 |
| 3984 | Continuous Home Care w/AIDS Min 21 Hours | $1,469.06 | $33.05 | $9.92 | $1,512.03 | 1527.15 |
| 3985 | Continuous Home Care w/AIDS Min 22 Hours | $1,539.01 | $34.63 | $9.92 | $1,583.56 | 1599.4 |
| 3986 | Continuous Home Care w/AIDS Min 23 Hours | $1,608.97 | $36.20 | $9.92 | $1,655.09 | 1671.64 |
| 3987 | Continuous Home Care w/AIDS Min 24 Hours | $1,678.92 | $37.78 | $9.92 | $1,726.62 | 1743.89 |
| 3988 | General Inpatient w/ AIDS | $1,274.16 | $28.67 | $9.92 | $1,312.75 | 1325.88 |
| 3989 | Routine Home Care w/ AIDS Escort | $380.00 | $8.55 | $9.92 | $398.47 | 402.45 |
| 3991 | Service Intensity Add-on | $66.11 | $1.49 | $0.00 | $67.60 | 68.28 |
* 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 | $267.21 | $6.01 | $9.92 | $283.14 | 285.97 |
| 3946 | Inpatient Respite | $641.37 | $14.43 | $9.92 | $665.72 | 672.38 |
| 3947 | General Inpatient Care | $1,380.05 | $31.05 | $9.92 | $1,421.02 | 1435.23 |
| 3948 | Continuous Home Care - Min 8 Hours | $657.61 | $14.80 | $9.92 | $682.33 | 689.15 |
| 3949 | Continuous Home Care - Min 9 Hours | $739.81 | $16.65 | $9.92 | $766.38 | 774.04 |
| 3950 | Continuous Home Care - Min 10 Hours | $822.01 | $18.50 | $9.92 | $850.43 | 858.93 |
| 3951 | Continuous Home Care - Min 11 Hours | $904.21 | $20.34 | $9.92 | $934.47 | 943.81 |
| 3952 | Continuous Home Care - Min 12 Hours | $986.41 | $22.19 | $9.92 | $1,018.52 | 1028.71 |
| 3953 | Continuous Home Care - Min 13 Hours | $1,068.61 | $24.04 | $9.92 | $1,102.57 | 1113.6 |
| 3954 | Continuous Home Care - Min 14 Hours | $1,150.81 | $25.89 | $9.92 | $1,186.62 | 1198.49 |
| 3955 | Continuous Home Care - Min 15 Hours | $1,233.01 | $27.74 | $9.92 | $1,270.67 | 1283.38 |
| 3956 | Continuous Home Care - Min 16 Hours | $1,315.21 | $29.59 | $9.92 | $1,354.72 | 1368.27 |
| 3957 | Continuous Home Care - Min 17 Hours | $1,397.41 | $31.44 | $9.92 | $1,438.77 | 1453.16 |
| 3958 | Continuous Home Care - Min 18 Hours | $1,479.62 | $33.29 | $9.92 | $1,522.83 | 1538.06 |
| 3959 | Continuous Home Care - Min 19 Hours | $1,561.82 | $35.14 | $9.92 | $1,606.88 | 1622.95 |
| 3960 | Continuous Home Care - Min 20 Hours | $1,644.02 | $36.99 | $9.92 | $1,690.93 | 1707.84 |
| 3961 | Continuous Home Care - Min 21 Hours | $1,726.22 | $38.84 | $9.92 | $1,774.98 | 1792.73 |
| 3962 | Continuous Home Care - Min 22 Hours | $1,808.42 | $40.69 | $9.92 | $1,859.03 | 1877.62 |
| 3963 | Continuous Home Care - Min 23 Hours | $1,890.62 | $42.54 | $9.92 | $1,943.08 | 1962.51 |
| 3964 | Continuous Home Care - Min 24 Hours | $1,972.82 | $44.39 | $9.92 | $2,027.13 | 2047.4 |
| 3965 | Hospice Inpatient Respite Care Coinsurance Rate - 5% of 3946 | $32.07 | $0.72 | $0.50 | $33.29 | 33.62 |
| 3966 | Drugs Coinsurance Rate | $1.00 | $0.00 | $0.00 | $1.00 | 1.01 |
| 3969 | Routine Home Care w/AIDS | $434.33 | $9.77 | $9.92 | $454.02 | 458.56 |
| 3970 | Routine Home Care w/Escort | $288.90 | $6.50 | $9.92 | $305.32 | 308.37 |
| 3971 | Continuous Home Care w/AIDS Min 8 Hours | $728.85 | $16.40 | $9.92 | $755.17 | 762.72 |
| 3972 | Continuous Home Care w/AIDS Min 9 Hours | $819.96 | $18.45 | $9.92 | $848.33 | 856.81 |
| 3973 | Continuous Home Care w/AIDS Min 10 Hours | $911.06 | $20.50 | $9.92 | $941.48 | 950.89 |
| 3974 | Continuous Home Care w/AIDS Min 11 Hours | $1,002.17 | $22.55 | $9.92 | $1,034.64 | 1044.99 |
| 3975 | Continuous Home Care w/AIDS Min 12 Hours | $1,093.28 | $24.60 | $9.92 | $1,127.80 | 1139.08 |
| 3976 | Continuous Home Care w/AIDS Min 13 Hours | $1,184.38 | $26.65 | $9.92 | $1,220.95 | 1233.16 |
| 3977 | Continuous Home Care w/AIDS Min 14 Hours | $1,275.49 | $28.70 | $9.92 | $1,314.11 | 1327.25 |
| 3978 | Continuous Home Care w/AIDS Min 15 Hours | $1,366.59 | $30.75 | $9.92 | $1,407.26 | 1421.33 |
| 3979 | Continuous Home Care w/AIDS Min 16 Hours | $1,457.70 | $32.80 | $9.92 | $1,500.42 | 1515.42 |
| 3980 | Continuous Home Care w/AIDS Min 17 Hours | $1,548.81 | $34.85 | $9.92 | $1,593.58 | 1609.52 |
| 3981 | Continuous Home Care w/AIDS Min 18 Hours | $1,639.91 | $36.90 | $9.92 | $1,686.73 | 1703.6 |
| 3982 | Continuous Home Care w/AIDS Min 19 Hours | $1,731.02 | $38.95 | $9.92 | $1,779.89 | 1797.69 |
| 3983 | Continuous Home Care w/AIDS Min 20 Hours | $1,822.13 | $41.00 | $9.92 | $1,873.05 | 1891.78 |
| 3984 | Continuous Home Care w/AIDS Min 21 Hours | $1,913.23 | $43.05 | $9.92 | $1,966.20 | 1985.86 |
| 3985 | Continuous Home Care w/AIDS Min 22 Hours | $2,004.34 | $45.10 | $9.92 | $2,059.36 | 2079.95 |
| 3986 | Continuous Home Care w/AIDS Min 23 Hours | $2,095.44 | $47.15 | $9.92 | $2,152.51 | 2174.04 |
| 3987 | Continuous Home Care w/AIDS Min 24 Hours | $2,186.55 | $49.20 | $9.92 | $2,245.67 | 2268.13 |
| 3988 | General Inpatient w/ AIDS | $1,533.79 | $34.51 | $9.92 | $1,578.22 | 1594 |
| 3989 | Routine Home Care w/ AIDS Escort | $456.02 | $10.26 | $9.92 | $476.20 | 480.96 |
| 3991 | Service Intensity Add-on | $82.20 | $1.85 | $0.00 | $84.05 | 84.89 |
* 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 | $276.15 | $6.21 | $9.92 | $292.28 | 295.2 |
| 3946 | Inpatient Respite | $661.41 | $14.88 | $9.92 | $686.21 | 693.07 |
| 3947 | General Inpatient Care | $1,424.70 | $32.06 | $9.92 | $1,466.68 | 1481.35 |
| 3948 | Continuous Home Care - Min 8 Hours | $682.21 | $15.35 | $9.92 | $707.48 | 714.55 |
| 3949 | Continuous Home Care - Min 9 Hours | $767.49 | $17.27 | $9.92 | $794.68 | 802.63 |
| 3950 | Continuous Home Care - Min 10 Hours | $852.76 | $19.19 | $9.92 | $881.87 | 890.69 |
| 3951 | Continuous Home Care - Min 11 Hours | $938.04 | $21.11 | $9.92 | $969.07 | 978.76 |
| 3952 | Continuous Home Care - Min 12 Hours | $1,023.32 | $23.02 | $9.92 | $1,056.26 | 1066.82 |
| 3953 | Continuous Home Care - Min 13 Hours | $1,108.59 | $24.94 | $9.92 | $1,143.45 | 1154.88 |
| 3954 | Continuous Home Care - Min 14 Hours | $1,193.87 | $26.86 | $9.92 | $1,230.65 | 1242.96 |
| 3955 | Continuous Home Care - Min 15 Hours | $1,279.14 | $28.78 | $9.92 | $1,317.84 | 1331.02 |
| 3956 | Continuous Home Care - Min 16 Hours | $1,364.42 | $30.70 | $9.92 | $1,405.04 | 1419.09 |
| 3957 | Continuous Home Care - Min 17 Hours | $1,449.70 | $32.62 | $9.92 | $1,492.24 | 1507.16 |
| 3958 | Continuous Home Care - Min 18 Hours | $1,534.97 | $34.54 | $9.92 | $1,579.43 | 1595.22 |
| 3959 | Continuous Home Care - Min 19 Hours | $1,620.25 | $36.46 | $9.92 | $1,666.63 | 1683.3 |
| 3960 | Continuous Home Care - Min 20 Hours | $1,705.53 | $38.37 | $9.92 | $1,753.82 | 1771.36 |
| 3961 | Continuous Home Care - Min 21 Hours | $1,790.80 | $40.29 | $9.92 | $1,841.01 | 1859.42 |
| 3962 | Continuous Home Care - Min 22 Hours | $1,876.08 | $42.21 | $9.92 | $1,928.21 | 1947.49 |
| 3963 | Continuous Home Care - Min 23 Hours | $1,961.35 | $44.13 | $9.92 | $2,015.40 | 2035.55 |
| 3964 | Continuous Home Care - Min 24 Hours | $2,046.63 | $46.05 | $9.92 | $2,102.60 | 2123.63 |
| 3965 | Hospice Inpatient Respite Care Coinsurance Rate - 5% of 3946 | $33.07 | $0.74 | $0.50 | $34.31 | 34.65 |
| 3966 | Drugs Coinsurance Rate | $1.00 | $0.00 | $0.00 | $1.00 | 1.01 |
| 3969 | Routine Home Care w/AIDS | $448.86 | $10.10 | $9.92 | $468.88 | 473.57 |
| 3970 | Routine Home Care w/Escort | $297.84 | $6.70 | $9.92 | $314.46 | 317.6 |
| 3971 | Continuous Home Care w/AIDS Min 8 Hours | $761.19 | $17.13 | $9.92 | $788.24 | 796.12 |
| 3972 | Continuous Home Care w/AIDS Min 9 Hours | $856.34 | $19.27 | $9.92 | $885.53 | 894.39 |
| 3973 | Continuous Home Care w/AIDS Min 10 Hours | $951.49 | $21.41 | $9.92 | $982.82 | 992.65 |
| 3974 | Continuous Home Care w/AIDS Min 11 Hours | $1,046.64 | $23.55 | $9.92 | $1,080.11 | 1090.91 |
| 3975 | Continuous Home Care w/AIDS Min 12 Hours | $1,141.79 | $25.69 | $9.92 | $1,177.40 | 1189.17 |
| 3976 | Continuous Home Care w/AIDS Min 13 Hours | $1,236.93 | $27.83 | $9.92 | $1,274.68 | 1287.43 |
| 3977 | Continuous Home Care w/AIDS Min 14 Hours | $1,332.08 | $29.97 | $9.92 | $1,371.97 | 1385.69 |
| 3978 | Continuous Home Care w/AIDS Min 15 Hours | $1,427.23 | $32.11 | $9.92 | $1,469.26 | 1483.95 |
| 3979 | Continuous Home Care w/AIDS Min 16 Hours | $1,522.38 | $34.25 | $9.92 | $1,566.55 | 1582.22 |
| 3980 | Continuous Home Care w/AIDS Min 17 Hours | $1,617.53 | $36.39 | $9.92 | $1,663.84 | 1680.48 |
| 3981 | Continuous Home Care w/AIDS Min 18 Hours | $1,712.68 | $38.54 | $9.92 | $1,761.14 | 1778.75 |
| 3982 | Continuous Home Care w/AIDS Min 19 Hours | $1,807.83 | $40.68 | $9.92 | $1,858.43 | 1877.01 |
| 3983 | Continuous Home Care w/AIDS Min 20 Hours | $1,902.98 | $42.82 | $9.92 | $1,955.72 | 1975.28 |
| 3984 | Continuous Home Care w/AIDS Min 21 Hours | $1,998.12 | $44.96 | $9.92 | $2,053.00 | 2073.53 |
| 3985 | Continuous Home Care w/AIDS Min 22 Hours | $2,093.27 | $47.10 | $9.92 | $2,150.29 | 2171.79 |
| 3986 | Continuous Home Care w/AIDS Min 23 Hours | $2,188.42 | $49.24 | $9.92 | $2,247.58 | 2270.06 |
| 3987 | Continuous Home Care w/AIDS Min 24 Hours | $2,283.57 | $51.38 | $9.92 | $2,344.87 | 2368.32 |
| 3988 | General Inpatient w/ AIDS | $1,583.41 | $35.63 | $9.92 | $1,628.96 | 1645.25 |
| 3989 | Routine Home Care w/ AIDS Escort | $470.55 | $10.59 | $9.92 | $491.06 | 495.97 |
| 3991 | Service Intensity Add-on | $85.28 | $1.92 | $0.00 | $87.20 | 88.07 |
* 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 | $240.98 | $5.42 | $9.92 | $256.32 | 258.88 |
| 3946 | Inpatient Respite | $582.60 | $13.11 | $9.92 | $605.63 | 611.69 |
| 3947 | General Inpatient Care | $1,249.08 | $28.10 | $9.92 | $1,287.10 | 1299.97 |
| 3948 | Continuous Home Care - Min 8 Hours | $585.44 | $13.17 | $9.92 | $608.53 | 614.62 |
| 3949 | Continuous Home Care - Min 9 Hours | $658.62 | $14.82 | $9.92 | $683.36 | 690.19 |
| 3950 | Continuous Home Care - Min 10 Hours | $731.80 | $16.47 | $9.92 | $758.19 | 765.77 |
| 3951 | Continuous Home Care - Min 11 Hours | $804.98 | $18.11 | $9.92 | $833.01 | 841.34 |
| 3952 | Continuous Home Care - Min 12 Hours | $878.16 | $19.76 | $9.92 | $907.84 | 916.92 |
| 3953 | Continuous Home Care - Min 13 Hours | $951.33 | $21.40 | $9.92 | $982.65 | 992.48 |
| 3954 | Continuous Home Care - Min 14 Hours | $1,024.51 | $23.05 | $9.92 | $1,057.48 | 1068.05 |
| 3955 | Continuous Home Care - Min 15 Hours | $1,097.69 | $24.70 | $9.92 | $1,132.31 | 1143.63 |
| 3956 | Continuous Home Care - Min 16 Hours | $1,170.87 | $26.34 | $9.92 | $1,207.13 | 1219.2 |
| 3957 | Continuous Home Care - Min 17 Hours | $1,244.05 | $27.99 | $9.92 | $1,281.96 | 1294.78 |
| 3958 | Continuous Home Care - Min 18 Hours | $1,317.23 | $29.64 | $9.92 | $1,356.79 | 1370.36 |
| 3959 | Continuous Home Care - Min 19 Hours | $1,390.41 | $31.28 | $9.92 | $1,431.61 | 1445.93 |
| 3960 | Continuous Home Care - Min 20 Hours | $1,463.59 | $32.93 | $9.92 | $1,506.44 | 1521.5 |
| 3961 | Continuous Home Care - Min 21 Hours | $1,536.77 | $34.58 | $9.92 | $1,581.27 | 1597.08 |
| 3962 | Continuous Home Care - Min 22 Hours | $1,609.95 | $36.22 | $9.92 | $1,656.09 | 1672.65 |
| 3963 | Continuous Home Care - Min 23 Hours | $1,683.13 | $37.87 | $9.92 | $1,730.92 | 1748.23 |
| 3964 | Continuous Home Care - Min 24 Hours | $1,756.31 | $39.52 | $9.92 | $1,805.75 | 1823.81 |
| 3965 | Hospice Inpatient Respite Care Coinsurance Rate - 5% of 3946 | $29.13 | $0.66 | $0.50 | $30.29 | 30.59 |
| 3966 | Drugs Coinsurance Rate | $1.00 | $0.00 | $0.00 | $1.00 | 1.01 |
| 3969 | Routine Home Care w/AIDS | $391.71 | $8.81 | $9.92 | $410.44 | 414.54 |
| 3970 | Routine Home Care w/Escort | $262.67 | $5.91 | $9.92 | $278.50 | 281.29 |
| 3971 | Continuous Home Care w/AIDS Min 8 Hours | $633.98 | $14.26 | $9.92 | $658.16 | 664.74 |
| 3972 | Continuous Home Care w/AIDS Min 9 Hours | $713.23 | $16.05 | $9.92 | $739.20 | 746.59 |
| 3973 | Continuous Home Care w/AIDS Min 10 Hours | $792.48 | $17.83 | $9.92 | $820.23 | 828.43 |
| 3974 | Continuous Home Care w/AIDS Min 11 Hours | $871.72 | $19.61 | $9.92 | $901.25 | 910.26 |
| 3975 | Continuous Home Care w/AIDS Min 12 Hours | $950.97 | $21.40 | $9.92 | $982.29 | 992.11 |
| 3976 | Continuous Home Care w/AIDS Min 13 Hours | $1,030.22 | $23.18 | $9.92 | $1,063.32 | 1073.95 |
| 3977 | Continuous Home Care w/AIDS Min 14 Hours | $1,109.47 | $24.96 | $9.92 | $1,144.35 | 1155.79 |
| 3978 | Continuous Home Care w/AIDS Min 15 Hours | $1,188.71 | $26.75 | $9.92 | $1,225.38 | 1237.63 |
| 3979 | Continuous Home Care w/AIDS Min 16 Hours | $1,267.96 | $28.53 | $9.92 | $1,306.41 | 1319.47 |
| 3980 | Continuous Home Care w/AIDS Min 17 Hours | $1,347.21 | $30.31 | $9.92 | $1,387.44 | 1401.31 |
| 3981 | Continuous Home Care w/AIDS Min 18 Hours | $1,426.46 | $32.10 | $9.92 | $1,468.48 | 1483.16 |
| 3982 | Continuous Home Care w/AIDS Min 19 Hours | $1,505.70 | $33.88 | $9.92 | $1,549.50 | 1565 |
| 3983 | Continuous Home Care w/AIDS Min 20 Hours | $1,584.95 | $35.66 | $9.92 | $1,630.53 | 1646.84 |
| 3984 | Continuous Home Care w/AIDS Min 21 Hours | $1,664.20 | $37.44 | $9.92 | $1,711.56 | 1728.68 |
| 3985 | Continuous Home Care w/AIDS Min 22 Hours | $1,743.45 | $39.23 | $9.92 | $1,792.60 | 1810.53 |
| 3986 | Continuous Home Care w/AIDS Min 23 Hours | $1,822.69 | $41.01 | $9.92 | $1,873.62 | 1892.36 |
| 3987 | Continuous Home Care w/AIDS Min 24 Hours | $1,901.94 | $42.79 | $9.92 | $1,954.65 | 1974.2 |
| 3988 | General Inpatient w/ AIDS | $1,388.23 | $31.24 | $9.92 | $1,429.39 | 1443.68 |
| 3989 | Routine Home Care w/ AIDS Escort | $413.40 | $9.30 | $9.92 | $432.62 | 436.95 |
| 3991 | Service Intensity Add-on | $73.18 | $1.65 | $0.00 | $74.83 | 75.58 |
* 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 | $276.15 | $6.21 | $9.92 | $292.28 | 295.2 |
| 3946 | Inpatient Respite | $661.41 | $14.88 | $9.92 | $686.21 | 693.07 |
| 3947 | General Inpatient Care | $1,424.70 | $32.06 | $9.92 | $1,466.68 | 1481.35 |
| 3948 | Continuous Home Care - Min 8 Hours | $682.21 | $15.35 | $9.92 | $707.48 | 714.55 |
| 3949 | Continuous Home Care - Min 9 Hours | $767.49 | $17.27 | $9.92 | $794.68 | 802.63 |
| 3950 | Continuous Home Care - Min 10 Hours | $852.76 | $19.19 | $9.92 | $881.87 | 890.69 |
| 3951 | Continuous Home Care - Min 11 Hours | $938.04 | $21.11 | $9.92 | $969.07 | 978.76 |
| 3952 | Continuous Home Care - Min 12 Hours | $1,023.32 | $23.02 | $9.92 | $1,056.26 | 1066.82 |
| 3953 | Continuous Home Care - Min 13 Hours | $1,108.59 | $24.94 | $9.92 | $1,143.45 | 1154.88 |
| 3954 | Continuous Home Care - Min 14 Hours | $1,193.87 | $26.86 | $9.92 | $1,230.65 | 1242.96 |
| 3955 | Continuous Home Care - Min 15 Hours | $1,279.14 | $28.78 | $9.92 | $1,317.84 | 1331.02 |
| 3956 | Continuous Home Care - Min 16 Hours | $1,364.42 | $30.70 | $9.92 | $1,405.04 | 1419.09 |
| 3957 | Continuous Home Care - Min 17 Hours | $1,449.70 | $32.62 | $9.92 | $1,492.24 | 1507.16 |
| 3958 | Continuous Home Care - Min 18 Hours | $1,534.97 | $34.54 | $9.92 | $1,579.43 | 1595.22 |
| 3959 | Continuous Home Care - Min 19 Hours | $1,620.25 | $36.46 | $9.92 | $1,666.63 | 1683.3 |
| 3960 | Continuous Home Care - Min 20 Hours | $1,705.53 | $38.37 | $9.92 | $1,753.82 | 1771.36 |
| 3961 | Continuous Home Care - Min 21 Hours | $1,790.80 | $40.29 | $9.92 | $1,841.01 | 1859.42 |
| 3962 | Continuous Home Care - Min 22 Hours | $1,876.08 | $42.21 | $9.92 | $1,928.21 | 1947.49 |
| 3963 | Continuous Home Care - Min 23 Hours | $1,961.35 | $44.13 | $9.92 | $2,015.40 | 2035.55 |
| 3964 | Continuous Home Care - Min 24 Hours | $2,046.63 | $46.05 | $9.92 | $2,102.60 | 2123.63 |
| 3965 | Hospice Inpatient Respite Care Coinsurance Rate - 5% of 3946 | $33.07 | $0.74 | $0.50 | $34.31 | 34.65 |
| 3966 | Drugs Coinsurance Rate | $1.00 | $0.00 | $0.00 | $1.00 | 1.01 |
| 3969 | Routine Home Care w/AIDS | $448.86 | $10.10 | $9.92 | $468.88 | 473.57 |
| 3970 | Routine Home Care w/Escort | $297.84 | $6.70 | $9.92 | $314.46 | 317.6 |
| 3971 | Continuous Home Care w/AIDS Min 8 Hours | $761.19 | $17.13 | $9.92 | $788.24 | 796.12 |
| 3972 | Continuous Home Care w/AIDS Min 9 Hours | $856.34 | $19.27 | $9.92 | $885.53 | 894.39 |
| 3973 | Continuous Home Care w/AIDS Min 10 Hours | $951.49 | $21.41 | $9.92 | $982.82 | 992.65 |
| 3974 | Continuous Home Care w/AIDS Min 11 Hours | $1,046.64 | $23.55 | $9.92 | $1,080.11 | 1090.91 |
| 3975 | Continuous Home Care w/AIDS Min 12 Hours | $1,141.79 | $25.69 | $9.92 | $1,177.40 | 1189.17 |
| 3976 | Continuous Home Care w/AIDS Min 13 Hours | $1,236.93 | $27.83 | $9.92 | $1,274.68 | 1287.43 |
| 3977 | Continuous Home Care w/AIDS Min 14 Hours | $1,332.08 | $29.97 | $9.92 | $1,371.97 | 1385.69 |
| 3978 | Continuous Home Care w/AIDS Min 15 Hours | $1,427.23 | $32.11 | $9.92 | $1,469.26 | 1483.95 |
| 3979 | Continuous Home Care w/AIDS Min 16 Hours | $1,522.38 | $34.25 | $9.92 | $1,566.55 | 1582.22 |
| 3980 | Continuous Home Care w/AIDS Min 17 Hours | $1,617.53 | $36.39 | $9.92 | $1,663.84 | 1680.48 |
| 3981 | Continuous Home Care w/AIDS Min 18 Hours | $1,712.68 | $38.54 | $9.92 | $1,761.14 | 1778.75 |
| 3982 | Continuous Home Care w/AIDS Min 19 Hours | $1,807.83 | $40.68 | $9.92 | $1,858.43 | 1877.01 |
| 3983 | Continuous Home Care w/AIDS Min 20 Hours | $1,902.98 | $42.82 | $9.92 | $1,955.72 | 1975.28 |
| 3984 | Continuous Home Care w/AIDS Min 21 Hours | $1,998.12 | $44.96 | $9.92 | $2,053.00 | 2073.53 |
| 3985 | Continuous Home Care w/AIDS Min 22 Hours | $2,093.27 | $47.10 | $9.92 | $2,150.29 | 2171.79 |
| 3986 | Continuous Home Care w/AIDS Min 23 Hours | $2,188.42 | $49.24 | $9.92 | $2,247.58 | 2270.06 |
| 3987 | Continuous Home Care w/AIDS Min 24 Hours | $2,283.57 | $51.38 | $9.92 | $2,344.87 | 2368.32 |
| 3988 | General Inpatient w/ AIDS | $1,583.41 | $35.63 | $9.92 | $1,628.96 | 1645.25 |
| 3989 | Routine Home Care w/ AIDS Escort | $470.55 | $10.59 | $9.92 | $491.06 | 495.97 |
| 3991 | Service Intensity Add-on | $85.28 | $1.92 | $0.00 | $87.20 | 88.07 |
* 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 | $257.37 | $5.79 | $9.92 | $273.08 | 275.81 |
| 3946 | Inpatient Respite | $619.32 | $13.93 | $9.92 | $643.17 | 649.6 |
| 3947 | General Inpatient Care | $1,330.91 | $29.95 | $9.92 | $1,370.78 | 1384.49 |
| 3948 | Continuous Home Care - Min 8 Hours | $630.53 | $14.19 | $9.92 | $654.64 | 661.19 |
| 3949 | Continuous Home Care - Min 9 Hours | $709.34 | $15.96 | $9.92 | $735.22 | 742.57 |
| 3950 | Continuous Home Care - Min 10 Hours | $788.16 | $17.73 | $9.92 | $815.81 | 823.97 |
| 3951 | Continuous Home Care - Min 11 Hours | $866.97 | $19.51 | $9.92 | $896.40 | 905.36 |
| 3952 | Continuous Home Care - Min 12 Hours | $945.79 | $21.28 | $9.92 | $976.99 | 986.76 |
| 3953 | Continuous Home Care - Min 13 Hours | $1,024.61 | $23.05 | $9.92 | $1,057.58 | 1068.16 |
| 3954 | Continuous Home Care - Min 14 Hours | $1,103.42 | $24.83 | $9.92 | $1,138.17 | 1149.55 |
| 3955 | Continuous Home Care - Min 15 Hours | $1,182.24 | $26.60 | $9.92 | $1,218.76 | 1230.95 |
| 3956 | Continuous Home Care - Min 16 Hours | $1,261.05 | $28.37 | $9.92 | $1,299.34 | 1312.33 |
| 3957 | Continuous Home Care - Min 17 Hours | $1,339.87 | $30.15 | $9.92 | $1,379.94 | 1393.74 |
| 3958 | Continuous Home Care - Min 18 Hours | $1,418.69 | $31.92 | $9.92 | $1,460.53 | 1475.14 |
| 3959 | Continuous Home Care - Min 19 Hours | $1,497.50 | $33.69 | $9.92 | $1,541.11 | 1556.52 |
| 3960 | Continuous Home Care - Min 20 Hours | $1,576.32 | $35.47 | $9.92 | $1,621.71 | 1637.93 |
| 3961 | Continuous Home Care - Min 21 Hours | $1,655.13 | $37.24 | $9.92 | $1,702.29 | 1719.31 |
| 3962 | Continuous Home Care - Min 22 Hours | $1,733.95 | $39.01 | $9.92 | $1,782.88 | 1800.71 |
| 3963 | Continuous Home Care - Min 23 Hours | $1,812.76 | $40.79 | $9.92 | $1,863.47 | 1882.1 |
| 3964 | Continuous Home Care - Min 24 Hours | $1,891.58 | $42.56 | $9.92 | $1,944.06 | 1963.5 |
| 3965 | Hospice Inpatient Respite Care Coinsurance Rate - 5% of 3946 | $30.97 | $0.70 | $0.50 | $32.17 | 32.49 |
| 3966 | Drugs Coinsurance Rate | $1.00 | $0.00 | $0.00 | $1.00 | 1.01 |
| 3969 | Routine Home Care w/AIDS | $418.34 | $9.41 | $9.92 | $437.67 | 442.05 |
| 3970 | Routine Home Care w/Escort | $279.06 | $6.28 | $9.92 | $295.26 | 298.21 |
| 3971 | Continuous Home Care w/AIDS Min 8 Hours | $693.25 | $15.60 | $9.92 | $718.77 | 725.96 |
| 3972 | Continuous Home Care w/AIDS Min 9 Hours | $779.91 | $17.55 | $9.92 | $807.38 | 815.45 |
| 3973 | Continuous Home Care w/AIDS Min 10 Hours | $866.57 | $19.50 | $9.92 | $895.99 | 904.95 |
| 3974 | Continuous Home Care w/AIDS Min 11 Hours | $953.22 | $21.45 | $9.92 | $984.59 | 994.44 |
| 3975 | Continuous Home Care w/AIDS Min 12 Hours | $1,039.88 | $23.40 | $9.92 | $1,073.20 | 1083.93 |
| 3976 | Continuous Home Care w/AIDS Min 13 Hours | $1,126.54 | $25.35 | $9.92 | $1,161.81 | 1173.43 |
| 3977 | Continuous Home Care w/AIDS Min 14 Hours | $1,213.19 | $27.30 | $9.92 | $1,250.41 | 1262.91 |
| 3978 | Continuous Home Care w/AIDS Min 15 Hours | $1,299.85 | $29.25 | $9.92 | $1,339.02 | 1352.41 |
| 3979 | Continuous Home Care w/AIDS Min 16 Hours | $1,386.51 | $31.20 | $9.92 | $1,427.63 | 1441.91 |
| 3980 | Continuous Home Care w/AIDS Min 17 Hours | $1,473.16 | $33.15 | $9.92 | $1,516.23 | 1531.39 |
| 3981 | Continuous Home Care w/AIDS Min 18 Hours | $1,559.82 | $35.10 | $9.92 | $1,604.84 | 1620.89 |
| 3982 | Continuous Home Care w/AIDS Min 19 Hours | $1,646.48 | $37.05 | $9.92 | $1,693.45 | 1710.38 |
| 3983 | Continuous Home Care w/AIDS Min 20 Hours | $1,733.13 | $39.00 | $9.92 | $1,782.05 | 1799.87 |
| 3984 | Continuous Home Care w/AIDS Min 21 Hours | $1,819.79 | $40.95 | $9.92 | $1,870.66 | 1889.37 |
| 3985 | Continuous Home Care w/AIDS Min 22 Hours | $1,906.45 | $42.90 | $9.92 | $1,959.27 | 1978.86 |
| 3986 | Continuous Home Care w/AIDS Min 23 Hours | $1,993.10 | $44.84 | $9.92 | $2,047.86 | 2068.34 |
| 3987 | Continuous Home Care w/AIDS Min 24 Hours | $2,079.76 | $46.79 | $9.92 | $2,136.47 | 2157.83 |
| 3988 | General Inpatient w/ AIDS | $1,479.17 | $33.28 | $9.92 | $1,522.37 | 1537.59 |
| 3989 | Routine Home Care w/ AIDS Escort | $440.03 | $9.90 | $9.92 | $459.85 | 464.45 |
| 3991 | Service Intensity Add-on | $78.82 | $1.77 | $0.00 | $80.59 | 81.4 |
* 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 | $223.49 | $5.03 | $9.92 | $238.44 | 240.82 |
| 3946 | Inpatient Respite | $543.38 | $12.23 | $9.92 | $565.53 | 571.19 |
| 3947 | General Inpatient Care | $1,161.69 | $26.14 | $9.92 | $1,197.75 | 1209.73 |
| 3948 | Continuous Home Care - Min 8 Hours | $537.28 | $12.09 | $9.92 | $559.29 | 564.88 |
| 3949 | Continuous Home Care - Min 9 Hours | $604.44 | $13.60 | $9.92 | $627.96 | 634.24 |
| 3950 | Continuous Home Care - Min 10 Hours | $671.60 | $15.11 | $9.92 | $696.63 | 703.6 |
| 3951 | Continuous Home Care - Min 11 Hours | $738.76 | $16.62 | $9.92 | $765.30 | 772.95 |
| 3952 | Continuous Home Care - Min 12 Hours | $805.92 | $18.13 | $9.92 | $833.97 | 842.31 |
| 3953 | Continuous Home Care - Min 13 Hours | $873.08 | $19.64 | $9.92 | $902.64 | 911.67 |
| 3954 | Continuous Home Care - Min 14 Hours | $940.24 | $21.16 | $9.92 | $971.32 | 981.03 |
| 3955 | Continuous Home Care - Min 15 Hours | $1,007.40 | $22.67 | $9.92 | $1,039.99 | 1050.39 |
| 3956 | Continuous Home Care - Min 16 Hours | $1,074.56 | $24.18 | $9.92 | $1,108.66 | 1119.75 |
| 3957 | Continuous Home Care - Min 17 Hours | $1,141.72 | $25.69 | $9.92 | $1,177.33 | 1189.1 |
| 3958 | Continuous Home Care - Min 18 Hours | $1,208.88 | $27.20 | $9.92 | $1,246.00 | 1258.46 |
| 3959 | Continuous Home Care - Min 19 Hours | $1,276.04 | $28.71 | $9.92 | $1,314.67 | 1327.82 |
| 3960 | Continuous Home Care - Min 20 Hours | $1,343.20 | $30.22 | $9.92 | $1,383.34 | 1397.17 |
| 3961 | Continuous Home Care - Min 21 Hours | $1,410.36 | $31.73 | $9.92 | $1,452.01 | 1466.53 |
| 3962 | Continuous Home Care - Min 22 Hours | $1,477.52 | $33.24 | $9.92 | $1,520.68 | 1535.89 |
| 3963 | Continuous Home Care - Min 23 Hours | $1,544.68 | $34.76 | $9.92 | $1,589.36 | 1605.25 |
| 3964 | Continuous Home Care - Min 24 Hours | $1,611.84 | $36.27 | $9.92 | $1,658.03 | 1674.61 |
| 3965 | Hospice Inpatient Respite Care Coinsurance Rate - 5% of 3946 | $27.17 | $0.61 | $0.50 | $28.28 | 28.56 |
| 3966 | Drugs Coinsurance Rate | $1.00 | $0.00 | $0.00 | $1.00 | 1.01 |
| 3969 | Routine Home Care w/AIDS | $363.27 | $8.17 | $9.92 | $381.36 | 385.17 |
| 3970 | Routine Home Care w/Escort | $245.18 | $5.52 | $9.92 | $260.62 | 263.23 |
| 3971 | Continuous Home Care w/AIDS Min 8 Hours | $570.68 | $12.84 | $9.92 | $593.44 | 599.37 |
| 3972 | Continuous Home Care w/AIDS Min 9 Hours | $642.01 | $14.45 | $9.92 | $666.38 | 673.04 |
| 3973 | Continuous Home Care w/AIDS Min 10 Hours | $713.35 | $16.05 | $9.92 | $739.32 | 746.71 |
| 3974 | Continuous Home Care w/AIDS Min 11 Hours | $784.68 | $17.66 | $9.92 | $812.26 | 820.38 |
| 3975 | Continuous Home Care w/AIDS Min 12 Hours | $856.02 | $19.26 | $9.92 | $885.20 | 894.05 |
| 3976 | Continuous Home Care w/AIDS Min 13 Hours | $927.35 | $20.87 | $9.92 | $958.14 | 967.72 |
| 3977 | Continuous Home Care w/AIDS Min 14 Hours | $998.68 | $22.47 | $9.92 | $1,031.07 | 1041.38 |
| 3978 | Continuous Home Care w/AIDS Min 15 Hours | $1,070.02 | $24.08 | $9.92 | $1,104.02 | 1115.06 |
| 3979 | Continuous Home Care w/AIDS Min 16 Hours | $1,141.35 | $25.68 | $9.92 | $1,176.95 | 1188.72 |
| 3980 | Continuous Home Care w/AIDS Min 17 Hours | $1,212.69 | $27.29 | $9.92 | $1,249.90 | 1262.4 |
| 3981 | Continuous Home Care w/AIDS Min 18 Hours | $1,284.02 | $28.89 | $9.92 | $1,322.83 | 1336.06 |
| 3982 | Continuous Home Care w/AIDS Min 19 Hours | $1,355.36 | $30.50 | $9.92 | $1,395.78 | 1409.74 |
| 3983 | Continuous Home Care w/AIDS Min 20 Hours | $1,426.69 | $32.10 | $9.92 | $1,468.71 | 1483.4 |
| 3984 | Continuous Home Care w/AIDS Min 21 Hours | $1,498.03 | $33.71 | $9.92 | $1,541.66 | 1557.08 |
| 3985 | Continuous Home Care w/AIDS Min 22 Hours | $1,569.36 | $35.31 | $9.92 | $1,614.59 | 1630.74 |
| 3986 | Continuous Home Care w/AIDS Min 23 Hours | $1,640.70 | $36.92 | $9.92 | $1,687.54 | 1704.42 |
| 3987 | Continuous Home Care w/AIDS Min 24 Hours | $1,712.03 | $38.52 | $9.92 | $1,760.47 | 1778.07 |
| 3988 | General Inpatient w/ AIDS | $1,291.10 | $29.05 | $9.92 | $1,330.07 | 1343.37 |
| 3989 | Routine Home Care w/ AIDS Escort | $384.96 | $8.66 | $9.92 | $403.54 | 407.58 |
| 3991 | Service Intensity Add-on | $67.16 | $1.51 | $0.00 | $68.67 | 69.36 |
* 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 | $233.97 | $5.26 | $9.92 | $249.15 | 251.64 |
| 3946 | Inpatient Respite | $566.87 | $12.75 | $9.92 | $589.54 | 595.44 |
| 3947 | General Inpatient Care | $1,214.03 | $27.32 | $9.92 | $1,251.27 | 1263.78 |
| 3948 | Continuous Home Care - Min 8 Hours | $566.12 | $12.74 | $9.92 | $588.78 | 594.67 |
| 3949 | Continuous Home Care - Min 9 Hours | $636.89 | $14.33 | $9.92 | $661.14 | 667.75 |
| 3950 | Continuous Home Care - Min 10 Hours | $707.65 | $15.92 | $9.92 | $733.49 | 740.82 |
| 3951 | Continuous Home Care - Min 11 Hours | $778.42 | $17.51 | $9.92 | $805.85 | 813.91 |
| 3952 | Continuous Home Care - Min 12 Hours | $849.19 | $19.11 | $9.92 | $878.22 | 887 |
| 3953 | Continuous Home Care - Min 13 Hours | $919.95 | $20.70 | $9.92 | $950.57 | 960.08 |
| 3954 | Continuous Home Care - Min 14 Hours | $990.72 | $22.29 | $9.92 | $1,022.93 | 1033.16 |
| 3955 | Continuous Home Care - Min 15 Hours | $1,061.48 | $23.88 | $9.92 | $1,095.28 | 1106.23 |
| 3956 | Continuous Home Care - Min 16 Hours | $1,132.25 | $25.48 | $9.92 | $1,167.65 | 1179.33 |
| 3957 | Continuous Home Care - Min 17 Hours | $1,203.01 | $27.07 | $9.92 | $1,240.00 | 1252.4 |
| 3958 | Continuous Home Care - Min 18 Hours | $1,273.78 | $28.66 | $9.92 | $1,312.36 | 1325.48 |
| 3959 | Continuous Home Care - Min 19 Hours | $1,344.54 | $30.25 | $9.92 | $1,384.71 | 1398.56 |
| 3960 | Continuous Home Care - Min 20 Hours | $1,415.31 | $31.84 | $9.92 | $1,457.07 | 1471.64 |
| 3961 | Continuous Home Care - Min 21 Hours | $1,486.07 | $33.44 | $9.92 | $1,529.43 | 1544.72 |
| 3962 | Continuous Home Care - Min 22 Hours | $1,556.84 | $35.03 | $9.92 | $1,601.79 | 1617.81 |
| 3963 | Continuous Home Care - Min 23 Hours | $1,627.60 | $36.62 | $9.92 | $1,674.14 | 1690.88 |
| 3964 | Continuous Home Care - Min 24 Hours | $1,698.37 | $38.21 | $9.92 | $1,746.50 | 1763.97 |
| 3965 | Hospice Inpatient Respite Care Coinsurance Rate - 5% of 3946 | $28.34 | $0.64 | $0.50 | $29.48 | 29.77 |
| 3966 | Drugs Coinsurance Rate | $1.00 | $0.00 | $0.00 | $1.00 | 1.01 |
| 3969 | Routine Home Care w/AIDS | $380.30 | $8.56 | $9.92 | $398.78 | 402.77 |
| 3970 | Routine Home Care w/Escort | $255.66 | $5.75 | $9.92 | $271.33 | 274.04 |
| 3971 | Continuous Home Care w/AIDS Min 8 Hours | $608.59 | $13.69 | $9.92 | $632.20 | 638.52 |
| 3972 | Continuous Home Care w/AIDS Min 9 Hours | $684.67 | $15.41 | $9.92 | $710.00 | 717.1 |
| 3973 | Continuous Home Care w/AIDS Min 10 Hours | $760.74 | $17.12 | $9.92 | $787.78 | 795.66 |
| 3974 | Continuous Home Care w/AIDS Min 11 Hours | $836.82 | $18.83 | $9.92 | $865.57 | 874.23 |
| 3975 | Continuous Home Care w/AIDS Min 12 Hours | $912.89 | $20.54 | $9.92 | $943.35 | 952.78 |
| 3976 | Continuous Home Care w/AIDS Min 13 Hours | $988.96 | $22.25 | $9.92 | $1,021.13 | 1031.34 |
| 3977 | Continuous Home Care w/AIDS Min 14 Hours | $1,065.04 | $23.96 | $9.92 | $1,098.92 | 1109.91 |
| 3978 | Continuous Home Care w/AIDS Min 15 Hours | $1,141.11 | $25.67 | $9.92 | $1,176.70 | 1188.47 |
| 3979 | Continuous Home Care w/AIDS Min 16 Hours | $1,217.19 | $27.39 | $9.92 | $1,254.50 | 1267.05 |
| 3980 | Continuous Home Care w/AIDS Min 17 Hours | $1,293.26 | $29.10 | $9.92 | $1,332.28 | 1345.6 |
| 3981 | Continuous Home Care w/AIDS Min 18 Hours | $1,369.34 | $30.81 | $9.92 | $1,410.07 | 1424.17 |
| 3982 | Continuous Home Care w/AIDS Min 19 Hours | $1,445.41 | $32.52 | $9.92 | $1,487.85 | 1502.73 |
| 3983 | Continuous Home Care w/AIDS Min 20 Hours | $1,521.48 | $34.23 | $9.92 | $1,565.63 | 1581.29 |
| 3984 | Continuous Home Care w/AIDS Min 21 Hours | $1,597.56 | $35.95 | $9.92 | $1,643.43 | 1659.86 |
| 3985 | Continuous Home Care w/AIDS Min 22 Hours | $1,673.63 | $37.66 | $9.92 | $1,721.21 | 1738.42 |
| 3986 | Continuous Home Care w/AIDS Min 23 Hours | $1,749.71 | $39.37 | $9.92 | $1,799.00 | 1816.99 |
| 3987 | Continuous Home Care w/AIDS Min 24 Hours | $1,825.78 | $41.08 | $9.92 | $1,876.78 | 1895.55 |
| 3988 | General Inpatient w/ AIDS | $1,349.27 | $30.36 | $9.92 | $1,389.55 | 1403.45 |
| 3989 | Routine Home Care w/ AIDS Escort | $401.99 | $9.04 | $9.92 | $420.95 | 425.16 |
| 3991 | Service Intensity Add-on | $70.77 | $1.59 | $0.00 | $72.36 | 73.08 |
* 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 | $217.60 | $4.90 | $9.92 | $232.42 | 234.74 |
| 3946 | Inpatient Respite | $530.18 | $11.93 | $9.92 | $552.03 | 557.55 |
| 3947 | General Inpatient Care | $1,132.28 | $25.48 | $9.92 | $1,167.68 | 1179.36 |
| 3948 | Continuous Home Care - Min 8 Hours | $521.07 | $11.72 | $9.92 | $542.71 | 548.14 |
| 3949 | Continuous Home Care - Min 9 Hours | $586.21 | $13.19 | $9.92 | $609.32 | 615.41 |
| 3950 | Continuous Home Care - Min 10 Hours | $651.34 | $14.66 | $9.92 | $675.92 | 682.68 |
| 3951 | Continuous Home Care - Min 11 Hours | $716.48 | $16.12 | $9.92 | $742.52 | 749.95 |
| 3952 | Continuous Home Care - Min 12 Hours | $781.61 | $17.59 | $9.92 | $809.12 | 817.21 |
| 3953 | Continuous Home Care - Min 13 Hours | $846.74 | $19.05 | $9.92 | $875.71 | 884.47 |
| 3954 | Continuous Home Care - Min 14 Hours | $911.88 | $20.52 | $9.92 | $942.32 | 951.74 |
| 3955 | Continuous Home Care - Min 15 Hours | $977.01 | $21.98 | $9.92 | $1,008.91 | 1019 |
| 3956 | Continuous Home Care - Min 16 Hours | $1,042.15 | $23.45 | $9.92 | $1,075.52 | 1086.28 |
| 3957 | Continuous Home Care - Min 17 Hours | $1,107.28 | $24.91 | $9.92 | $1,142.11 | 1153.53 |
| 3958 | Continuous Home Care - Min 18 Hours | $1,172.42 | $26.38 | $9.92 | $1,208.72 | 1220.81 |
| 3959 | Continuous Home Care - Min 19 Hours | $1,237.55 | $27.84 | $9.92 | $1,275.31 | 1288.06 |
| 3960 | Continuous Home Care - Min 20 Hours | $1,302.68 | $29.31 | $9.92 | $1,341.91 | 1355.33 |
| 3961 | Continuous Home Care - Min 21 Hours | $1,367.82 | $30.78 | $9.92 | $1,408.52 | 1422.61 |
| 3962 | Continuous Home Care - Min 22 Hours | $1,432.95 | $32.24 | $9.92 | $1,475.11 | 1489.86 |
| 3963 | Continuous Home Care - Min 23 Hours | $1,498.09 | $33.71 | $9.92 | $1,541.72 | 1557.14 |
| 3964 | Continuous Home Care - Min 24 Hours | $1,563.22 | $35.17 | $9.92 | $1,608.31 | 1624.39 |
| 3965 | Hospice Inpatient Respite Care Coinsurance Rate - 5% of 3946 | $26.51 | $0.60 | $0.50 | $27.61 | 27.89 |
| 3966 | Drugs Coinsurance Rate | $1.00 | $0.00 | $0.00 | $1.00 | 1.01 |
| 3969 | Routine Home Care w/AIDS | $353.70 | $7.96 | $9.92 | $371.58 | 375.3 |
| 3970 | Routine Home Care w/Escort | $239.29 | $5.38 | $9.92 | $254.59 | 257.14 |
| 3971 | Continuous Home Care w/AIDS Min 8 Hours | $549.37 | $12.36 | $9.92 | $571.65 | 577.37 |
| 3972 | Continuous Home Care w/AIDS Min 9 Hours | $618.05 | $13.91 | $9.92 | $641.88 | 648.3 |
| 3973 | Continuous Home Care w/AIDS Min 10 Hours | $686.72 | $15.45 | $9.92 | $712.09 | 719.21 |
| 3974 | Continuous Home Care w/AIDS Min 11 Hours | $755.39 | $17.00 | $9.92 | $782.31 | 790.13 |
| 3975 | Continuous Home Care w/AIDS Min 12 Hours | $824.06 | $18.54 | $9.92 | $852.52 | 861.05 |
| 3976 | Continuous Home Care w/AIDS Min 13 Hours | $892.73 | $20.09 | $9.92 | $922.74 | 931.97 |
| 3977 | Continuous Home Care w/AIDS Min 14 Hours | $961.40 | $21.63 | $9.92 | $992.95 | 1002.88 |
| 3978 | Continuous Home Care w/AIDS Min 15 Hours | $1,030.08 | $23.18 | $9.92 | $1,063.18 | 1073.81 |
| 3979 | Continuous Home Care w/AIDS Min 16 Hours | $1,098.75 | $24.72 | $9.92 | $1,133.39 | 1144.72 |
| 3980 | Continuous Home Care w/AIDS Min 17 Hours | $1,167.42 | $26.27 | $9.92 | $1,203.61 | 1215.65 |
| 3981 | Continuous Home Care w/AIDS Min 18 Hours | $1,236.09 | $27.81 | $9.92 | $1,273.82 | 1286.56 |
| 3982 | Continuous Home Care w/AIDS Min 19 Hours | $1,304.76 | $29.36 | $9.92 | $1,344.04 | 1357.48 |
| 3983 | Continuous Home Care w/AIDS Min 20 Hours | $1,373.43 | $30.90 | $9.92 | $1,414.25 | 1428.39 |
| 3984 | Continuous Home Care w/AIDS Min 21 Hours | $1,442.11 | $32.45 | $9.92 | $1,484.48 | 1499.32 |
| 3985 | Continuous Home Care w/AIDS Min 22 Hours | $1,510.78 | $33.99 | $9.92 | $1,554.69 | 1570.24 |
| 3986 | Continuous Home Care w/AIDS Min 23 Hours | $1,579.45 | $35.54 | $9.92 | $1,624.91 | 1641.16 |
| 3987 | Continuous Home Care w/AIDS Min 24 Hours | $1,648.12 | $37.08 | $9.92 | $1,695.12 | 1712.07 |
| 3988 | General Inpatient w/ AIDS | $1,258.42 | $28.31 | $9.92 | $1,296.65 | 1309.62 |
| 3989 | Routine Home Care w/ AIDS Escort | $375.39 | $8.45 | $9.92 | $393.76 | 397.7 |
| 3991 | Service Intensity Add-on | $65.14 | $1.47 | $0.00 | $66.61 | 67.28 |
* 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 | $214.23 | $4.82 | $9.92 | $228.97 | 231.26 |
| 3946 | Inpatient Respite | $522.63 | $11.76 | $9.92 | $544.31 | 549.75 |
| 3947 | General Inpatient Care | $1,115.44 | $25.10 | $9.92 | $1,150.46 | 1161.96 |
| 3948 | Continuous Home Care - Min 8 Hours | $511.79 | $11.52 | $9.92 | $533.23 | 538.56 |
| 3949 | Continuous Home Care - Min 9 Hours | $575.77 | $12.95 | $9.92 | $598.64 | 604.63 |
| 3950 | Continuous Home Care - Min 10 Hours | $639.74 | $14.39 | $9.92 | $664.05 | 670.69 |
| 3951 | Continuous Home Care - Min 11 Hours | $703.72 | $15.83 | $9.92 | $729.47 | 736.76 |
| 3952 | Continuous Home Care - Min 12 Hours | $767.69 | $17.27 | $9.92 | $794.88 | 802.83 |
| 3953 | Continuous Home Care - Min 13 Hours | $831.66 | $18.71 | $9.92 | $860.29 | 868.89 |
| 3954 | Continuous Home Care - Min 14 Hours | $895.64 | $20.15 | $9.92 | $925.71 | 934.97 |
| 3955 | Continuous Home Care - Min 15 Hours | $959.61 | $21.59 | $9.92 | $991.12 | 1001.03 |
| 3956 | Continuous Home Care - Min 16 Hours | $1,023.59 | $23.03 | $9.92 | $1,056.54 | 1067.11 |
| 3957 | Continuous Home Care - Min 17 Hours | $1,087.56 | $24.47 | $9.92 | $1,121.95 | 1133.17 |
| 3958 | Continuous Home Care - Min 18 Hours | $1,151.54 | $25.91 | $9.92 | $1,187.37 | 1199.24 |
| 3959 | Continuous Home Care - Min 19 Hours | $1,215.51 | $27.35 | $9.92 | $1,252.78 | 1265.31 |
| 3960 | Continuous Home Care - Min 20 Hours | $1,279.48 | $28.79 | $9.92 | $1,318.19 | 1331.37 |
| 3961 | Continuous Home Care - Min 21 Hours | $1,343.46 | $30.23 | $9.92 | $1,383.61 | 1397.45 |
| 3962 | Continuous Home Care - Min 22 Hours | $1,407.43 | $31.67 | $9.92 | $1,449.02 | 1463.51 |
| 3963 | Continuous Home Care - Min 23 Hours | $1,471.41 | $33.11 | $9.92 | $1,514.44 | 1529.58 |
| 3964 | Continuous Home Care - Min 24 Hours | $1,535.38 | $34.55 | $9.92 | $1,579.85 | 1595.65 |
| 3965 | Hospice Inpatient Respite Care Coinsurance Rate - 5% of 3946 | $26.13 | $0.59 | $0.50 | $27.22 | 27.49 |
| 3966 | Drugs Coinsurance Rate | $1.00 | $0.00 | $0.00 | $1.00 | 1.01 |
| 3969 | Routine Home Care w/AIDS | $348.22 | $7.83 | $9.92 | $365.97 | 369.63 |
| 3970 | Routine Home Care w/Escort | $235.92 | $5.31 | $9.92 | $251.15 | 253.66 |
| 3971 | Continuous Home Care w/AIDS Min 8 Hours | $537.18 | $12.09 | $9.92 | $559.19 | 564.78 |
| 3972 | Continuous Home Care w/AIDS Min 9 Hours | $604.32 | $13.60 | $9.92 | $627.84 | 634.12 |
| 3973 | Continuous Home Care w/AIDS Min 10 Hours | $671.47 | $15.11 | $9.92 | $696.50 | 703.47 |
| 3974 | Continuous Home Care w/AIDS Min 11 Hours | $738.62 | $16.62 | $9.92 | $765.16 | 772.81 |
| 3975 | Continuous Home Care w/AIDS Min 12 Hours | $805.77 | $18.13 | $9.92 | $833.82 | 842.16 |
| 3976 | Continuous Home Care w/AIDS Min 13 Hours | $872.91 | $19.64 | $9.92 | $902.47 | 911.49 |
| 3977 | Continuous Home Care w/AIDS Min 14 Hours | $940.06 | $21.15 | $9.92 | $971.13 | 980.84 |
| 3978 | Continuous Home Care w/AIDS Min 15 Hours | $1,007.21 | $22.66 | $9.92 | $1,039.79 | 1050.19 |
| 3979 | Continuous Home Care w/AIDS Min 16 Hours | $1,074.35 | $24.17 | $9.92 | $1,108.44 | 1119.52 |
| 3980 | Continuous Home Care w/AIDS Min 17 Hours | $1,141.50 | $25.68 | $9.92 | $1,177.10 | 1188.87 |
| 3981 | Continuous Home Care w/AIDS Min 18 Hours | $1,208.65 | $27.19 | $9.92 | $1,245.76 | 1258.22 |
| 3982 | Continuous Home Care w/AIDS Min 19 Hours | $1,275.79 | $28.71 | $9.92 | $1,314.42 | 1327.56 |
| 3983 | Continuous Home Care w/AIDS Min 20 Hours | $1,342.94 | $30.22 | $9.92 | $1,383.08 | 1396.91 |
| 3984 | Continuous Home Care w/AIDS Min 21 Hours | $1,410.09 | $31.73 | $9.92 | $1,451.74 | 1466.26 |
| 3985 | Continuous Home Care w/AIDS Min 22 Hours | $1,477.24 | $33.24 | $9.92 | $1,520.40 | 1535.6 |
| 3986 | Continuous Home Care w/AIDS Min 23 Hours | $1,544.38 | $34.75 | $9.92 | $1,589.05 | 1604.94 |
| 3987 | Continuous Home Care w/AIDS Min 24 Hours | $1,611.53 | $36.26 | $9.92 | $1,657.71 | 1674.29 |
| 3988 | General Inpatient w/ AIDS | $1,239.70 | $27.89 | $9.92 | $1,277.51 | 1290.29 |
| 3989 | Routine Home Care w/ AIDS Escort | $369.91 | $8.32 | $9.92 | $388.15 | 392.03 |
| 3991 | Service Intensity Add-on | $63.98 | $1.44 | $0.00 | $65.42 | 66.07 |
* WRR ='Worker Recruitment and Retention addon' if applicable
* RTR ='Recruitment, Training and Retention addon' if applicable
