Certified Hospice Program
Medicaid Rate Sheet
Effective: 10/01/2023 - 09/30/2024
- 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 | $190.78 | $4.29 | $9.92 | $204.99 | $207.04 |
| 3946 | Inpatient Respite | $471.54 | $10.61 | $9.92 | $492.07 | $496.99 |
| 3947 | General Inpatient Care | $1,005.02 | $22.61 | $9.92 | $1,037.55 | $1,047.93 |
| 3948 | Continuous Home Care - Min 8 Hours | $446.30 | $10.04 | $9.92 | $466.26 | $470.92 |
| 3949 | Continuous Home Care - Min 9 Hours | $502.09 | $11.30 | $9.92 | $523.31 | $528.54 |
| 3950 | Continuous Home Care - Min 10 Hours | $557.88 | $12.55 | $9.92 | $580.35 | $586.15 |
| 3951 | Continuous Home Care - Min 11 Hours | $613.66 | $13.81 | $9.92 | $637.39 | $643.76 |
| 3952 | Continuous Home Care - Min 12 Hours | $669.45 | $15.06 | $9.92 | $694.43 | $701.37 |
| 3953 | Continuous Home Care - Min 13 Hours | $725.24 | $16.32 | $9.92 | $751.48 | $758.99 |
| 3954 | Continuous Home Care - Min 14 Hours | $781.03 | $17.57 | $9.92 | $808.52 | $816.61 |
| 3955 | Continuous Home Care - Min 15 Hours | $836.81 | $18.83 | $9.92 | $865.56 | $874.22 |
| 3956 | Continuous Home Care - Min 16 Hours | $892.60 | $20.08 | $9.92 | $922.60 | $931.83 |
| 3957 | Continuous Home Care - Min 17 Hours | $948.39 | $21.34 | $9.92 | $979.65 | $989.45 |
| 3958 | Continuous Home Care - Min 18 Hours | $1,004.18 | $22.59 | $9.92 | $1,036.69 | $1,047.06 |
| 3959 | Continuous Home Care - Min 19 Hours | $1,059.96 | $23.85 | $9.92 | $1,093.73 | $1,104.67 |
| 3960 | Continuous Home Care - Min 20 Hours | $1,115.75 | $25.10 | $9.92 | $1,150.77 | $1,162.28 |
| 3961 | Continuous Home Care - Min 21 Hours | $1,171.54 | $26.36 | $9.92 | $1,207.82 | $1,219.90 |
| 3962 | Continuous Home Care - Min 22 Hours | $1,227.33 | $27.61 | $9.92 | $1,264.86 | $1,277.51 |
| 3963 | Continuous Home Care - Min 23 Hours | $1,283.11 | $28.87 | $9.92 | $1,321.90 | $1,335.12 |
| 3964 | Continuous Home Care - Min 24 Hours | $1,338.90 | $30.13 | $9.92 | $1,378.95 | $1,392.74 |
| 3965 | Hospice Inpatient Respite Care Coinsurance Rate - | |||||
| 5% of 3946 | $23.58 | $0.53 | $0.50 | $24.61 | $24.86 | |
| 3966 | Drugs Coinsurance Rate | $1.00 | $0.00 | $0.00 | $1.00 | $1.01 |
| 3969 | Routine Home Care w/AIDS | $310.39 | $6.98 | $9.92 | $327.29 | $330.56 |
| 3970 | Routine Home Care w/Escort | $211.34 | $4.76 | $9.92 | $226.02 | $228.28 |
| 3971 | Continuous Home Care w/AIDS Min 8 Hours | $460.33 | $10.36 | $9.92 | $480.61 | $485.42 |
| 3972 | Continuous Home Care w/AIDS Min 9 Hours | $517.87 | $11.65 | $9.92 | $539.44 | $544.83 |
| 3973 | Continuous Home Care w/AIDS Min 10 Hours | $575.41 | $12.95 | $9.92 | $598.28 | $604.26 |
| 3974 | Continuous Home Care w/AIDS Min 11 Hours | $632.95 | $14.24 | $9.92 | $657.11 | $663.68 |
| 3975 | Continuous Home Care w/AIDS Min 12 Hours | $690.50 | $15.54 | $9.92 | $715.96 | $723.12 |
| 3976 | Continuous Home Care w/AIDS Min 13 Hours | $748.04 | $16.83 | $9.92 | $774.79 | $782.54 |
| 3977 | Continuous Home Care w/AIDS Min 14 Hours | $805.58 | $18.13 | $9.92 | $833.63 | $841.97 |
| 3978 | Continuous Home Care w/AIDS Min 15 Hours | $863.12 | $19.42 | $9.92 | $892.46 | $901.38 |
| 3979 | Continuous Home Care w/AIDS Min 16 Hours | $920.66 | $20.71 | $9.92 | $951.29 | $960.80 |
| 3980 | Continuous Home Care w/AIDS Min 17 Hours | $978.20 | $22.01 | $9.92 | $1,010.13 | $1,020.23 |
| 3981 | Continuous Home Care w/AIDS Min 18 Hours | $1,035.74 | $23.30 | $9.92 | $1,068.96 | $1,079.65 |
| 3982 | Continuous Home Care w/AIDS Min 19 Hours | $1,093.28 | $24.60 | $9.92 | $1,127.80 | $1,139.08 |
| 3983 | Continuous Home Care w/AIDS Min 20 Hours | $1,150.83 | $25.89 | $9.92 | $1,186.64 | $1,198.51 |
| 3984 | Continuous Home Care w/AIDS Min 21 Hours | $1,208.37 | $27.19 | $9.92 | $1,245.48 | $1,257.93 |
| 3985 | Continuous Home Care w/AIDS Min 22 Hours | $1,265.91 | $28.48 | $9.92 | $1,304.31 | $1,317.35 |
| 3986 | Continuous Home Care w/AIDS Min 23 Hours | $1,323.45 | $29.78 | $9.92 | $1,363.15 | $1,376.78 |
| 3987 | Continuous Home Care w/AIDS Min 24 Hours | $1,380.99 | $31.07 | $9.92 | $1,421.98 | $1,436.20 |
| 3988 | General Inpatient w/ AIDS | $1,116.98 | $25.13 | $9.92 | $1,152.03 | $1,163.55 |
| 3989 | Routine Home Care w/ AIDS Escort | $330.95 | $7.45 | $9.92 | $348.32 | $351.80 |
| 3991 | Service Intensity Add-on | $56.94 | $1.28 | $0.00 | $58.22 | $58.80 |
* 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 | $195.93 | $4.41 | $9.92 | $210.26 | $212.36 |
| 3946 | Inpatient Respite | $483.18 | $10.87 | $9.92 | $503.97 | $509.01 |
| 3947 | General Inpatient Care | $1,030.98 | $23.20 | $9.92 | $1,064.10 | $1,074.74 |
| 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 | $748.01 | $16.83 | $9.92 | $774.76 | $782.51 |
| 3954 | Continuous Home Care - Min 14 Hours | $805.55 | $18.12 | $9.92 | $833.59 | $841.93 |
| 3955 | Continuous Home Care - Min 15 Hours | $863.09 | $19.42 | $9.92 | $892.43 | $901.35 |
| 3956 | Continuous Home Care - Min 16 Hours | $920.63 | $20.71 | $9.92 | $951.26 | $960.77 |
| 3957 | Continuous Home Care - Min 17 Hours | $978.17 | $22.01 | $9.92 | $1,010.10 | $1,020.20 |
| 3958 | Continuous Home Care - Min 18 Hours | $1,035.71 | $23.30 | $9.92 | $1,068.93 | $1,079.62 |
| 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 | $1,208.32 | $27.19 | $9.92 | $1,245.43 | $1,257.88 |
| 3962 | Continuous Home Care - Min 22 Hours | $1,265.86 | $28.48 | $9.92 | $1,304.26 | $1,317.30 |
| 3963 | Continuous Home Care - Min 23 Hours | $1,323.40 | $29.78 | $9.92 | $1,363.10 | $1,376.73 |
| 3964 | Continuous Home Care - Min 24 Hours | $1,380.94 | $31.07 | $9.92 | $1,421.93 | $1,436.15 |
| 3965 | Hospice Inpatient Respite Care Coinsurance Rate - | |||||
| 5% of 3946 | $24.16 | $0.54 | $0.50 | $25.20 | $25.45 | |
| 3966 | Drugs Coinsurance Rate | $1.00 | $0.00 | $0.00 | $1.00 | $1.01 |
| 3969 | Routine Home Care w/AIDS | $318.77 | $7.17 | $9.92 | $335.86 | $339.22 |
| 3970 | Routine Home Care w/Escort | $216.49 | $4.87 | $9.92 | $231.28 | $233.59 |
| 3971 | Continuous Home Care w/AIDS Min 8 Hours | $478.77 | $10.77 | $9.92 | $499.46 | $504.45 |
| 3972 | Continuous Home Care w/AIDS Min 9 Hours | $538.61 | $12.12 | $9.92 | $560.65 | $566.26 |
| 3973 | Continuous Home Care w/AIDS Min 10 Hours | $598.46 | $13.47 | $9.92 | $621.85 | $628.07 |
| 3974 | Continuous Home Care w/AIDS Min 11 Hours | $658.30 | $14.81 | $9.92 | $683.03 | $689.86 |
| 3975 | Continuous Home Care w/AIDS Min 12 Hours | $718.15 | $16.16 | $9.92 | $744.23 | $751.67 |
| 3976 | Continuous Home Care w/AIDS Min 13 Hours | $778.00 | $17.51 | $9.92 | $805.43 | $813.48 |
| 3977 | Continuous Home Care w/AIDS Min 14 Hours | $837.84 | $18.85 | $9.92 | $866.61 | $875.28 |
| 3978 | Continuous Home Care w/AIDS Min 15 Hours | $897.69 | $20.20 | $9.92 | $927.81 | $937.09 |
| 3979 | Continuous Home Care w/AIDS Min 16 Hours | $957.53 | $21.54 | $9.92 | $988.99 | $998.88 |
| 3980 | Continuous Home Care w/AIDS Min 17 Hours | $1,017.38 | $22.89 | $9.92 | $1,050.19 | $1,060.69 |
| 3981 | Continuous Home Care w/AIDS Min 18 Hours | $1,077.23 | $24.24 | $9.92 | $1,111.39 | $1,122.50 |
| 3982 | Continuous Home Care w/AIDS Min 19 Hours | $1,137.07 | $25.58 | $9.92 | $1,172.57 | $1,184.30 |
| 3983 | Continuous Home Care w/AIDS Min 20 Hours | $1,196.92 | $26.93 | $9.92 | $1,233.77 | $1,246.11 |
| 3984 | Continuous Home Care w/AIDS Min 21 Hours | $1,256.76 | $28.28 | $9.92 | $1,294.96 | $1,307.91 |
| 3985 | Continuous Home Care w/AIDS Min 22 Hours | $1,316.61 | $29.62 | $9.92 | $1,356.15 | $1,369.71 |
| 3986 | Continuous Home Care w/AIDS Min 23 Hours | $1,376.45 | $30.97 | $9.92 | $1,417.34 | $1,431.51 |
| 3987 | Continuous Home Care w/AIDS Min 24 Hours | $1,436.30 | $32.32 | $9.92 | $1,478.54 | $1,493.33 |
| 3988 | General Inpatient w/ AIDS | $1,145.83 | $25.78 | $9.92 | $1,181.53 | $1,193.35 |
| 3989 | Routine Home Care w/ AIDS Escort | $339.33 | $7.63 | $9.92 | $356.88 | $360.45 |
| 3991 | Service Intensity Add-on | $58.48 | $1.32 | $0.00 | $59.80 | $60.40 |
* 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 | $226.37 | $5.09 | $9.92 | $241.38 | $243.79 |
| 3946 | Inpatient Respite | $551.97 | $12.42 | $9.92 | $574.31 | $580.05 |
| 3947 | General Inpatient Care | $1,184.44 | $26.65 | $9.92 | $1,221.01 | $1,233.22 |
| 3948 | Continuous Home Care - Min 8 Hours | $543.14 | $12.22 | $9.92 | $565.28 | $570.93 |
| 3949 | Continuous Home Care - Min 9 Hours | $611.04 | $13.75 | $9.92 | $634.71 | $641.06 |
| 3950 | Continuous Home Care - Min 10 Hours | $678.93 | $15.28 | $9.92 | $704.13 | $711.17 |
| 3951 | Continuous Home Care - Min 11 Hours | $746.82 | $16.80 | $9.92 | $773.54 | $781.28 |
| 3952 | Continuous Home Care - Min 12 Hours | $814.72 | $18.33 | $9.92 | $842.97 | $851.40 |
| 3953 | Continuous Home Care - Min 13 Hours | $882.61 | $19.86 | $9.92 | $912.39 | $921.51 |
| 3954 | Continuous Home Care - Min 14 Hours | $950.50 | $21.39 | $9.92 | $981.81 | $991.63 |
| 3955 | Continuous Home Care - Min 15 Hours | $1,018.39 | $22.91 | $9.92 | $1,051.22 | $1,061.73 |
| 3956 | Continuous Home Care - Min 16 Hours | $1,086.29 | $24.44 | $9.92 | $1,120.65 | $1,131.86 |
| 3957 | Continuous Home Care - Min 17 Hours | $1,154.18 | $25.97 | $9.92 | $1,190.07 | $1,201.97 |
| 3958 | Continuous Home Care - Min 18 Hours | $1,222.07 | $27.50 | $9.92 | $1,259.49 | $1,272.08 |
| 3959 | Continuous Home Care - Min 19 Hours | $1,289.97 | $29.02 | $9.92 | $1,328.91 | $1,342.20 |
| 3960 | Continuous Home Care - Min 20 Hours | $1,357.86 | $30.55 | $9.92 | $1,398.33 | $1,412.31 |
| 3961 | Continuous Home Care - Min 21 Hours | $1,425.75 | $32.08 | $9.92 | $1,467.75 | $1,482.43 |
| 3962 | Continuous Home Care - Min 22 Hours | $1,493.64 | $33.61 | $9.92 | $1,537.17 | $1,552.54 |
| 3963 | Continuous Home Care - Min 23 Hours | $1,561.54 | $35.13 | $9.92 | $1,606.59 | $1,622.66 |
| 3964 | Continuous Home Care - Min 24 Hours | $1,629.43 | $36.66 | $9.92 | $1,676.01 | $1,692.77 |
| 3965 | Hospice Inpatient Respite Care Coinsurance Rate - | |||||
| 5% of 3946 | $27.60 | $0.62 | $0.50 | $28.72 | $29.01 | |
| 3966 | Drugs Coinsurance Rate | $1.00 | $0.00 | $0.00 | $1.00 | $1.01 |
| 3969 | Routine Home Care w/AIDS | $368.30 | $8.29 | $9.92 | $386.51 | $390.38 |
| 3970 | Routine Home Care w/Escort | $246.93 | $5.56 | $9.92 | $262.41 | $265.03 |
| 3971 | Continuous Home Care w/AIDS Min 8 Hours | $587.75 | $13.22 | $9.92 | $610.89 | $617.00 |
| 3972 | Continuous Home Care w/AIDS Min 9 Hours | $661.22 | $14.88 | $9.92 | $686.02 | $692.88 |
| 3973 | Continuous Home Care w/AIDS Min 10 Hours | $734.69 | $16.53 | $9.92 | $761.14 | $768.75 |
| 3974 | Continuous Home Care w/AIDS Min 11 Hours | $808.16 | $18.18 | $9.92 | $836.26 | $844.62 |
| 3975 | Continuous Home Care w/AIDS Min 12 Hours | $881.63 | $19.84 | $9.92 | $911.39 | $920.50 |
| 3976 | Continuous Home Care w/AIDS Min 13 Hours | $955.09 | $21.49 | $9.92 | $986.50 | $996.37 |
| 3977 | Continuous Home Care w/AIDS Min 14 Hours | $1,028.56 | $23.14 | $9.92 | $1,061.62 | $1,072.24 |
| 3978 | Continuous Home Care w/AIDS Min 15 Hours | $1,102.03 | $24.80 | $9.92 | $1,136.75 | $1,148.12 |
| 3979 | Continuous Home Care w/AIDS Min 16 Hours | $1,175.50 | $26.45 | $9.92 | $1,211.87 | $1,223.99 |
| 3980 | Continuous Home Care w/AIDS Min 17 Hours | $1,248.97 | $28.10 | $9.92 | $1,286.99 | $1,299.86 |
| 3981 | Continuous Home Care w/AIDS Min 18 Hours | $1,322.44 | $29.75 | $9.92 | $1,362.11 | $1,375.73 |
| 3982 | Continuous Home Care w/AIDS Min 19 Hours | $1,395.91 | $31.41 | $9.92 | $1,437.24 | $1,451.61 |
| 3983 | Continuous Home Care w/AIDS Min 20 Hours | $1,469.38 | $33.06 | $9.92 | $1,512.36 | $1,527.48 |
| 3984 | Continuous Home Care w/AIDS Min 21 Hours | $1,542.84 | $34.71 | $9.92 | $1,587.47 | $1,603.34 |
| 3985 | Continuous Home Care w/AIDS Min 22 Hours | $1,616.31 | $36.37 | $9.92 | $1,662.60 | $1,679.23 |
| 3986 | Continuous Home Care w/AIDS Min 23 Hours | $1,689.78 | $38.02 | $9.92 | $1,737.72 | $1,755.10 |
| 3987 | Continuous Home Care w/AIDS Min 24 Hours | $1,763.25 | $39.67 | $9.92 | $1,812.84 | $1,830.97 |
| 3988 | General Inpatient w/ AIDS | $1,316.39 | $29.62 | $9.92 | $1,355.93 | $1,369.49 |
| 3989 | Routine Home Care w/ AIDS Escort | $388.86 | $8.75 | $9.92 | $407.53 | $411.61 |
| 3991 | Service Intensity Add-on | $67.57 | $1.52 | $0.00 | $69.09 | $69.78 |
* 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 | $200.58 | $4.51 | $9.92 | $215.01 | $217.16 |
| 3946 | Inpatient Respite | $493.68 | $11.11 | $9.92 | $514.71 | $519.86 |
| 3947 | General Inpatient Care | $1,054.40 | $23.72 | $9.92 | $1,088.04 | $1,098.92 |
| 3948 | Continuous Home Care - Min 8 Hours | $472.95 | $10.64 | $9.92 | $493.51 | $498.45 |
| 3949 | Continuous Home Care - Min 9 Hours | $532.07 | $11.97 | $9.92 | $553.96 | $559.50 |
| 3950 | Continuous Home Care - Min 10 Hours | $591.19 | $13.30 | $9.92 | $614.41 | $620.55 |
| 3951 | Continuous Home Care - Min 11 Hours | $650.31 | $14.63 | $9.92 | $674.86 | $681.61 |
| 3952 | Continuous Home Care - Min 12 Hours | $709.43 | $15.96 | $9.92 | $735.31 | $742.66 |
| 3953 | Continuous Home Care - Min 13 Hours | $768.55 | $17.29 | $9.92 | $795.76 | $803.72 |
| 3954 | Continuous Home Care - Min 14 Hours | $827.67 | $18.62 | $9.92 | $856.21 | $864.77 |
| 3955 | Continuous Home Care - Min 15 Hours | $886.79 | $19.95 | $9.92 | $916.66 | $925.83 |
| 3956 | Continuous Home Care - Min 16 Hours | $945.91 | $21.28 | $9.92 | $977.11 | $986.88 |
| 3957 | Continuous Home Care - Min 17 Hours | $1,005.03 | $22.61 | $9.92 | $1,037.56 | $1,047.94 |
| 3958 | Continuous Home Care - Min 18 Hours | $1,064.15 | $23.94 | $9.92 | $1,098.01 | $1,108.99 |
| 3959 | Continuous Home Care - Min 19 Hours | $1,123.26 | $25.27 | $9.92 | $1,158.45 | $1,170.03 |
| 3960 | Continuous Home Care - Min 20 Hours | $1,182.38 | $26.60 | $9.92 | $1,218.90 | $1,231.09 |
| 3961 | Continuous Home Care - Min 21 Hours | $1,241.50 | $27.93 | $9.92 | $1,279.35 | $1,292.14 |
| 3962 | Continuous Home Care - Min 22 Hours | $1,300.62 | $29.26 | $9.92 | $1,339.80 | $1,353.20 |
| 3963 | Continuous Home Care - Min 23 Hours | $1,359.74 | $30.59 | $9.92 | $1,400.25 | $1,414.25 |
| 3964 | Continuous Home Care - Min 24 Hours | $1,418.86 | $31.92 | $9.92 | $1,460.70 | $1,475.31 |
| 3965 | Hospice Inpatient Respite Care Coinsurance Rate - | |||||
| 5% of 3946 | $24.68 | $0.56 | $0.50 | $25.74 | $26.00 | |
| 3966 | Drugs Coinsurance Rate | $1.00 | $0.00 | $0.00 | $1.00 | $1.01 |
| 3969 | Routine Home Care w/AIDS | $326.33 | $7.34 | $9.92 | $343.59 | $347.03 |
| 3970 | Routine Home Care w/Escort | $221.14 | $4.98 | $9.92 | $236.04 | $238.40 |
| 3971 | Continuous Home Care w/AIDS Min 8 Hours | $495.40 | $11.15 | $9.92 | $516.47 | $521.63 |
| 3972 | Continuous Home Care w/AIDS Min 9 Hours | $557.33 | $12.54 | $9.92 | $579.79 | $585.59 |
| 3973 | Continuous Home Care w/AIDS Min 10 Hours | $619.25 | $13.93 | $9.92 | $643.10 | $649.53 |
| 3974 | Continuous Home Care w/AIDS Min 11 Hours | $681.18 | $15.33 | $9.92 | $706.43 | $713.49 |
| 3975 | Continuous Home Care w/AIDS Min 12 Hours | $743.10 | $16.72 | $9.92 | $769.74 | $777.44 |
| 3976 | Continuous Home Care w/AIDS Min 13 Hours | $805.03 | $18.11 | $9.92 | $833.06 | $841.39 |
| 3977 | Continuous Home Care w/AIDS Min 14 Hours | $866.95 | $19.51 | $9.92 | $896.38 | $905.34 |
| 3978 | Continuous Home Care w/AIDS Min 15 Hours | $928.88 | $20.90 | $9.92 | $959.70 | $969.30 |
| 3979 | Continuous Home Care w/AIDS Min 16 Hours | $990.80 | $22.29 | $9.92 | $1,023.01 | $1,033.24 |
| 3980 | Continuous Home Care w/AIDS Min 17 Hours | $1,052.73 | $23.69 | $9.92 | $1,086.34 | $1,097.20 |
| 3981 | Continuous Home Care w/AIDS Min 18 Hours | $1,114.65 | $25.08 | $9.92 | $1,149.65 | $1,161.15 |
| 3982 | Continuous Home Care w/AIDS Min 19 Hours | $1,176.58 | $26.47 | $9.92 | $1,212.97 | $1,225.10 |
| 3983 | Continuous Home Care w/AIDS Min 20 Hours | $1,238.50 | $27.87 | $9.92 | $1,276.29 | $1,289.05 |
| 3984 | Continuous Home Care w/AIDS Min 21 Hours | $1,300.43 | $29.26 | $9.92 | $1,339.61 | $1,353.01 |
| 3985 | Continuous Home Care w/AIDS Min 22 Hours | $1,362.35 | $30.65 | $9.92 | $1,402.92 | $1,416.95 |
| 3986 | Continuous Home Care w/AIDS Min 23 Hours | $1,424.28 | $32.05 | $9.92 | $1,466.25 | $1,480.91 |
| 3987 | Continuous Home Care w/AIDS Min 24 Hours | $1,486.20 | $33.44 | $9.92 | $1,529.56 | $1,544.86 |
| 3988 | General Inpatient w/ AIDS | $1,171.86 | $26.37 | $9.92 | $1,208.15 | $1,220.23 |
| 3989 | Routine Home Care w/ AIDS Escort | $346.89 | $7.81 | $9.92 | $364.62 | $368.27 |
| 3991 | Service Intensity Add-on | $59.87 | $1.35 | $0.00 | $61.22 | $61.83 |
* 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 | $194.39 | $4.37 | $9.92 | $208.68 | $210.77 |
| 3946 | Inpatient Respite | $479.69 | $10.79 | $9.92 | $500.40 | $505.40 |
| 3947 | General Inpatient Care | $1,023.20 | $23.02 | $9.92 | $1,056.14 | $1,066.70 |
| 3948 | Continuous Home Care - Min 8 Hours | $456.11 | $10.26 | $9.92 | $476.29 | $481.05 |
| 3949 | Continuous Home Care - Min 9 Hours | $513.13 | $11.55 | $9.92 | $534.60 | $539.95 |
| 3950 | Continuous Home Care - Min 10 Hours | $570.14 | $12.83 | $9.92 | $592.89 | $598.82 |
| 3951 | Continuous Home Care - Min 11 Hours | $627.16 | $14.11 | $9.92 | $651.19 | $657.70 |
| 3952 | Continuous Home Care - Min 12 Hours | $684.17 | $15.39 | $9.92 | $709.48 | $716.57 |
| 3953 | Continuous Home Care - Min 13 Hours | $741.18 | $16.68 | $9.92 | $767.78 | $775.46 |
| 3954 | Continuous Home Care - Min 14 Hours | $798.20 | $17.96 | $9.92 | $826.08 | $834.34 |
| 3955 | Continuous Home Care - Min 15 Hours | $855.21 | $19.24 | $9.92 | $884.37 | $893.21 |
| 3956 | Continuous Home Care - Min 16 Hours | $912.23 | $20.53 | $9.92 | $942.68 | $952.11 |
| 3957 | Continuous Home Care - Min 17 Hours | $969.24 | $21.81 | $9.92 | $1,000.97 | $1,010.98 |
| 3958 | Continuous Home Care - Min 18 Hours | $1,026.26 | $23.09 | $9.92 | $1,059.27 | $1,069.86 |
| 3959 | Continuous Home Care - Min 19 Hours | $1,083.27 | $24.37 | $9.92 | $1,117.56 | $1,128.74 |
| 3960 | Continuous Home Care - Min 20 Hours | $1,140.28 | $25.66 | $9.92 | $1,175.86 | $1,187.62 |
| 3961 | Continuous Home Care - Min 21 Hours | $1,197.30 | $26.94 | $9.92 | $1,234.16 | $1,246.50 |
| 3962 | Continuous Home Care - Min 22 Hours | $1,254.31 | $28.22 | $9.92 | $1,292.45 | $1,305.37 |
| 3963 | Continuous Home Care - Min 23 Hours | $1,311.33 | $29.50 | $9.92 | $1,350.75 | $1,364.26 |
| 3964 | Continuous Home Care - Min 24 Hours | $1,368.34 | $30.79 | $9.92 | $1,409.05 | $1,423.14 |
| 3965 | Hospice Inpatient Respite Care Coinsurance Rate - | |||||
| 5% of 3946 | $23.98 | $0.54 | $0.50 | $25.02 | $25.27 | |
| 3966 | Drugs Coinsurance Rate | $1.00 | $0.00 | $0.00 | $1.00 | $1.01 |
| 3969 | Routine Home Care w/AIDS | $316.26 | $7.12 | $9.92 | $333.30 | $336.63 |
| 3970 | Routine Home Care w/Escort | $214.95 | $4.84 | $9.92 | $229.71 | $232.01 |
| 3971 | Continuous Home Care w/AIDS Min 8 Hours | $473.24 | $10.65 | $9.92 | $493.81 | $498.75 |
| 3972 | Continuous Home Care w/AIDS Min 9 Hours | $532.40 | $11.98 | $9.92 | $554.30 | $559.84 |
| 3973 | Continuous Home Care w/AIDS Min 10 Hours | $591.55 | $13.31 | $9.92 | $614.78 | $620.93 |
| 3974 | Continuous Home Care w/AIDS Min 11 Hours | $650.71 | $14.64 | $9.92 | $675.27 | $682.02 |
| 3975 | Continuous Home Care w/AIDS Min 12 Hours | $709.86 | $15.97 | $9.92 | $735.75 | $743.11 |
| 3976 | Continuous Home Care w/AIDS Min 13 Hours | $769.02 | $17.30 | $9.92 | $796.24 | $804.20 |
| 3977 | Continuous Home Care w/AIDS Min 14 Hours | $828.17 | $18.63 | $9.92 | $856.72 | $865.29 |
| 3978 | Continuous Home Care w/AIDS Min 15 Hours | $887.33 | $19.96 | $9.92 | $917.21 | $926.38 |
| 3979 | Continuous Home Care w/AIDS Min 16 Hours | $946.48 | $21.30 | $9.92 | $977.70 | $987.48 |
| 3980 | Continuous Home Care w/AIDS Min 17 Hours | $1,005.64 | $22.63 | $9.92 | $1,038.19 | $1,048.57 |
| 3981 | Continuous Home Care w/AIDS Min 18 Hours | $1,064.79 | $23.96 | $9.92 | $1,098.67 | $1,109.66 |
| 3982 | Continuous Home Care w/AIDS Min 19 Hours | $1,123.95 | $25.29 | $9.92 | $1,159.16 | $1,170.75 |
| 3983 | Continuous Home Care w/AIDS Min 20 Hours | $1,183.10 | $26.62 | $9.92 | $1,219.64 | $1,231.84 |
| 3984 | Continuous Home Care w/AIDS Min 21 Hours | $1,242.26 | $27.95 | $9.92 | $1,280.13 | $1,292.93 |
| 3985 | Continuous Home Care w/AIDS Min 22 Hours | $1,301.41 | $29.28 | $9.92 | $1,340.61 | $1,354.02 |
| 3986 | Continuous Home Care w/AIDS Min 23 Hours | $1,360.57 | $30.61 | $9.92 | $1,401.10 | $1,415.11 |
| 3987 | Continuous Home Care w/AIDS Min 24 Hours | $1,419.72 | $31.94 | $9.92 | $1,461.58 | $1,476.20 |
| 3988 | General Inpatient w/ AIDS | $1,137.18 | $25.59 | $9.92 | $1,172.69 | $1,184.42 |
| 3989 | Routine Home Care w/ AIDS Escort | $336.82 | $7.58 | $9.92 | $354.32 | $357.86 |
| 3991 | Service Intensity Add-on | $58.02 | $1.31 | $0.00 | $59.33 | $59.92 |
* 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 | $266.77 | $6.00 | $9.92 | $282.69 | $285.52 |
| 3946 | Inpatient Respite | $643.25 | $14.47 | $9.92 | $667.64 | $674.32 |
| 3947 | General Inpatient Care | $1,388.07 | $31.23 | $9.92 | $1,429.22 | $1,443.51 |
| 3948 | Continuous Home Care - Min 8 Hours | $653.06 | $14.69 | $9.92 | $677.67 | $684.45 |
| 3949 | Continuous Home Care - Min 9 Hours | $734.69 | $16.53 | $9.92 | $761.14 | $768.75 |
| 3950 | Continuous Home Care - Min 10 Hours | $816.33 | $18.37 | $9.92 | $844.62 | $853.07 |
| 3951 | Continuous Home Care - Min 11 Hours | $897.96 | $20.20 | $9.92 | $928.08 | $937.36 |
| 3952 | Continuous Home Care - Min 12 Hours | $979.59 | $22.04 | $9.92 | $1,011.55 | $1,021.67 |
| 3953 | Continuous Home Care - Min 13 Hours | $1,061.22 | $23.88 | $9.92 | $1,095.02 | $1,105.97 |
| 3954 | Continuous Home Care - Min 14 Hours | $1,142.86 | $25.71 | $9.92 | $1,178.49 | $1,190.27 |
| 3955 | Continuous Home Care - Min 15 Hours | $1,224.49 | $27.55 | $9.92 | $1,261.96 | $1,274.58 |
| 3956 | Continuous Home Care - Min 16 Hours | $1,306.12 | $29.39 | $9.92 | $1,345.43 | $1,358.88 |
| 3957 | Continuous Home Care - Min 17 Hours | $1,387.75 | $31.22 | $9.92 | $1,428.89 | $1,443.18 |
| 3958 | Continuous Home Care - Min 18 Hours | $1,469.39 | $33.06 | $9.92 | $1,512.37 | $1,527.49 |
| 3959 | Continuous Home Care - Min 19 Hours | $1,551.02 | $34.90 | $9.92 | $1,595.84 | $1,611.80 |
| 3960 | Continuous Home Care - Min 20 Hours | $1,632.65 | $36.73 | $9.92 | $1,679.30 | $1,696.09 |
| 3961 | Continuous Home Care - Min 21 Hours | $1,714.28 | $38.57 | $9.92 | $1,762.77 | $1,780.40 |
| 3962 | Continuous Home Care - Min 22 Hours | $1,795.92 | $40.41 | $9.92 | $1,846.25 | $1,864.71 |
| 3963 | Continuous Home Care - Min 23 Hours | $1,877.55 | $42.24 | $9.92 | $1,929.71 | $1,949.01 |
| 3964 | Continuous Home Care - Min 24 Hours | $1,959.18 | $44.08 | $9.92 | $2,013.18 | $2,033.31 |
| 3965 | Hospice Inpatient Respite Care Coinsurance Rate - | |||||
| 5% of 3946 | $32.16 | $0.72 | $0.50 | $33.38 | $33.71 | |
| 3966 | Drugs Coinsurance Rate | $1.00 | $0.00 | $0.00 | $1.00 | $1.01 |
| 3969 | Routine Home Care w/AIDS | $434.03 | $9.77 | $9.92 | $453.72 | $458.26 |
| 3970 | Routine Home Care w/Escort | $287.33 | $6.46 | $9.92 | $303.71 | $306.75 |
| 3971 | Continuous Home Care w/AIDS Min 8 Hours | $732.37 | $16.48 | $9.92 | $758.77 | $766.36 |
| 3972 | Continuous Home Care w/AIDS Min 9 Hours | $823.92 | $18.54 | $9.92 | $852.38 | $860.90 |
| 3973 | Continuous Home Care w/AIDS Min 10 Hours | $915.47 | $20.60 | $9.92 | $945.99 | $955.45 |
| 3974 | Continuous Home Care w/AIDS Min 11 Hours | $1,007.01 | $22.66 | $9.92 | $1,039.59 | $1,049.99 |
| 3975 | Continuous Home Care w/AIDS Min 12 Hours | $1,098.56 | $24.72 | $9.92 | $1,133.20 | $1,144.53 |
| 3976 | Continuous Home Care w/AIDS Min 13 Hours | $1,190.11 | $26.78 | $9.92 | $1,226.81 | $1,239.08 |
| 3977 | Continuous Home Care w/AIDS Min 14 Hours | $1,281.65 | $28.84 | $9.92 | $1,320.41 | $1,333.61 |
| 3978 | Continuous Home Care w/AIDS Min 15 Hours | $1,373.20 | $30.90 | $9.92 | $1,414.02 | $1,428.16 |
| 3979 | Continuous Home Care w/AIDS Min 16 Hours | $1,464.75 | $32.96 | $9.92 | $1,507.63 | $1,522.71 |
| 3980 | Continuous Home Care w/AIDS Min 17 Hours | $1,556.29 | $35.02 | $9.92 | $1,601.23 | $1,617.24 |
| 3981 | Continuous Home Care w/AIDS Min 18 Hours | $1,647.84 | $37.08 | $9.92 | $1,694.84 | $1,711.79 |
| 3982 | Continuous Home Care w/AIDS Min 19 Hours | $1,739.39 | $39.14 | $9.92 | $1,788.45 | $1,806.33 |
| 3983 | Continuous Home Care w/AIDS Min 20 Hours | $1,830.93 | $41.20 | $9.92 | $1,882.05 | $1,900.87 |
| 3984 | Continuous Home Care w/AIDS Min 21 Hours | $1,922.48 | $43.26 | $9.92 | $1,975.66 | $1,995.42 |
| 3985 | Continuous Home Care w/AIDS Min 22 Hours | $2,014.03 | $45.32 | $9.92 | $2,069.27 | $2,089.96 |
| 3986 | Continuous Home Care w/AIDS Min 23 Hours | $2,105.57 | $47.38 | $9.92 | $2,162.87 | $2,184.50 |
| 3987 | Continuous Home Care w/AIDS Min 24 Hours | $2,197.12 | $49.44 | $9.92 | $2,256.48 | $2,279.04 |
| 3988 | General Inpatient w/ AIDS | $1,542.70 | $34.71 | $9.92 | $1,587.33 | $1,603.20 |
| 3989 | Routine Home Care w/ AIDS Escort | $454.59 | $10.23 | $9.92 | $474.74 | $479.49 |
| 3991 | Service Intensity Add-on | $79.63 | $1.79 | $0.00 | $81.42 | $82.23 |
* 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 | $272.41 | $6.13 | $9.92 | $288.46 | $291.34 |
| 3946 | Inpatient Respite | $656.00 | $14.76 | $9.92 | $680.68 | $687.49 |
| 3947 | General Inpatient Care | $1,416.51 | $31.87 | $9.92 | $1,458.30 | $1,472.88 |
| 3948 | Continuous Home Care - Min 8 Hours | $668.41 | $15.04 | $9.92 | $693.37 | $700.30 |
| 3949 | Continuous Home Care - Min 9 Hours | $751.96 | $16.92 | $9.92 | $778.80 | $786.59 |
| 3950 | Continuous Home Care - Min 10 Hours | $835.51 | $18.80 | $9.92 | $864.23 | $872.87 |
| 3951 | Continuous Home Care - Min 11 Hours | $919.06 | $20.68 | $9.92 | $949.66 | $959.16 |
| 3952 | Continuous Home Care - Min 12 Hours | $1,002.62 | $22.56 | $9.92 | $1,035.10 | $1,045.45 |
| 3953 | Continuous Home Care - Min 13 Hours | $1,086.17 | $24.44 | $9.92 | $1,120.53 | $1,131.74 |
| 3954 | Continuous Home Care - Min 14 Hours | $1,169.72 | $26.32 | $9.92 | $1,205.96 | $1,218.02 |
| 3955 | Continuous Home Care - Min 15 Hours | $1,253.27 | $28.20 | $9.92 | $1,291.39 | $1,304.30 |
| 3956 | Continuous Home Care - Min 16 Hours | $1,336.82 | $30.08 | $9.92 | $1,376.82 | $1,390.59 |
| 3957 | Continuous Home Care - Min 17 Hours | $1,420.37 | $31.96 | $9.92 | $1,462.25 | $1,476.87 |
| 3958 | Continuous Home Care - Min 18 Hours | $1,503.92 | $33.84 | $9.92 | $1,547.68 | $1,563.16 |
| 3959 | Continuous Home Care - Min 19 Hours | $1,587.47 | $35.72 | $9.92 | $1,633.11 | $1,649.44 |
| 3960 | Continuous Home Care - Min 20 Hours | $1,671.03 | $37.60 | $9.92 | $1,718.55 | $1,735.74 |
| 3961 | Continuous Home Care - Min 21 Hours | $1,754.58 | $39.48 | $9.92 | $1,803.98 | $1,822.02 |
| 3962 | Continuous Home Care - Min 22 Hours | $1,838.13 | $41.36 | $9.92 | $1,889.41 | $1,908.30 |
| 3963 | Continuous Home Care - Min 23 Hours | $1,921.68 | $43.24 | $9.92 | $1,974.84 | $1,994.59 |
| 3964 | Continuous Home Care - Min 24 Hours | $2,005.23 | $45.12 | $9.92 | $2,060.27 | $2,080.87 |
| 3965 | Hospice Inpatient Respite Care Coinsurance Rate - | |||||
| 5% of 3946 | $32.80 | $0.74 | $0.50 | $34.04 | $34.38 | |
| 3966 | Drugs Coinsurance Rate | $1.00 | $0.00 | $0.00 | $1.00 | $1.01 |
| 3969 | Routine Home Care w/AIDS | $443.20 | $9.97 | $9.92 | $463.09 | $467.72 |
| 3970 | Routine Home Care w/Escort | $292.97 | $6.59 | $9.92 | $309.48 | $312.57 |
| 3971 | Continuous Home Care w/AIDS Min 8 Hours | $752.57 | $16.93 | $9.92 | $779.42 | $787.21 |
| 3972 | Continuous Home Care w/AIDS Min 9 Hours | $846.64 | $19.05 | $9.92 | $875.61 | $884.37 |
| 3973 | Continuous Home Care w/AIDS Min 10 Hours | $940.71 | $21.17 | $9.92 | $971.80 | $981.52 |
| 3974 | Continuous Home Care w/AIDS Min 11 Hours | $1,034.78 | $23.28 | $9.92 | $1,067.98 | $1,078.66 |
| 3975 | Continuous Home Care w/AIDS Min 12 Hours | $1,128.86 | $25.40 | $9.92 | $1,164.18 | $1,175.82 |
| 3976 | Continuous Home Care w/AIDS Min 13 Hours | $1,222.93 | $27.52 | $9.92 | $1,260.37 | $1,272.97 |
| 3977 | Continuous Home Care w/AIDS Min 14 Hours | $1,317.00 | $29.63 | $9.92 | $1,356.55 | $1,370.12 |
| 3978 | Continuous Home Care w/AIDS Min 15 Hours | $1,411.07 | $31.75 | $9.92 | $1,452.74 | $1,467.27 |
| 3979 | Continuous Home Care w/AIDS Min 16 Hours | $1,505.14 | $33.87 | $9.92 | $1,548.93 | $1,564.42 |
| 3980 | Continuous Home Care w/AIDS Min 17 Hours | $1,599.21 | $35.98 | $9.92 | $1,645.11 | $1,661.56 |
| 3981 | Continuous Home Care w/AIDS Min 18 Hours | $1,693.28 | $38.10 | $9.92 | $1,741.30 | $1,758.71 |
| 3982 | Continuous Home Care w/AIDS Min 19 Hours | $1,787.35 | $40.22 | $9.92 | $1,837.49 | $1,855.86 |
| 3983 | Continuous Home Care w/AIDS Min 20 Hours | $1,881.43 | $42.33 | $9.92 | $1,933.68 | $1,953.02 |
| 3984 | Continuous Home Care w/AIDS Min 21 Hours | $1,975.50 | $44.45 | $9.92 | $2,029.87 | $2,050.17 |
| 3985 | Continuous Home Care w/AIDS Min 22 Hours | $2,069.57 | $46.57 | $9.92 | $2,126.06 | $2,147.32 |
| 3986 | Continuous Home Care w/AIDS Min 23 Hours | $2,163.64 | $48.68 | $9.92 | $2,222.24 | $2,244.46 |
| 3987 | Continuous Home Care w/AIDS Min 24 Hours | $2,257.71 | $50.80 | $9.92 | $2,318.43 | $2,341.61 |
| 3988 | General Inpatient w/ AIDS | $1,574.31 | $35.42 | $9.92 | $1,619.65 | $1,635.85 |
| 3989 | Routine Home Care w/ AIDS Escort | $463.76 | $10.43 | $9.92 | $484.11 | $488.95 |
| 3991 | Service Intensity Add-on | $81.31 | $1.83 | $0.00 | $83.14 | $83.97 |
* 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 | $226.37 | $5.09 | $9.92 | $241.38 | $243.79 |
| 3946 | Inpatient Respite | $551.97 | $12.42 | $9.92 | $574.31 | $580.05 |
| 3947 | General Inpatient Care | $1,184.44 | $26.65 | $9.92 | $1,221.01 | $1,233.22 |
| 3948 | Continuous Home Care - Min 8 Hours | $543.14 | $12.22 | $9.92 | $565.28 | $570.93 |
| 3949 | Continuous Home Care - Min 9 Hours | $611.04 | $13.75 | $9.92 | $634.71 | $641.06 |
| 3950 | Continuous Home Care - Min 10 Hours | $678.93 | $15.28 | $9.92 | $704.13 | $711.17 |
| 3951 | Continuous Home Care - Min 11 Hours | $746.82 | $16.80 | $9.92 | $773.54 | $781.28 |
| 3952 | Continuous Home Care - Min 12 Hours | $814.72 | $18.33 | $9.92 | $842.97 | $851.40 |
| 3953 | Continuous Home Care - Min 13 Hours | $882.61 | $19.86 | $9.92 | $912.39 | $921.51 |
| 3954 | Continuous Home Care - Min 14 Hours | $950.50 | $21.39 | $9.92 | $981.81 | $991.63 |
| 3955 | Continuous Home Care - Min 15 Hours | $1,018.39 | $22.91 | $9.92 | $1,051.22 | $1,061.73 |
| 3956 | Continuous Home Care - Min 16 Hours | $1,086.29 | $24.44 | $9.92 | $1,120.65 | $1,131.86 |
| 3957 | Continuous Home Care - Min 17 Hours | $1,154.18 | $25.97 | $9.92 | $1,190.07 | $1,201.97 |
| 3958 | Continuous Home Care - Min 18 Hours | $1,222.07 | $27.50 | $9.92 | $1,259.49 | $1,272.08 |
| 3959 | Continuous Home Care - Min 19 Hours | $1,289.97 | $29.02 | $9.92 | $1,328.91 | $1,342.20 |
| 3960 | Continuous Home Care - Min 20 Hours | $1,357.86 | $30.55 | $9.92 | $1,398.33 | $1,412.31 |
| 3961 | Continuous Home Care - Min 21 Hours | $1,425.75 | $32.08 | $9.92 | $1,467.75 | $1,482.43 |
| 3962 | Continuous Home Care - Min 22 Hours | $1,493.64 | $33.61 | $9.92 | $1,537.17 | $1,552.54 |
| 3963 | Continuous Home Care - Min 23 Hours | $1,561.54 | $35.13 | $9.92 | $1,606.59 | $1,622.66 |
| 3964 | Continuous Home Care - Min 24 Hours | $1,629.43 | $36.66 | $9.92 | $1,676.01 | $1,692.77 |
| 3965 | Hospice Inpatient Respite Care Coinsurance Rate - | |||||
| 5% of 3946 | $27.60 | $0.62 | $0.50 | $28.72 | $29.01 | |
| 3966 | Drugs Coinsurance Rate | $1.00 | $0.00 | $0.00 | $1.00 | $1.01 |
| 3969 | Routine Home Care w/AIDS | $368.30 | $8.29 | $9.92 | $386.51 | $390.38 |
| 3970 | Routine Home Care w/Escort | $246.93 | $5.56 | $9.92 | $262.41 | $265.03 |
| 3971 | Continuous Home Care w/AIDS Min 8 Hours | $587.75 | $13.22 | $9.92 | $610.89 | $617.00 |
| 3972 | Continuous Home Care w/AIDS Min 9 Hours | $661.22 | $14.88 | $9.92 | $686.02 | $692.88 |
| 3973 | Continuous Home Care w/AIDS Min 10 Hours | $734.69 | $16.53 | $9.92 | $761.14 | $768.75 |
| 3974 | Continuous Home Care w/AIDS Min 11 Hours | $808.16 | $18.18 | $9.92 | $836.26 | $844.62 |
| 3975 | Continuous Home Care w/AIDS Min 12 Hours | $881.63 | $19.84 | $9.92 | $911.39 | $920.50 |
| 3976 | Continuous Home Care w/AIDS Min 13 Hours | $955.09 | $21.49 | $9.92 | $986.50 | $996.37 |
| 3977 | Continuous Home Care w/AIDS Min 14 Hours | $1,028.56 | $23.14 | $9.92 | $1,061.62 | $1,072.24 |
| 3978 | Continuous Home Care w/AIDS Min 15 Hours | $1,102.03 | $24.80 | $9.92 | $1,136.75 | $1,148.12 |
| 3979 | Continuous Home Care w/AIDS Min 16 Hours | $1,175.50 | $26.45 | $9.92 | $1,211.87 | $1,223.99 |
| 3980 | Continuous Home Care w/AIDS Min 17 Hours | $1,248.97 | $28.10 | $9.92 | $1,286.99 | $1,299.86 |
| 3981 | Continuous Home Care w/AIDS Min 18 Hours | $1,322.44 | $29.75 | $9.92 | $1,362.11 | $1,375.73 |
| 3982 | Continuous Home Care w/AIDS Min 19 Hours | $1,395.91 | $31.41 | $9.92 | $1,437.24 | $1,451.61 |
| 3983 | Continuous Home Care w/AIDS Min 20 Hours | $1,469.38 | $33.06 | $9.92 | $1,512.36 | $1,527.48 |
| 3984 | Continuous Home Care w/AIDS Min 21 Hours | $1,542.84 | $34.71 | $9.92 | $1,587.47 | $1,603.34 |
| 3985 | Continuous Home Care w/AIDS Min 22 Hours | $1,616.31 | $36.37 | $9.92 | $1,662.60 | $1,679.23 |
| 3986 | Continuous Home Care w/AIDS Min 23 Hours | $1,689.78 | $38.02 | $9.92 | $1,737.72 | $1,755.10 |
| 3987 | Continuous Home Care w/AIDS Min 24 Hours | $1,763.25 | $39.67 | $9.92 | $1,812.84 | $1,830.97 |
| 3988 | General Inpatient w/ AIDS | $1,316.39 | $29.62 | $9.92 | $1,355.93 | $1,369.49 |
| 3989 | Routine Home Care w/ AIDS Escort | $388.86 | $8.75 | $9.92 | $407.53 | $411.61 |
| 3991 | Service Intensity Add-on | $67.57 | $1.52 | $0.00 | $69.09 | $69.78 |
* 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 | $272.41 | $6.13 | $9.92 | $288.46 | $291.34 |
| 3946 | Inpatient Respite | $656.00 | $14.76 | $9.92 | $680.68 | $687.49 |
| 3947 | General Inpatient Care | $1,416.51 | $31.87 | $9.92 | $1,458.30 | $1,472.88 |
| 3948 | Continuous Home Care - Min 8 Hours | $668.41 | $15.04 | $9.92 | $693.37 | $700.30 |
| 3949 | Continuous Home Care - Min 9 Hours | $751.96 | $16.92 | $9.92 | $778.80 | $786.59 |
| 3950 | Continuous Home Care - Min 10 Hours | $835.51 | $18.80 | $9.92 | $864.23 | $872.87 |
| 3951 | Continuous Home Care - Min 11 Hours | $919.06 | $20.68 | $9.92 | $949.66 | $959.16 |
| 3952 | Continuous Home Care - Min 12 Hours | $1,002.62 | $22.56 | $9.92 | $1,035.10 | $1,045.45 |
| 3953 | Continuous Home Care - Min 13 Hours | $1,086.17 | $24.44 | $9.92 | $1,120.53 | $1,131.74 |
| 3954 | Continuous Home Care - Min 14 Hours | $1,169.72 | $26.32 | $9.92 | $1,205.96 | $1,218.02 |
| 3955 | Continuous Home Care - Min 15 Hours | $1,253.27 | $28.20 | $9.92 | $1,291.39 | $1,304.30 |
| 3956 | Continuous Home Care - Min 16 Hours | $1,336.82 | $30.08 | $9.92 | $1,376.82 | $1,390.59 |
| 3957 | Continuous Home Care - Min 17 Hours | $1,420.37 | $31.96 | $9.92 | $1,462.25 | $1,476.87 |
| 3958 | Continuous Home Care - Min 18 Hours | $1,503.92 | $33.84 | $9.92 | $1,547.68 | $1,563.16 |
| 3959 | Continuous Home Care - Min 19 Hours | $1,587.47 | $35.72 | $9.92 | $1,633.11 | $1,649.44 |
| 3960 | Continuous Home Care - Min 20 Hours | $1,671.03 | $37.60 | $9.92 | $1,718.55 | $1,735.74 |
| 3961 | Continuous Home Care - Min 21 Hours | $1,754.58 | $39.48 | $9.92 | $1,803.98 | $1,822.02 |
| 3962 | Continuous Home Care - Min 22 Hours | $1,838.13 | $41.36 | $9.92 | $1,889.41 | $1,908.30 |
| 3963 | Continuous Home Care - Min 23 Hours | $1,921.68 | $43.24 | $9.92 | $1,974.84 | $1,994.59 |
| 3964 | Continuous Home Care - Min 24 Hours | $2,005.23 | $45.12 | $9.92 | $2,060.27 | $2,080.87 |
| 3965 | Hospice Inpatient Respite Care Coinsurance Rate - | |||||
| 5% of 3946 | $32.80 | $0.74 | $0.50 | $34.04 | $34.38 | |
| 3966 | Drugs Coinsurance Rate | $1.00 | $0.00 | $0.00 | $1.00 | $1.01 |
| 3969 | Routine Home Care w/AIDS | $443.20 | $9.97 | $9.92 | $463.09 | $467.72 |
| 3970 | Routine Home Care w/Escort | $292.97 | $6.59 | $9.92 | $309.48 | $312.57 |
| 3971 | Continuous Home Care w/AIDS Min 8 Hours | $752.57 | $16.93 | $9.92 | $779.42 | $787.21 |
| 3972 | Continuous Home Care w/AIDS Min 9 Hours | $846.64 | $19.05 | $9.92 | $875.61 | $884.37 |
| 3973 | Continuous Home Care w/AIDS Min 10 Hours | $940.71 | $21.17 | $9.92 | $971.80 | $981.52 |
| 3974 | Continuous Home Care w/AIDS Min 11 Hours | $1,034.78 | $23.28 | $9.92 | $1,067.98 | $1,078.66 |
| 3975 | Continuous Home Care w/AIDS Min 12 Hours | $1,128.86 | $25.40 | $9.92 | $1,164.18 | $1,175.82 |
| 3976 | Continuous Home Care w/AIDS Min 13 Hours | $1,222.93 | $27.52 | $9.92 | $1,260.37 | $1,272.97 |
| 3977 | Continuous Home Care w/AIDS Min 14 Hours | $1,317.00 | $29.63 | $9.92 | $1,356.55 | $1,370.12 |
| 3978 | Continuous Home Care w/AIDS Min 15 Hours | $1,411.07 | $31.75 | $9.92 | $1,452.74 | $1,467.27 |
| 3979 | Continuous Home Care w/AIDS Min 16 Hours | $1,505.14 | $33.87 | $9.92 | $1,548.93 | $1,564.42 |
| 3980 | Continuous Home Care w/AIDS Min 17 Hours | $1,599.21 | $35.98 | $9.92 | $1,645.11 | $1,661.56 |
| 3981 | Continuous Home Care w/AIDS Min 18 Hours | $1,693.28 | $38.10 | $9.92 | $1,741.30 | $1,758.71 |
| 3982 | Continuous Home Care w/AIDS Min 19 Hours | $1,787.35 | $40.22 | $9.92 | $1,837.49 | $1,855.86 |
| 3983 | Continuous Home Care w/AIDS Min 20 Hours | $1,881.43 | $42.33 | $9.92 | $1,933.68 | $1,953.02 |
| 3984 | Continuous Home Care w/AIDS Min 21 Hours | $1,975.50 | $44.45 | $9.92 | $2,029.87 | $2,050.17 |
| 3985 | Continuous Home Care w/AIDS Min 22 Hours | $2,069.57 | $46.57 | $9.92 | $2,126.06 | $2,147.32 |
| 3986 | Continuous Home Care w/AIDS Min 23 Hours | $2,163.64 | $48.68 | $9.92 | $2,222.24 | $2,244.46 |
| 3987 | Continuous Home Care w/AIDS Min 24 Hours | $2,257.71 | $50.80 | $9.92 | $2,318.43 | $2,341.61 |
| 3988 | General Inpatient w/ AIDS | $1,574.31 | $35.42 | $9.92 | $1,619.65 | $1,635.85 |
| 3989 | Routine Home Care w/ AIDS Escort | $463.76 | $10.43 | $9.92 | $484.11 | $488.95 |
| 3991 | Service Intensity Add-on | $81.31 | $1.83 | $0.00 | $83.14 | $83.97 |
* 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 | $260.19 | $5.85 | $9.92 | $275.96 | $278.72 |
| 3946 | Inpatient Respite | $628.38 | $14.14 | $9.92 | $652.44 | $658.96 |
| 3947 | General Inpatient Care | $1,354.91 | $30.49 | $9.92 | $1,395.32 | $1,409.27 |
| 3948 | Continuous Home Care - Min 8 Hours | $635.16 | $14.29 | $9.92 | $659.37 | $665.96 |
| 3949 | Continuous Home Care - Min 9 Hours | $714.56 | $16.08 | $9.92 | $740.56 | $747.97 |
| 3950 | Continuous Home Care - Min 10 Hours | $793.95 | $17.86 | $9.92 | $821.73 | $829.95 |
| 3951 | Continuous Home Care - Min 11 Hours | $873.35 | $19.65 | $9.92 | $902.92 | $911.95 |
| 3952 | Continuous Home Care - Min 12 Hours | $952.74 | $21.44 | $9.92 | $984.10 | $993.94 |
| 3953 | Continuous Home Care - Min 13 Hours | $1,032.14 | $23.22 | $9.92 | $1,065.28 | $1,075.93 |
| 3954 | Continuous Home Care - Min 14 Hours | $1,111.53 | $25.01 | $9.92 | $1,146.46 | $1,157.92 |
| 3955 | Continuous Home Care - Min 15 Hours | $1,190.93 | $26.80 | $9.92 | $1,227.65 | $1,239.93 |
| 3956 | Continuous Home Care - Min 16 Hours | $1,270.32 | $28.58 | $9.92 | $1,308.82 | $1,321.91 |
| 3957 | Continuous Home Care - Min 17 Hours | $1,349.72 | $30.37 | $9.92 | $1,390.01 | $1,403.91 |
| 3958 | Continuous Home Care - Min 18 Hours | $1,429.11 | $32.15 | $9.92 | $1,471.18 | $1,485.89 |
| 3959 | Continuous Home Care - Min 19 Hours | $1,508.51 | $33.94 | $9.92 | $1,552.37 | $1,567.89 |
| 3960 | Continuous Home Care - Min 20 Hours | $1,587.90 | $35.73 | $9.92 | $1,633.55 | $1,649.89 |
| 3961 | Continuous Home Care - Min 21 Hours | $1,667.30 | $37.51 | $9.92 | $1,714.73 | $1,731.88 |
| 3962 | Continuous Home Care - Min 22 Hours | $1,746.69 | $39.30 | $9.92 | $1,795.91 | $1,813.87 |
| 3963 | Continuous Home Care - Min 23 Hours | $1,826.09 | $41.09 | $9.92 | $1,877.10 | $1,895.87 |
| 3964 | Continuous Home Care - Min 24 Hours | $1,905.48 | $42.87 | $9.92 | $1,958.27 | $1,977.85 |
| 3965 | Hospice Inpatient Respite Care Coinsurance Rate - | |||||
| 5% of 3946 | $31.42 | $0.71 | $0.50 | $32.63 | $32.96 | |
| 3966 | Drugs Coinsurance Rate | $1.00 | $0.00 | $0.00 | $1.00 | $1.01 |
| 3969 | Routine Home Care w/AIDS | $423.32 | $9.52 | $9.92 | $442.76 | $447.19 |
| 3970 | Routine Home Care w/Escort | $280.75 | $6.32 | $9.92 | $296.99 | $299.96 |
| 3971 | Continuous Home Care w/AIDS Min 8 Hours | $708.82 | $15.95 | $9.92 | $734.69 | $742.04 |
| 3972 | Continuous Home Care w/AIDS Min 9 Hours | $797.42 | $17.94 | $9.92 | $825.28 | $833.53 |
| 3973 | Continuous Home Care w/AIDS Min 10 Hours | $886.03 | $19.94 | $9.92 | $915.89 | $925.05 |
| 3974 | Continuous Home Care w/AIDS Min 11 Hours | $974.63 | $21.93 | $9.92 | $1,006.48 | $1,016.54 |
| 3975 | Continuous Home Care w/AIDS Min 12 Hours | $1,063.23 | $23.92 | $9.92 | $1,097.07 | $1,108.04 |
| 3976 | Continuous Home Care w/AIDS Min 13 Hours | $1,151.83 | $25.92 | $9.92 | $1,187.67 | $1,199.55 |
| 3977 | Continuous Home Care w/AIDS Min 14 Hours | $1,240.44 | $27.91 | $9.92 | $1,278.27 | $1,291.05 |
| 3978 | Continuous Home Care w/AIDS Min 15 Hours | $1,329.04 | $29.90 | $9.92 | $1,368.86 | $1,382.55 |
| 3979 | Continuous Home Care w/AIDS Min 16 Hours | $1,417.64 | $31.90 | $9.92 | $1,459.46 | $1,474.05 |
| 3980 | Continuous Home Care w/AIDS Min 17 Hours | $1,506.24 | $33.89 | $9.92 | $1,550.05 | $1,565.55 |
| 3981 | Continuous Home Care w/AIDS Min 18 Hours | $1,594.85 | $35.88 | $9.92 | $1,640.65 | $1,657.06 |
| 3982 | Continuous Home Care w/AIDS Min 19 Hours | $1,683.45 | $37.88 | $9.92 | $1,731.25 | $1,748.56 |
| 3983 | Continuous Home Care w/AIDS Min 20 Hours | $1,772.05 | $39.87 | $9.92 | $1,821.84 | $1,840.06 |
| 3984 | Continuous Home Care w/AIDS Min 21 Hours | $1,860.65 | $41.86 | $9.92 | $1,912.43 | $1,931.55 |
| 3985 | Continuous Home Care w/AIDS Min 22 Hours | $1,949.26 | $43.86 | $9.92 | $2,003.04 | $2,023.07 |
| 3986 | Continuous Home Care w/AIDS Min 23 Hours | $2,037.86 | $45.85 | $9.92 | $2,093.63 | $2,114.57 |
| 3987 | Continuous Home Care w/AIDS Min 24 Hours | $2,126.46 | $47.85 | $9.92 | $2,184.23 | $2,206.07 |
| 3988 | General Inpatient w/ AIDS | $1,505.85 | $33.88 | $9.92 | $1,549.65 | $1,565.15 |
| 3989 | Routine Home Care w/ AIDS Escort | $443.88 | $9.99 | $9.92 | $463.79 | $468.43 |
| 3991 | Service Intensity Add-on | $77.66 | $1.75 | $0.00 | $79.41 | $80.20 |
* 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 | $206.25 | $4.64 | $9.92 | $220.81 | $223.02 |
| 3946 | Inpatient Respite | $506.49 | $11.40 | $9.92 | $527.81 | $533.09 |
| 3947 | General Inpatient Care | $1,082.98 | $24.37 | $9.92 | $1,117.27 | $1,128.44 |
| 3948 | Continuous Home Care - Min 8 Hours | $488.38 | $10.99 | $9.92 | $509.29 | $514.38 |
| 3949 | Continuous Home Care - Min 9 Hours | $549.43 | $12.36 | $9.92 | $571.71 | $577.43 |
| 3950 | Continuous Home Care - Min 10 Hours | $610.48 | $13.74 | $9.92 | $634.14 | $640.48 |
| 3951 | Continuous Home Care - Min 11 Hours | $671.52 | $15.11 | $9.92 | $696.55 | $703.52 |
| 3952 | Continuous Home Care - Min 12 Hours | $732.57 | $16.48 | $9.92 | $758.97 | $766.56 |
| 3953 | Continuous Home Care - Min 13 Hours | $793.62 | $17.86 | $9.92 | $821.40 | $829.61 |
| 3954 | Continuous Home Care - Min 14 Hours | $854.67 | $19.23 | $9.92 | $883.82 | $892.66 |
| 3955 | Continuous Home Care - Min 15 Hours | $915.71 | $20.60 | $9.92 | $946.23 | $955.69 |
| 3956 | Continuous Home Care - Min 16 Hours | $976.76 | $21.98 | $9.92 | $1,008.66 | $1,018.75 |
| 3957 | Continuous Home Care - Min 17 Hours | $1,037.81 | $23.35 | $9.92 | $1,071.08 | $1,081.79 |
| 3958 | Continuous Home Care - Min 18 Hours | $1,098.86 | $24.72 | $9.92 | $1,133.50 | $1,144.84 |
| 3959 | Continuous Home Care - Min 19 Hours | $1,159.90 | $26.10 | $9.92 | $1,195.92 | $1,207.88 |
| 3960 | Continuous Home Care - Min 20 Hours | $1,220.95 | $27.47 | $9.92 | $1,258.34 | $1,270.92 |
| 3961 | Continuous Home Care - Min 21 Hours | $1,282.00 | $28.85 | $9.92 | $1,320.77 | $1,333.98 |
| 3962 | Continuous Home Care - Min 22 Hours | $1,343.05 | $30.22 | $9.92 | $1,383.19 | $1,397.02 |
| 3963 | Continuous Home Care - Min 23 Hours | $1,404.09 | $31.59 | $9.92 | $1,445.60 | $1,460.06 |
| 3964 | Continuous Home Care - Min 24 Hours | $1,465.14 | $32.97 | $9.92 | $1,508.03 | $1,523.11 |
| 3965 | Hospice Inpatient Respite Care Coinsurance Rate - | |||||
| 5% of 3946 | $25.32 | $0.57 | $0.50 | $26.39 | $26.65 | |
| 3966 | Drugs Coinsurance Rate | $1.00 | $0.00 | $0.00 | $1.00 | $1.01 |
| 3969 | Routine Home Care w/AIDS | $335.55 | $7.55 | $9.92 | $353.02 | $356.55 |
| 3970 | Routine Home Care w/Escort | $226.81 | $5.10 | $9.92 | $241.83 | $244.25 |
| 3971 | Continuous Home Care w/AIDS Min 8 Hours | $515.70 | $11.60 | $9.92 | $537.22 | $542.59 |
| 3972 | Continuous Home Care w/AIDS Min 9 Hours | $580.16 | $13.05 | $9.92 | $603.13 | $609.16 |
| 3973 | Continuous Home Care w/AIDS Min 10 Hours | $644.63 | $14.50 | $9.92 | $669.05 | $675.74 |
| 3974 | Continuous Home Care w/AIDS Min 11 Hours | $709.09 | $15.95 | $9.92 | $734.96 | $742.31 |
| 3975 | Continuous Home Care w/AIDS Min 12 Hours | $773.55 | $17.40 | $9.92 | $800.87 | $808.88 |
| 3976 | Continuous Home Care w/AIDS Min 13 Hours | $838.01 | $18.86 | $9.92 | $866.79 | $875.46 |
| 3977 | Continuous Home Care w/AIDS Min 14 Hours | $902.48 | $20.31 | $9.92 | $932.71 | $942.04 |
| 3978 | Continuous Home Care w/AIDS Min 15 Hours | $966.94 | $21.76 | $9.92 | $998.62 | $1,008.61 |
| 3979 | Continuous Home Care w/AIDS Min 16 Hours | $1,031.40 | $23.21 | $9.92 | $1,064.53 | $1,075.18 |
| 3980 | Continuous Home Care w/AIDS Min 17 Hours | $1,095.86 | $24.66 | $9.92 | $1,130.44 | $1,141.74 |
| 3981 | Continuous Home Care w/AIDS Min 18 Hours | $1,160.33 | $26.11 | $9.92 | $1,196.36 | $1,208.32 |
| 3982 | Continuous Home Care w/AIDS Min 19 Hours | $1,224.79 | $27.56 | $9.92 | $1,262.27 | $1,274.89 |
| 3983 | Continuous Home Care w/AIDS Min 20 Hours | $1,289.25 | $29.01 | $9.92 | $1,328.18 | $1,341.46 |
| 3984 | Continuous Home Care w/AIDS Min 21 Hours | $1,353.71 | $30.46 | $9.92 | $1,394.09 | $1,408.03 |
| 3985 | Continuous Home Care w/AIDS Min 22 Hours | $1,418.18 | $31.91 | $9.92 | $1,460.01 | $1,474.61 |
| 3986 | Continuous Home Care w/AIDS Min 23 Hours | $1,482.64 | $33.36 | $9.92 | $1,525.92 | $1,541.18 |
| 3987 | Continuous Home Care w/AIDS Min 24 Hours | $1,547.10 | $34.81 | $9.92 | $1,591.83 | $1,607.75 |
| 3988 | General Inpatient w/ AIDS | $1,203.62 | $27.08 | $9.92 | $1,240.62 | $1,253.03 |
| 3989 | Routine Home Care w/ AIDS Escort | $356.11 | $8.01 | $9.92 | $374.04 | $377.78 |
| 3991 | Service Intensity Add-on | $61.56 | $1.39 | $0.00 | $62.95 | $63.58 |
* 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 | $218.73 | $4.92 | $9.92 | $233.57 | $235.91 |
| 3946 | Inpatient Respite | $534.69 | $12.03 | $9.92 | $556.64 | $562.21 |
| 3947 | General Inpatient Care | $1,145.89 | $25.78 | $9.92 | $1,181.59 | $1,193.41 |
| 3948 | Continuous Home Care - Min 8 Hours | $522.34 | $11.75 | $9.92 | $544.01 | $549.45 |
| 3949 | Continuous Home Care - Min 9 Hours | $587.63 | $13.22 | $9.92 | $610.77 | $616.88 |
| 3950 | Continuous Home Care - Min 10 Hours | $652.92 | $14.69 | $9.92 | $677.53 | $684.31 |
| 3951 | Continuous Home Care - Min 11 Hours | $718.21 | $16.16 | $9.92 | $744.29 | $751.73 |
| 3952 | Continuous Home Care - Min 12 Hours | $783.51 | $17.63 | $9.92 | $811.06 | $819.17 |
| 3953 | Continuous Home Care - Min 13 Hours | $848.80 | $19.10 | $9.92 | $877.82 | $886.60 |
| 3954 | Continuous Home Care - Min 14 Hours | $914.09 | $20.57 | $9.92 | $944.58 | $954.03 |
| 3955 | Continuous Home Care - Min 15 Hours | $979.38 | $22.04 | $9.92 | $1,011.34 | $1,021.45 |
| 3956 | Continuous Home Care - Min 16 Hours | $1,044.67 | $23.51 | $9.92 | $1,078.10 | $1,088.88 |
| 3957 | Continuous Home Care - Min 17 Hours | $1,109.97 | $24.97 | $9.92 | $1,144.86 | $1,156.31 |
| 3958 | Continuous Home Care - Min 18 Hours | $1,175.26 | $26.44 | $9.92 | $1,211.62 | $1,223.74 |
| 3959 | Continuous Home Care - Min 19 Hours | $1,240.55 | $27.91 | $9.92 | $1,278.38 | $1,291.16 |
| 3960 | Continuous Home Care - Min 20 Hours | $1,305.84 | $29.38 | $9.92 | $1,345.14 | $1,358.59 |
| 3961 | Continuous Home Care - Min 21 Hours | $1,371.13 | $30.85 | $9.92 | $1,411.90 | $1,426.02 |
| 3962 | Continuous Home Care - Min 22 Hours | $1,436.43 | $32.32 | $9.92 | $1,478.67 | $1,493.46 |
| 3963 | Continuous Home Care - Min 23 Hours | $1,501.72 | $33.79 | $9.92 | $1,545.43 | $1,560.88 |
| 3964 | Continuous Home Care - Min 24 Hours | $1,567.01 | $35.26 | $9.92 | $1,612.19 | $1,628.31 |
| 3965 | Hospice Inpatient Respite Care Coinsurance Rate - | |||||
| 5% of 3946 | $26.73 | $0.60 | $0.50 | $27.83 | $28.11 | |
| 3966 | Drugs Coinsurance Rate | $1.00 | $0.00 | $0.00 | $1.00 | $1.01 |
| 3969 | Routine Home Care w/AIDS | $355.86 | $8.01 | $9.92 | $373.79 | $377.53 |
| 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 | $560.38 | $12.61 | $9.92 | $582.91 | $588.74 |
| 3972 | Continuous Home Care w/AIDS Min 9 Hours | $630.42 | $14.18 | $9.92 | $654.52 | $661.07 |
| 3973 | Continuous Home Care w/AIDS Min 10 Hours | $700.47 | $15.76 | $9.92 | $726.15 | $733.41 |
| 3974 | Continuous Home Care w/AIDS Min 11 Hours | $770.52 | $17.34 | $9.92 | $797.78 | $805.76 |
| 3975 | Continuous Home Care w/AIDS Min 12 Hours | $840.57 | $18.91 | $9.92 | $869.40 | $878.09 |
| 3976 | Continuous Home Care w/AIDS Min 13 Hours | $910.61 | $20.49 | $9.92 | $941.02 | $950.43 |
| 3977 | Continuous Home Care w/AIDS Min 14 Hours | $980.66 | $22.06 | $9.92 | $1,012.64 | $1,022.77 |
| 3978 | Continuous Home Care w/AIDS Min 15 Hours | $1,050.71 | $23.64 | $9.92 | $1,084.27 | $1,095.11 |
| 3979 | Continuous Home Care w/AIDS Min 16 Hours | $1,120.75 | $25.22 | $9.92 | $1,155.89 | $1,167.45 |
| 3980 | Continuous Home Care w/AIDS Min 17 Hours | $1,190.80 | $26.79 | $9.92 | $1,227.51 | $1,239.79 |
| 3981 | Continuous Home Care w/AIDS Min 18 Hours | $1,260.85 | $28.37 | $9.92 | $1,299.14 | $1,312.13 |
| 3982 | Continuous Home Care w/AIDS Min 19 Hours | $1,330.89 | $29.95 | $9.92 | $1,370.76 | $1,384.47 |
| 3983 | Continuous Home Care w/AIDS Min 20 Hours | $1,400.94 | $31.52 | $9.92 | $1,442.38 | $1,456.80 |
| 3984 | Continuous Home Care w/AIDS Min 21 Hours | $1,470.99 | $33.10 | $9.92 | $1,514.01 | $1,529.15 |
| 3985 | Continuous Home Care w/AIDS Min 22 Hours | $1,541.04 | $34.67 | $9.92 | $1,585.63 | $1,601.49 |
| 3986 | Continuous Home Care w/AIDS Min 23 Hours | $1,611.08 | $36.25 | $9.92 | $1,657.25 | $1,673.82 |
| 3987 | Continuous Home Care w/AIDS Min 24 Hours | $1,681.13 | $37.83 | $9.92 | $1,728.88 | $1,746.17 |
| 3988 | General Inpatient w/ AIDS | $1,273.54 | $28.65 | $9.92 | $1,312.11 | $1,325.23 |
| 3989 | Routine Home Care w/ AIDS Escort | $376.42 | $8.47 | $9.92 | $394.81 | $398.76 |
| 3991 | Service Intensity Add-on | $65.28 | $1.47 | $0.00 | $66.75 | $67.42 |
* 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 | $201.14 | $4.53 | $9.92 | $215.59 | $217.75 |
| 3946 | Inpatient Respite | $494.95 | $11.14 | $9.92 | $516.01 | $521.17 |
| 3947 | General Inpatient Care | $1,057.24 | $23.79 | $9.92 | $1,090.95 | $1,101.86 |
| 3948 | Continuous Home Care - Min 8 Hours | $474.48 | $10.68 | $9.92 | $495.08 | $500.03 |
| 3949 | Continuous Home Care - Min 9 Hours | $533.79 | $12.01 | $9.92 | $555.72 | $561.28 |
| 3950 | Continuous Home Care - Min 10 Hours | $593.10 | $13.34 | $9.92 | $616.36 | $622.52 |
| 3951 | Continuous Home Care - Min 11 Hours | $652.41 | $14.68 | $9.92 | $677.01 | $683.78 |
| 3952 | Continuous Home Care - Min 12 Hours | $711.73 | $16.01 | $9.92 | $737.66 | $745.04 |
| 3953 | Continuous Home Care - Min 13 Hours | $771.04 | $17.35 | $9.92 | $798.31 | $806.29 |
| 3954 | Continuous Home Care - Min 14 Hours | $830.35 | $18.68 | $9.92 | $858.95 | $867.54 |
| 3955 | Continuous Home Care - Min 15 Hours | $889.66 | $20.02 | $9.92 | $919.60 | $928.80 |
| 3956 | Continuous Home Care - Min 16 Hours | $948.97 | $21.35 | $9.92 | $980.24 | $990.04 |
| 3957 | Continuous Home Care - Min 17 Hours | $1,008.28 | $22.69 | $9.92 | $1,040.89 | $1,051.30 |
| 3958 | Continuous Home Care - Min 18 Hours | $1,067.59 | $24.02 | $9.92 | $1,101.53 | $1,112.55 |
| 3959 | Continuous Home Care - Min 19 Hours | $1,126.90 | $25.36 | $9.92 | $1,162.18 | $1,173.80 |
| 3960 | Continuous Home Care - Min 20 Hours | $1,186.21 | $26.69 | $9.92 | $1,222.82 | $1,235.05 |
| 3961 | Continuous Home Care - Min 21 Hours | $1,245.52 | $28.02 | $9.92 | $1,283.46 | $1,296.29 |
| 3962 | Continuous Home Care - Min 22 Hours | $1,304.83 | $29.36 | $9.92 | $1,344.11 | $1,357.55 |
| 3963 | Continuous Home Care - Min 23 Hours | $1,364.14 | $30.69 | $9.92 | $1,404.75 | $1,418.80 |
| 3964 | Continuous Home Care - Min 24 Hours | $1,423.45 | $32.03 | $9.92 | $1,465.40 | $1,480.05 |
| 3965 | Hospice Inpatient Respite Care Coinsurance Rate - | |||||
| 5% of 3946 | $24.75 | $0.56 | $0.50 | $25.81 | $26.07 | |
| 3966 | Drugs Coinsurance Rate | $1.00 | $0.00 | $0.00 | $1.00 | $1.01 |
| 3969 | Routine Home Care w/AIDS | $327.24 | $7.36 | $9.92 | $344.52 | $347.97 |
| 3970 | Routine Home Care w/Escort | $221.70 | $4.99 | $9.92 | $236.61 | $238.98 |
| 3971 | Continuous Home Care w/AIDS Min 8 Hours | $497.41 | $11.19 | $9.92 | $518.52 | $523.71 |
| 3972 | Continuous Home Care w/AIDS Min 9 Hours | $559.59 | $12.59 | $9.92 | $582.10 | $587.92 |
| 3973 | Continuous Home Care w/AIDS Min 10 Hours | $621.77 | $13.99 | $9.92 | $645.68 | $652.14 |
| 3974 | Continuous Home Care w/AIDS Min 11 Hours | $683.94 | $15.39 | $9.92 | $709.25 | $716.34 |
| 3975 | Continuous Home Care w/AIDS Min 12 Hours | $746.12 | $16.79 | $9.92 | $772.83 | $780.56 |
| 3976 | Continuous Home Care w/AIDS Min 13 Hours | $808.30 | $18.19 | $9.92 | $836.41 | $844.77 |
| 3977 | Continuous Home Care w/AIDS Min 14 Hours | $870.47 | $19.59 | $9.92 | $899.98 | $908.98 |
| 3978 | Continuous Home Care w/AIDS Min 15 Hours | $932.65 | $20.98 | $9.92 | $963.55 | $973.19 |
| 3979 | Continuous Home Care w/AIDS Min 16 Hours | $994.83 | $22.38 | $9.92 | $1,027.13 | $1,037.40 |
| 3980 | Continuous Home Care w/AIDS Min 17 Hours | $1,057.00 | $23.78 | $9.92 | $1,090.70 | $1,101.61 |
| 3981 | Continuous Home Care w/AIDS Min 18 Hours | $1,119.18 | $25.18 | $9.92 | $1,154.28 | $1,165.82 |
| 3982 | Continuous Home Care w/AIDS Min 19 Hours | $1,181.36 | $26.58 | $9.92 | $1,217.86 | $1,230.04 |
| 3983 | Continuous Home Care w/AIDS Min 20 Hours | $1,243.53 | $27.98 | $9.92 | $1,281.43 | $1,294.24 |
| 3984 | Continuous Home Care w/AIDS Min 21 Hours | $1,305.71 | $29.38 | $9.92 | $1,345.01 | $1,358.46 |
| 3985 | Continuous Home Care w/AIDS Min 22 Hours | $1,367.89 | $30.78 | $9.92 | $1,408.59 | $1,422.68 |
| 3986 | Continuous Home Care w/AIDS Min 23 Hours | $1,430.06 | $32.18 | $9.92 | $1,472.16 | $1,486.88 |
| 3987 | Continuous Home Care w/AIDS Min 24 Hours | $1,492.24 | $33.58 | $9.92 | $1,535.74 | $1,551.10 |
| 3988 | General Inpatient w/ AIDS | $1,175.02 | $26.44 | $9.92 | $1,211.38 | $1,223.49 |
| 3989 | Routine Home Care w/ AIDS Escort | $347.80 | $7.83 | $9.92 | $365.55 | $369.21 |
| 3991 | Service Intensity Add-on | $60.03 | $1.35 | $0.00 | $61.38 | $61.99 |
* 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 | $196.62 | $4.42 | $9.92 | $210.96 | $213.07 |
| 3946 | Inpatient Respite | $484.75 | $10.91 | $9.92 | $505.58 | $510.64 |
| 3947 | General Inpatient Care | $1,034.47 | $23.28 | $9.92 | $1,067.67 | $1,078.35 |
| 3948 | Continuous Home Care - Min 8 Hours | $462.20 | $10.40 | $9.92 | $482.52 | $487.35 |
| 3949 | Continuous Home Care - Min 9 Hours | $519.97 | $11.70 | $9.92 | $541.59 | $547.01 |
| 3950 | Continuous Home Care - Min 10 Hours | $577.75 | $13.00 | $9.92 | $600.67 | $606.68 |
| 3951 | Continuous Home Care - Min 11 Hours | $635.52 | $14.30 | $9.92 | $659.74 | $666.34 |
| 3952 | Continuous Home Care - Min 12 Hours | $693.30 | $15.60 | $9.92 | $718.82 | $726.01 |
| 3953 | Continuous Home Care - Min 13 Hours | $751.07 | $16.90 | $9.92 | $777.89 | $785.67 |
| 3954 | Continuous Home Care - Min 14 Hours | $808.84 | $18.20 | $9.92 | $836.96 | $845.33 |
| 3955 | Continuous Home Care - Min 15 Hours | $866.62 | $19.50 | $9.92 | $896.04 | $905.00 |
| 3956 | Continuous Home Care - Min 16 Hours | $924.39 | $20.80 | $9.92 | $955.11 | $964.66 |
| 3957 | Continuous Home Care - Min 17 Hours | $982.17 | $22.10 | $9.92 | $1,014.19 | $1,024.33 |
| 3958 | Continuous Home Care - Min 18 Hours | $1,039.94 | $23.40 | $9.92 | $1,073.26 | $1,083.99 |
| 3959 | Continuous Home Care - Min 19 Hours | $1,097.72 | $24.70 | $9.92 | $1,132.34 | $1,143.66 |
| 3960 | Continuous Home Care - Min 20 Hours | $1,155.49 | $26.00 | $9.92 | $1,191.41 | $1,203.32 |
| 3961 | Continuous Home Care - Min 21 Hours | $1,213.27 | $27.30 | $9.92 | $1,250.49 | $1,262.99 |
| 3962 | Continuous Home Care - Min 22 Hours | $1,271.04 | $28.60 | $9.92 | $1,309.56 | $1,322.66 |
| 3963 | Continuous Home Care - Min 23 Hours | $1,328.82 | $29.90 | $9.92 | $1,368.64 | $1,382.33 |
| 3964 | Continuous Home Care - Min 24 Hours | $1,386.59 | $31.20 | $9.92 | $1,427.71 | $1,441.99 |
| 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 | $319.90 | $7.20 | $9.92 | $337.02 | $340.39 |
| 3970 | Routine Home Care w/Escort | $217.18 | $4.89 | $9.92 | $231.99 | $234.31 |
| 3971 | Continuous Home Care w/AIDS Min 8 Hours | $481.25 | $10.83 | $9.92 | $502.00 | $507.02 |
| 3972 | Continuous Home Care w/AIDS Min 9 Hours | $541.40 | $12.18 | $9.92 | $563.50 | $569.14 |
| 3973 | Continuous Home Care w/AIDS Min 10 Hours | $601.56 | $13.54 | $9.92 | $625.02 | $631.27 |
| 3974 | Continuous Home Care w/AIDS Min 11 Hours | $661.71 | $14.89 | $9.92 | $686.52 | $693.39 |
| 3975 | Continuous Home Care w/AIDS Min 12 Hours | $721.87 | $16.24 | $9.92 | $748.03 | $755.51 |
| 3976 | Continuous Home Care w/AIDS Min 13 Hours | $782.03 | $17.60 | $9.92 | $809.55 | $817.65 |
| 3977 | Continuous Home Care w/AIDS Min 14 Hours | $842.18 | $18.95 | $9.92 | $871.05 | $879.76 |
| 3978 | Continuous Home Care w/AIDS Min 15 Hours | $902.34 | $20.30 | $9.92 | $932.56 | $941.89 |
| 3979 | Continuous Home Care w/AIDS Min 16 Hours | $962.49 | $21.66 | $9.92 | $994.07 | $1,004.01 |
| 3980 | Continuous Home Care w/AIDS Min 17 Hours | $1,022.65 | $23.01 | $9.92 | $1,055.58 | $1,066.14 |
| 3981 | Continuous Home Care w/AIDS Min 18 Hours | $1,082.81 | $24.36 | $9.92 | $1,117.09 | $1,128.26 |
| 3982 | Continuous Home Care w/AIDS Min 19 Hours | $1,142.96 | $25.72 | $9.92 | $1,178.60 | $1,190.39 |
| 3983 | Continuous Home Care w/AIDS Min 20 Hours | $1,203.12 | $27.07 | $9.92 | $1,240.11 | $1,252.51 |
| 3984 | Continuous Home Care w/AIDS Min 21 Hours | $1,263.27 | $28.42 | $9.92 | $1,301.61 | $1,314.63 |
| 3985 | Continuous Home Care w/AIDS Min 22 Hours | $1,323.43 | $29.78 | $9.92 | $1,363.13 | $1,376.76 |
| 3986 | Continuous Home Care w/AIDS Min 23 Hours | $1,383.58 | $31.13 | $9.92 | $1,424.63 | $1,438.88 |
| 3987 | Continuous Home Care w/AIDS Min 24 Hours | $1,443.74 | $32.48 | $9.92 | $1,486.14 | $1,501.00 |
| 3988 | General Inpatient w/ AIDS | $1,149.71 | $25.87 | $9.92 | $1,185.50 | $1,197.36 |
| 3989 | Routine Home Care w/ AIDS Escort | $340.46 | $7.66 | $9.92 | $358.04 | $361.62 |
| 3991 | Service Intensity Add-on | $58.69 | $1.32 | $0.00 | $60.01 | $60.61 |
* WRR ='Worker Recruitment and Retention addon' if applicable
* RTR ='Recruitment, Training and Retention addon' if applicable
