INPATIENT EXEMPT UNIT RATES EFFECTIVE 1/1/2015 - 12/31/2015 (MA HMO ONLY)
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| MEDICAID MANAGED CARE PUB | ||||||
|---|---|---|---|---|---|---|
| (1) | (2) | (3) | (4) | (5) | ||
| PSYCHIATRIC | ||||||
| PSYCHIATRIC OPERATING BILLING RATE | PSYCHIATRIC NON-OPERATING BILLING RATE w/out DME |
*Informational Only* PSYCHIATRIC DME Add-on |
PSYCHIATRIC ECT PAYMENT | PSYCHIATRIC ALC PER DIEM | ||
| OPCERT | HOSPITAL NAME | |||||
| 1623001 | ADIRONDACK MEDICAL CENTER | $716.31 | $41.79 | $0.00 | $231.32 | $187.52 |
| 0101000 | ALBANY MEDICAL CTR HOSP | $614.25 | $73.60 | $29.80 | $244.16 | $187.52 |
| 0501000 | AUBURN COMMUNITY HOSPITAL | $750.25 | $29.34 | $0.00 | $242.28 | $187.52 |
| 7002001 | BELLEVUE HOSPITAL CENTER | $657.63 | $37.90 | $129.33 | $287.55 | $254.96 |
| 3535001 | BON SECOURS COMMUNITY HOSP | $589.64 | $34.22 | $0.00 | $257.82 | $187.52 |
| 7000001 | BRONX-LEBANON HOSPITAL CTR | $684.30 | $65.32 | $187.61 | $299.21 | $254.96 |
| 7001002 | BROOKDALE HOSPITAL MED CTR | $673.25 | $41.02 | $86.84 | $294.38 | $254.96 |
| 5123000 | BROOKHAVEN MEMORIAL HOSP | $654.42 | $35.14 | $0.00 | $286.14 | $254.96 |
| 5263000 | CATSKILL REGIONAL MED CTR | $796.11 | $22.41 | $0.00 | $257.09 | $187.52 |
| 5401001 | CAYUGA MEDICAL CENTER | $766.78 | $39.82 | $0.00 | $247.62 | $187.52 |
| 0901001 | CHAMPLAIN VALLEY PHYS | $731.19 | $63.36 | $0.00 | $236.12 | $187.52 |
| 4401000 | CLAXTON-HEPBURN MED CTR | $669.32 | $45.34 | $0.00 | $216.15 | $187.52 |
| 3421000 | CLIFTON SPRINGS HOSPITAL | $604.58 | $18.93 | $0.00 | $195.24 | $187.52 |
| 1001000 | COLUMBIA MEMORIAL HOSPITAL | $713.96 | $23.17 | $0.00 | $230.56 | $187.52 |
| 7001009 | CONEY ISLAND HOSPITAL | $649.73 | $54.53 | $116.79 | $284.09 | $254.96 |
| 1101000 | CORTLAND REGIONAL MED CTR | $698.73 | $107.55 | $0.00 | $225.64 | $187.52 |
| 5127000 | EASTERN LONG ISLAND HOSPITAL | $636.49 | $37.47 | $0.00 | $278.30 | $254.96 |
| 3101000 | EASTERN NIAGARA HOSPITAL | $571.41 | $8.46 | $0.00 | $227.13 | $187.52 |
| 4601001 | ELLIS HOSPITAL | $593.89 | $46.08 | $0.81 | $236.07 | $187.52 |
| 7003000 | ELMHURST HOSPITAL CTR | $691.69 | $49.86 | $257.88 | $302.44 | $254.96 |
| 1401005 | ERIE COUNTY MEDICAL CENTER | $651.64 | $38.15 | $35.05 | $259.03 | $187.52 |
| 3202003 | FAXTON-ST LUKES HEALTHCARE | $722.92 | $60.66 | $0.03 | $233.45 | $187.52 |
| 7003001 | FLUSHING HOSPITAL | $664.00 | $54.84 | $108.17 | $290.33 | $254.96 |
| 2910000 | FRANKLIN HOSPITAL | $631.67 | $41.49 | $0.08 | $276.19 | $254.96 |
| 2901000 | GLEN COVE HOSPITAL | $725.43 | $46.92 | $0.51 | $317.19 | $254.96 |
| 5601000 | GLENS FALLS HOSPITAL | $709.00 | $67.73 | $0.00 | $228.96 | $187.52 |
| 7002009 | HARLEM HOSPITAL CENTER | $675.37 | $115.74 | $212.95 | $295.30 | $254.96 |
| 5501000 | HEALTHALLIANCE HOSP MARYS AVE CAMPUS | $759.30 | $30.72 | $0.00 | $245.20 | $187.52 |
| 5153000 | HUNTINGTON HOSPITAL | $679.93 | $62.45 | $0.05 | $297.30 | $254.96 |
| 7001046 | INTERFAITH MEDICAL CENTER | $677.24 | $67.65 | $0.73 | $296.12 | $254.96 |
| 7000002 | JACOBI MEDICAL CENTER | $712.90 | $156.18 | $98.71 | $311.71 | $254.96 |
| 7003003 | JAMAICA HOSPITAL | $722.41 | $21.78 | $215.50 | $315.87 | $254.96 |
| 5149000 | JOHN T MATHER MEMORIAL HOSP | $661.04 | $66.97 | $0.00 | $289.04 | $254.96 |
| 7001016 | KINGS COUNTY HOSPITAL CENTER | $651.98 | $169.70 | $159.72 | $285.07 | $254.96 |
| 7001033 | KINGSBROOK JEWISH MED CTR | $737.90 | $25.25 | $23.66 | $322.64 | $254.96 |
| 7002017 | LENOX HILL HOSPITAL | $668.82 | $160.87 | $88.11 | $292.44 | $254.96 |
| 7000008 | LINCOLN MEDICAL | $663.29 | $51.12 | $236.99 | $290.02 | $254.96 |
| 7003004 | LONG ISLAND JEWISH | $699.34 | $62.43 | $73.43 | $305.78 | $254.96 |
| 7001019 | LUTHERAN MEDICAL CENTER | $653.71 | $36.14 | $65.98 | $285.83 | $254.96 |
| 7001020 | MAIMONIDES MEDICAL CENTER | $765.02 | $60.90 | $39.56 | $334.50 | $254.96 |
| 3824000 | MARY IMOGENE BASSETT HOSP | $655.92 | $45.83 | $6.41 | $211.82 | $187.52 |
| 2909000 | MERCY MEDICAL CENTER | $653.39 | $35.49 | $2.31 | $285.69 | $254.96 |
| 7002021 | METROPOLITAN HOSPITAL CENTER | $656.22 | $24.82 | $267.98 | $286.93 | $254.96 |
| 1302000 | MID-HUDSON VALLEY DIV OF WMC | $555.26 | $78.06 | $0.00 | $242.78 | $187.52 |
| 7000006 | MONTEFIORE MEDICAL CENTER | $721.64 | $57.82 | $538.26 | $315.53 | $254.96 |
| 5903001 | MONTEFIORE MOUNT VERNON HOSP | $678.01 | $28.63 | $0.06 | $296.46 | $254.96 |
| 7002002 | MOUNT SINAI BETH ISRAEL | $726.46 | $125.20 | $180.18 | $317.64 | $254.96 |
| 7002024 | MOUNT SINAI HOSPITAL | $720.16 | $145.99 | $78.95 | $314.89 | $254.96 |
| 7002032 | MOUNT SINAI ST LUKES / ROOSEVELT | $782.82 | $76.83 | $44.74 | $342.29 | $254.96 |
| 2950002 | NASSAU UNIV MED CTR | $727.75 | $32.62 | $22.76 | $318.20 | $254.96 |
| 5820000 | NEWARK-WAYNE COMMUNITY HOSP | $672.98 | $22.02 | $0.00 | $217.33 | $187.52 |
| 3102000 | NIAGARA FALLS MEMORIAL | $549.14 | $36.24 | $1.83 | $218.28 | $187.52 |
| 7000024 | NORTH CENTRAL BRONX HOSPITAL | $733.15 | $28.37 | $111.34 | $320.56 | $254.96 |
| 2951001 | NORTH SHORE UNIVERSITY HOSP | $746.58 | $51.30 | $469.17 | $326.44 | $254.96 |
| 5920000 | NORTHERN WESTCHESTER HOSP | $650.11 | $83.26 | $0.00 | $284.26 | $254.96 |
| 7001021 | NY METHODIST HOSP / BROOKLYN | $686.55 | $70.21 | $81.23 | $300.19 | $254.96 |
| 7002054 | NY PRESBYTERIAN HOSPITAL | $718.75 | $81.98 | $66.56 | $314.27 | $254.96 |
| 4324000 | NYACK HOSPITAL | $626.59 | $15.91 | $0.00 | $273.98 | $254.96 |
| 7002053 | NYU HOSPITALS CENTER | $687.71 | $186.32 | $391.91 | $300.70 | $254.96 |
| 0401001 | OLEAN GENERAL HOSPITAL | $668.37 | $45.36 | $0.00 | $215.84 | $187.52 |
| 3523000 | ORANGE REGIONAL MED CTR | $639.96 | $150.22 | $0.00 | $279.82 | $187.52 |
| 3702000 | OSWEGO HOSPITAL | $716.05 | $52.05 | $0.00 | $231.23 | $187.52 |
| 5932000 | PHELPS MEMORIAL HOSP | $642.66 | $77.99 | $0.00 | $281.00 | $254.96 |
| 3950000 | PUTNAM COMMUNITY HOSPITAL | $659.18 | $61.61 | $0.00 | $288.22 | $187.52 |
| 7003007 | QUEENS HOSPITAL CENTER | $732.50 | $65.66 | $215.88 | $320.28 | $254.96 |
| 7004010 | RICHMOND UNIV MED CTR | $642.53 | $19.64 | $8.99 | $280.94 | $254.96 |
| 2701003 | ROCHESTER GENERAL HOSPITAL | $600.25 | $59.70 | $1.17 | $238.60 | $187.52 |
| 3201002 | ROME MEMORIAL HOSPITAL | $670.63 | $14.88 | $0.00 | $216.57 | $187.52 |
| 4102002 | SAMARITAN HOSPITAL OF TROY | $562.08 | $21.21 | $0.00 | $223.42 | $187.52 |
| 2201000 | SAMARITAN MEDICAL CENTER | $734.76 | $42.57 | $0.29 | $237.28 | $187.52 |
| 4501000 | SARATOGA HOSPITAL | $588.30 | $65.00 | $0.00 | $233.85 | $187.52 |
| 6120700 | SOLDIERS AND SAILORS MEM HOSP | $583.35 | $56.51 | $0.00 | $188.38 | $187.52 |
| 2950001 | SOUTH NASSAU COMMUNITIES | $619.01 | $120.63 | $0.66 | $270.66 | $254.96 |
| 5154000 | SOUTHSIDE HOSPITAL | $672.74 | $53.25 | $0.07 | $294.15 | $254.96 |
| 7000014 | ST BARNABAS HOSPITAL | $659.82 | $74.61 | $23.69 | $288.50 | $254.96 |
| 5157003 | ST CATHERINE OF SIENA | $679.87 | $58.48 | $0.00 | $297.27 | $254.96 |
| 3202002 | ST ELIZABETH MEDICAL CENTER | $730.15 | $27.40 | $0.15 | $235.79 | $187.52 |
| 7001024 | ST JOHNS EPISCOPAL SO SHORE | $767.14 | $45.38 | $85.53 | $335.43 | $254.96 |
| 0701001 | ST JOSEPHS HOSP / ELMIRA | $646.44 | $10.95 | $0.00 | $208.75 | $187.52 |
| 3301003 | ST JOSEPHS HOSP HLTH CTR | $624.64 | $59.31 | $0.23 | $248.29 | $187.52 |
| 5907002 | ST JOSEPHS MEDICAL CENTER | $658.41 | $26.63 | $29.74 | $287.88 | $254.96 |
| 2801001 | ST MARYS HOSP / AMSTERDAM | $657.49 | $20.80 | $0.00 | $212.32 | $187.52 |
| 7001037 | STATE UNIV HOSP / DOWNSTATE | $701.08 | $109.45 | $165.42 | $306.54 | $254.96 |
| 7004003 | STATEN ISLAND UNIV HOSP | $654.10 | $67.12 | $61.53 | $286.00 | $254.96 |
| 2701005 | STRONG MEMORIAL HOSPITAL | $635.95 | $75.33 | $34.21 | $252.79 | $187.52 |
| 2754001 | THE UNITY HOSP OF ROCHESTER | $548.01 | $56.04 | $1.01 | $217.83 | $187.52 |
| 0427000 | TLC HEALTH NETWORK | $593.79 | $41.03 | $0.00 | $191.75 | $187.52 |
| 0303001 | UNITED HEALTH SERVICES INC | $599.76 | $39.91 | $0.76 | $238.40 | $187.52 |
| 5151001 | UNIV HOSP AT STONY BROOK | $659.18 | $46.99 | $112.48 | $288.22 | $254.96 |
| 3301007 | UNIV HOSP SUNY HLTH SCI CTR | $649.24 | $36.33 | $121.77 | $258.07 | $187.52 |
| 3301003 | UPSTATE UNIV HOSP/COMM GEN | $654.90 | $36.33 | $0.00 | $260.32 | $187.52 |
| 5957001 | WESTCHESTER MEDICAL CENTER | $732.18 | $78.06 | $99.94 | $320.14 | $254.96 |
| 0602001 | WOMANS CHRISTIAN ASSOC | $645.31 | $28.82 | $0.00 | $208.39 | $187.52 |
| 7001045 | WOODHULL MEDICAL | $653.91 | $37.10 | $72.58 | $285.92 | $254.96 |
| 6027000 | WYOMING CO COMMUNITY HOSP | $675.15 | $48.50 | $0.00 | $218.03 | $187.52 |
