Schedule of Workers' Compensation/No-Fault (WCNF)

INPATIENT EXEMPT UNIT RATES EFFECTIVE 4/1/2011 - 12/31/2011 (WCNF ONLY)

WCNF PUB
(1) (2) (3) (4)
PSYCHIATRIC
OPCERT HOSPITAL NAME PSYCHIATRIC
OPERATING
BILLING RATE
PSYCHIATRIC
NON-OPERATING
BILLING RATE
PSYCHIATRIC
ECT
PAYMENT
PSYCHIATRIC
ALC
PER DIEM
1623001 ADIRONDACK MEDICAL CENTER $637.58 $61.91 $231.32 $176.41
0101000 ALBANY MEDICAL CTR HOSP $546.74 $82.01 $244.16 $176.41
0501000 AUBURN MEMORIAL HOSPITAL $667.79 $43.73 $242.28 $176.41
7002001 BELLEVUE HOSPITAL CENTER $643.89 $201.28 $287.55 $268.30
5501000 BENEDICTINE HOSPITAL $675.85 $18.27 $245.20 $176.41
7002002 BETH ISRAEL MEDICAL CENTER $711.28 $275.34 $317.64 $268.30
3535001 BON SECOURS COMMUNITY HOSP $577.32 $17.18 $257.82 $176.41
7000001 BRONX-LEBANON HOSPITAL CTR $670.00 $243.82 $299.21 $268.30
7001002 BROOKDALE HOSPITAL MED CTR $659.18 $124.82 $294.38 $268.30
5123000 BROOKHAVEN MEMORIAL HOSP $640.74 $32.56 $286.14 $268.30
5263000 CATSKILL REGIONAL MED CTR $708.61 $24.83 $257.09 $176.41
5401001 CAYUGA MEDICAL CENTER $682.51 $41.19 $247.62 $176.41
0901001 CHAMPLAIN VALLEY PHYS $650.83 $50.83 $236.12 $176.41
4401000 CLAXTON-HEPBURN MED CTR $595.76 $23.85 $216.15 $176.41
3421000 CLIFTON SPRINGS HOSPITAL $437.19 $29.78 $195.24 $176.41
1001000 COLUMBIA MEMORIAL HOSPITAL $635.49 $28.62 $230.56 $176.41
3301003 COMMUNITY-GEN/GTR SYRACUSE $582.92 $22.01 $260.32 $176.41
7001009 CONEY ISLAND HOSPITAL $636.15 $165.42 $284.09 $268.30
1101000 CORTLAND REGIONAL MED CTR $621.94 $107.89 $225.64 $176.41
5127000 EASTERN LONG ISLAND HOSPITAL $623.19 $79.65 $278.30 $268.30
4601001 ELLIS HOSPITAL $528.62 $48.64 $236.07 $176.41
7003000 ELMHURST HOSPITAL CTR $677.24 $333.33 $302.44 $268.30
1401005 ERIE COUNTY MEDICAL CENTER $580.02 $78.16 $259.03 $176.41
3202003 FAXTON-ST LUKES HEALTHCARE $643.47 $45.71 $233.45 $176.41
7003001 FLUSHING HOSPITAL $650.12 $141.20 $290.33 $268.30
2910000 FRANKLIN HOSPITAL $618.47 $42.53 $276.19 $268.30
2901000 GLEN COVE HOSPITAL $710.27 $46.96 $317.19 $268.30
5601000 GLENS FALLS HOSPITAL $631.08 $48.68 $228.96 $176.41
7002009 HARLEM HOSPITAL CENTER $661.26 $251.14 $295.30 $268.30
5153000 HUNTINGTON HOSPITAL $665.73 $54.73 $297.30 $268.30
7001046 INTERFAITH MEDICAL CENTER $663.08 $95.59 $296.12 $268.30
7000002 JACOBI MEDICAL CENTER $698.00 $229.70 $311.71 $268.30
7003003 JAMAICA HOSPITAL $707.32 $250.43 $315.87 $268.30
5149000 JOHN T MATHER MEMORIAL HOSP $647.23 $43.55 $289.04 $268.30
1401014 KALEIDA HEALTH $583.55 $66.34 $260.60 $176.41
7001016 KINGS COUNTY HOSPITAL CENTER $638.35 $318.04 $285.07 $268.30
7001033 KINGSBROOK JEWISH MED CTR $722.48 $53.61 $322.64 $268.30
7002017 LENOX HILL HOSPITAL $654.84 $171.80 $292.44 $268.30
7000008 LINCOLN MEDICAL $649.43 $283.15 $290.02 $268.30
2902000 LONG BEACH MEDICAL CENTER $568.32 $77.24 $253.80 $268.30
7001017 LONG ISLAND COLLEGE HOSPITAL $650.18 $194.87 $290.36 $268.30
7003004 LONG ISLAND JEWISH $684.73 $127.13 $305.78 $268.30
7001019 LUTHERAN MEDICAL CENTER $640.05 $98.13 $285.83 $268.30
7001020 MAIMONIDES MEDICAL CENTER $749.04 $96.17 $334.50 $268.30
3824000 MARY IMOGENE BASSETT HOSP $583.83 $26.66 $211.82 $176.41
3622000 MEDINA MEMORIAL HOSPITAL $501.04 $0.00 $181.78 $176.41
2909000 MERCY MEDICAL CENTER $639.74 $44.13 $285.69 $268.30
7002021 METROPOLITAN HOSPITAL CENTER $642.51 $312.86 $286.93 $268.30
7000006 MONTEFIORE MEDICAL CENTER $706.56 $581.89 $315.53 $268.30
7002024 MOUNT SINAI HOSPITAL $705.12 $164.07 $314.89 $268.30
5903000 MOUNT VERNON HOSPITAL $663.84 $15.06 $296.46 $268.30
2950002 NASSAU UNIV MED CTR $712.54 $54.75 $318.20 $268.30
3102000 NIAGARA FALLS MEMORIAL $488.79 $32.41 $218.28 $176.41
7000024 NORTH CENTRAL BRONX HOSPITAL $717.83 $153.30 $320.56 $268.30
2951001 NORTH SHORE UNIVERSITY HOSP $730.98 $535.59 $326.44 $268.30
5920000 NORTHERN WESTCHESTER HOSP $636.53 $93.55 $284.26 $268.30
7001021 NY METHODIST HOSP / BROOKLYN $672.21 $150.61 $300.19 $268.30
7002054 NY PRESBYTERIAN HOSPITAL $703.73 $158.97 $314.27 $268.30
7002053 NYU HOSPITALS CENTER $673.34 $513.24 $300.70 $268.30
0401001 OLEAN GENERAL HOSPITAL $594.91 $50.63 $215.84 $176.41
3523000 ORANGE REGIONAL MED CTR $626.59 $55.50 $279.82 $176.41
3702000 OSWEGO HOSPITAL $637.35 $70.43 $231.23 $176.41
5932000 PHELPS MEMORIAL HOSP $629.23 $90.08 $281.00 $268.30
3950000 PUTNAM COMMUNITY HOSPITAL $645.40 $41.24 $288.22 $176.41
7003007 QUEENS HOSPITAL CENTER $717.20 $305.34 $320.28 $268.30
7004010 RICHMOND UNIV MED CTR $629.10 $48.20 $280.94 $268.30
2701003 ROCHESTER GENERAL HOSPITAL $534.28 $51.11 $238.60 $176.41
3201002 ROME MEMORIAL HOSPITAL $484.95 $28.78 $216.57 $176.41
4102002 SAMARITAN HOSPITAL OF TROY $500.30 $31.29 $223.42 $176.41
2201000 SAMARITAN MEDICAL CENTER $654.00 $33.42 $237.28 $176.41
4501000 SARATOGA HOSPITAL $523.65 $67.81 $233.85 $176.41
6120700 SOLDIERS AND SAILORS MEM HOSP $519.24 $24.73 $188.38 $176.41
2950001 SOUTH NASSAU COMMUNITIES $606.07 $83.93 $270.66 $268.30
5154000 SOUTHSIDE HOSPITAL $658.68 $45.60 $294.15 $268.30
7000014 ST BARNABAS HOSPITAL $646.03 $88.70 $288.50 $268.30
5157003 ST CATHERINE OF SIENA $665.66 $46.15 $297.27 $268.30
3202002 ST ELIZABETH MEDICAL CENTER $527.99 $26.36 $235.79 $176.41
1302000 ST FRANCIS HOSP / POUGH $543.65 $103.77 $242.78 $176.41
5002001 ST JAMES MERCY HOSPITAL $511.96 $29.91 $185.74 $176.41
7001024 ST JOHNS EPISCOPAL SO SHORE $751.11 $113.56 $335.43 $268.30
0701001 ST JOSEPHS HOSP / ELMIRA $467.45 $11.40 $208.75 $176.41
3301003 ST JOSEPHS HOSP HLTH CTR $555.99 $27.30 $248.29 $176.41
5907002 ST JOSEPHS MEDICAL CENTER $644.65 $43.15 $287.88 $268.30
7002032 ST LUKES / ROOSEVELT HOSP $766.47 $99.36 $342.29 $268.30
2801001 ST MARYS HOSP / AMSTERDAM $585.23 $23.94 $212.32 $176.41
7001037 STATE UNIV HOSP / DOWNSTATE $686.43 $231.14 $306.54 $268.30
7004003 STATEN ISLAND UNIV HOSP $640.43 $127.30 $286.00 $268.30
2701005 STRONG MEMORIAL HOSPITAL $566.06 $104.11 $252.79 $176.41
4353000 SUMMIT PARK HOSPITAL $621.87 $9.32 $277.71 $268.30
2754001 THE UNITY HOSP OF ROCHESTER $487.78 $35.92 $217.83 $176.41
0427000 TLC HEALTH NETWORK $528.53 $24.52 $191.75 $176.41
0303001 UNITED HEALTH SERVICES INC $533.84 $29.99 $238.40 $176.41
5151001 UNIV HOSP AT STONY BROOK $645.40 $191.76 $288.22 $268.30
3301007 UNIV HOSP SUNY HLTH SCI CTR $577.88 $176.51 $258.07 $176.41
5820000 WAYNE HEALTH CARE $486.65 $27.76 $217.33 $176.41
5957001 WESTCHESTER MEDICAL CENTER $716.88 $145.84 $320.14 $268.30
0602001 WOMANS CHRISTIAN ASSOC $574.38 $26.18 $208.39 $176.41
7001045 WOODHULL MEDICAL $640.24 $123.42 $285.92 $268.30
6027000 WYOMING CO COMMUNITY HOSP $600.95 $35.45 $218.03 $176.41