OASAS CERTIFIED INPATIENT CHEMICAL DEPENDENCY DETOX PER DIEM RATES

Effective 1/1/2014 - 12/31/2014

WORKERS' COMPENSATION - NO FAULT RATE SCHEDULE

OPCERT HOSPITAL NAME MMD w or w/o OBS days
(operating cost)		 MSIW w/o OBS days
(operating cost)		 MSIW w 1 OBS day
(operating cost)		 MSIW w 2 OBS days
(operating cost)		 Detox Capital Cost
(4800) (4801) (4802) (4803) (4804)
7002001 BELLEVUE HOSPITAL CENTER $1,911.58 $1,433.69 $1,433.69 $1,433.69 $76.67
7002002 BETH ISRAEL MEDICAL CENTER $1,911.58 $1,433.69 $1,433.69 $1,433.69 $84.10
3535001 BON SECOURS COMMUNITY HOSP $1,619.76 $1,214.82 $1,214.82 $1,214.82 $24.29
7000001 BRONX-LEBANON HOSPITAL CTR $1,911.58 $1,433.69 $1,433.69 $1,433.69 $84.52
7001003 BROOKLYN HOSPITAL $1,911.58 $1,433.69 $1,433.69 $1,433.69 $92.14
4429000 CANTON-POTSDAM HOSPITAL $1,764.40 $1,323.30 $1,323.30 $1,323.30 $54.60
7001009 CONEY ISLAND HOSPITAL $1,911.58 $1,433.69 $1,433.69 $1,433.69 $84.15
5127000 EASTERN LONG ISLAND HOSPITAL $1,514.14 $1,135.61 $1,135.61 $1,135.61 $51.35
1401005 ERIE COUNTY MEDICAL CENTER $1,782.01 $1,336.51 $1,336.51 $1,336.51 $38.55
7003001 FLUSHING HOSPITAL MED CTR $1,911.58 $1,433.69 $1,433.69 $1,433.69 $24.02
4329000 GOOD SAMARITAN / SUFFERN $1,619.76 $1,214.82 $1,214.82 $1,214.82 $46.42
7002009 HARLEM HOSPITAL CENTER $1,911.58 $1,433.69 $1,433.69 $1,433.69 $61.20
5501000 HEALTHALLIANCE HOSP MARYS AVE CAMPUS $1,619.76 $1,214.82 $1,214.82 $1,214.82 $20.71
7001046 INTERFAITH MEDICAL CENTER $1,911.58 $1,433.69 $1,433.69 $1,433.69 $38.23
7000002 JACOBI MEDICAL CENTER $1,911.58 $1,433.69 $1,433.69 $1,433.69 $93.87
7001016 KINGS COUNTY HOSPITAL CENTER $1,911.58 $1,433.69 $1,433.69 $1,433.69 $462.61
2902000 LONG BEACH MEDICAL CENTER $1,514.14 $1,135.61 $1,135.61 $1,135.61 $17.01
7001019 LUTHERAN MEDICAL CENTER $1,911.58 $1,433.69 $1,433.69 $1,433.69 $61.22
7002021 METROPOLITAN HOSPITAL CENTER $1,911.58 $1,433.69 $1,433.69 $1,433.69 $24.61
7000006 MONTEFIORE NORTH DIVISION (OLM) $1,911.58 $1,433.69 $1,433.69 $1,433.69 $67.41
2950002 NASSAU UNIV MED CTR $1,514.14 $1,135.61 $1,135.61 $1,135.61 $30.54
4324000 NYACK HOSPITAL $1,619.76 $1,214.82 $1,214.82 $1,214.82 $37.02
4102003 SETON HEALTH SYSTEMS $1,117.66 $838.25 $838.25 $838.25 $15.63
7000014 ST BARNABAS HOSPITAL $1,911.58 $1,433.69 $1,433.69 $1,433.69 $82.69
1302000 ST FRANCIS HOSP / POUGH $1,619.76 $1,214.82 $1,214.82 $1,214.82 $108.27
7001024 ST JOHNS EPISCOPAL SO SHORE $1,911.58 $1,433.69 $1,433.69 $1,433.69 $0.00
5907001 ST JOHNS RIVERSIDE HOSPITAL $1,619.76 $1,214.82 $1,214.82 $1,214.82 $16.16
7002032 ST LUKES / ROOSEVELT HOSP $1,911.58 $1,433.69 $1,433.69 $1,433.69 $313.57
0101004 ST PETERS HOSPITAL $1,117.66 $838.25 $838.25 $838.25 $67.92
7004003 STATEN ISLAND UNIV HOSP $1,911.58 $1,433.69 $1,433.69 $1,433.69 $56.08
7001045 WOODHULL MEDICAL $1,911.58 $1,433.69 $1,433.69 $1,433.69 $33.52

MMD = Medicaly Managed Detox
MSIW = Medicaly Supervised Inpatient Withdrawal
OBS = Observation