Episodic Payment System for Certified Home Health Agencies

Statewide Weighted Average Rates
Associated with CHHA Revenue Codes

Effective October 1, 2015

These rates will be used to determine "Total Service Price" for LUPA and Outlier calculations

Revenue Code Service Description Weighted Average Rate
0551 Nursing - Visit $153.85
0421 Physical Therapy - Visit $122.10
0441 Speech Pathology - Visit $125.71
0431 Occupational Therapy - Visit $121.54
0572 Home Health Aide - Hour $21.54
0579 Shared Aide - Quarter Hour $5.39
0559 AIDS Nursing - Visit $153.85
0780 Telehealth Services - Day $10.10
0590 Telehealth - Installation $50.00
0581 MOMS Health Supportive Services - Visit $78.03