Certified Hospice Program
Medicaid Rate Sheet
Effective: 10/01/2018 – 09/30/2019
- 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 | WRP Add–on * |
RTR Add–on * |
Total w/ addons |
|---|---|---|---|---|---|
| 3945 | Routine Home Care | $144.28 | $4.33 | $9.92 | $158.53 |
| 3946 | Inpatient Respite | $166.87 | $5.01 | $9.92 | $181.80 |
| 3947 | General Inpatient Care | $669.03 | $20.07 | $9.92 | $699.02 |
| 3948 | Continuous Home Care – Min 8 Hours | $290.66 | $8.72 | $9.92 | $309.30 |
| 3949 | Continuous Home Care – Min 9 Hours | $326.99 | $9.81 | $9.92 | $346.72 |
| 3950 | Continuous Home Care – Min 10 Hours | $363.32 | $10.90 | $9.92 | $384.14 |
| 3951 | Continuous Home Care – Min 11 Hours | $399.65 | $11.99 | $9.92 | $421.56 |
| 3952 | Continuous Home Care – Min 12 Hours | $435.99 | $13.08 | $9.92 | $458.99 |
| 3953 | Continuous Home Care – Min 13 Hours | $472.32 | $14.17 | $9.92 | $496.41 |
| 3954 | Continuous Home Care – Min 14 Hours | $508.65 | $15.26 | $9.92 | $533.83 |
| 3955 | Continuous Home Care – Min 15 Hours | $544.98 | $16.35 | $9.92 | $571.25 |
| 3956 | Continuous Home Care – Min 16 Hours | $581.31 | $17.44 | $9.92 | $608.67 |
| 3957 | Continuous Home Care – Min 17 Hours | $617.65 | $18.53 | $9.92 | $646.10 |
| 3958 | Continuous Home Care – Min 18 Hours | $653.98 | $19.62 | $9.92 | $683.52 |
| 3959 | Continuous Home Care – Min 19 Hours | $690.31 | $20.71 | $9.92 | $720.94 |
| 3960 | Continuous Home Care – Min 20 Hours | $726.64 | $21.80 | $9.92 | $758.36 |
| 3961 | Continuous Home Care – Min 21 Hours | $762.97 | $22.89 | $9.92 | $795.78 |
| 3962 | Continuous Home Care – Min 22 Hours | $799.31 | $23.98 | $9.92 | $833.21 |
| 3963 | Continuous Home Care – Min 23 Hours | $835.64 | $25.07 | $9.92 | $870.63 |
| 3964 | Continuous Home Care – Min 24 Hours | $871.97 | $26.16 | $9.92 | $908.05 |
| 3965 | Hospice Inpatient Respite Care Coinsurance Rate – | ||||
| 5% of 3946 | $8.51 | $0.26 | $0.50 | $9.27 | |
| 3966 | Drugs Coinsurance Rate | $1.00 | $0.00 | $0.00 | $1.00 |
| 3969 | Routine Home Care w/AIDS | $249.95 | $7.50 | $9.92 | $267.37 |
| 3970 | Routine Home Care w/Escort | $162.41 | $4.87 | $9.92 | $177.20 |
| 3971 | Continuous Home Care w/AIDS Min 8 Hours | $304.10 | $9.12 | $9.92 | $323.14 |
| 3972 | Continuous Home Care w/AIDS Min 9 Hours | $342.11 | $10.26 | $9.92 | $362.29 |
| 3973 | Continuous Home Care w/AIDS Min 10 Hours | $380.12 | $11.40 | $9.92 | $401.44 |
| 3974 | Continuous Home Care w/AIDS Min 11 Hours | $418.13 | $12.54 | $9.92 | $440.59 |
| 3975 | Continuous Home Care w/AIDS Min 12 Hours | $456.15 | $13.68 | $9.92 | $479.75 |
| 3976 | Continuous Home Care w/AIDS Min 13 Hours | $494.16 | $14.82 | $9.92 | $518.90 |
| 3977 | Continuous Home Care w/AIDS Min 14 Hours | $532.17 | $15.97 | $9.92 | $558.06 |
| 3978 | Continuous Home Care w/AIDS Min 15 Hours | $570.18 | $17.11 | $9.92 | $597.21 |
| 3979 | Continuous Home Care w/AIDS Min 16 Hours | $608.19 | $18.25 | $9.92 | $636.36 |
| 3980 | Continuous Home Care w/AIDS Min 17 Hours | $646.21 | $19.39 | $9.92 | $675.52 |
| 3981 | Continuous Home Care w/AIDS Min 18 Hours | $684.22 | $20.53 | $9.92 | $714.67 |
| 3982 | Continuous Home Care w/AIDS Min 19 Hours | $722.23 | $21.67 | $9.92 | $753.82 |
| 3983 | Continuous Home Care w/AIDS Min 20 Hours | $760.24 | $22.81 | $9.92 | $792.97 |
| 3984 | Continuous Home Care w/AIDS Min 21 Hours | $798.25 | $23.95 | $9.92 | $832.12 |
| 3985 | Continuous Home Care w/AIDS Min 22 Hours | $836.27 | $25.09 | $9.92 | $871.28 |
| 3986 | Continuous Home Care w/AIDS Min 23 Hours | $874.28 | $26.23 | $9.92 | $910.43 |
| 3987 | Continuous Home Care w/AIDS Min 24 Hours | $912.29 | $27.37 | $9.92 | $949.58 |
| 3988 | General Inpatient w/ AIDS | $743.56 | $22.31 | $9.92 | $775.79 |
| 3989 | Routine Home Care w/ AIDS Escort | $268.08 | $8.04 | $9.92 | $286.04 |
| 3991 | Service Intensity Add–on | $37.61 | $1.13 | $0.00 | $38.74 |
* 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 |
|---|---|---|---|---|---|
| 3945 | Routine Home Care | $147.46 | $4.42 | $9.92 | $161.80 |
| 3946 | Inpatient Respite | $169.67 | $5.09 | $9.92 | $184.68 |
| 3947 | General Inpatient Care | $682.62 | $20.48 | $9.92 | $713.02 |
| 3948 | Continuous Home Care – Min 8 Hours | $297.05 | $8.91 | $9.92 | $315.88 |
| 3949 | Continuous Home Care – Min 9 Hours | $334.19 | $10.03 | $9.92 | $354.14 |
| 3950 | Continuous Home Care – Min 10 Hours | $371.32 | $11.14 | $9.92 | $392.38 |
| 3951 | Continuous Home Care – Min 11 Hours | $408.45 | $12.25 | $9.92 | $430.62 |
| 3952 | Continuous Home Care – Min 12 Hours | $445.58 | $13.37 | $9.92 | $468.87 |
| 3953 | Continuous Home Care – Min 13 Hours | $482.71 | $14.48 | $9.92 | $507.11 |
| 3954 | Continuous Home Care – Min 14 Hours | $519.84 | $15.60 | $9.92 | $545.36 |
| 3955 | Continuous Home Care – Min 15 Hours | $556.98 | $16.71 | $9.92 | $583.61 |
| 3956 | Continuous Home Care – Min 16 Hours | $594.11 | $17.82 | $9.92 | $621.85 |
| 3957 | Continuous Home Care – Min 17 Hours | $631.24 | $18.94 | $9.92 | $660.10 |
| 3958 | Continuous Home Care – Min 18 Hours | $668.37 | $20.05 | $9.92 | $698.34 |
| 3959 | Continuous Home Care – Min 19 Hours | $705.50 | $21.17 | $9.92 | $736.59 |
| 3960 | Continuous Home Care – Min 20 Hours | $742.63 | $22.28 | $9.92 | $774.83 |
| 3961 | Continuous Home Care – Min 21 Hours | $779.77 | $23.39 | $9.92 | $813.08 |
| 3962 | Continuous Home Care – Min 22 Hours | $816.90 | $24.51 | $9.92 | $851.33 |
| 3963 | Continuous Home Care – Min 23 Hours | $854.03 | $25.62 | $9.92 | $889.57 |
| 3964 | Continuous Home Care – Min 24 Hours | $891.16 | $26.73 | $9.92 | $927.81 |
| 3965 | Hospice Inpatient Respite Care Coinsurance Rate – | ||||
| 5% of 3946 | $8.51 | $0.26 | $0.50 | $9.27 | |
| 3966 | Drugs Coinsurance Rate | $1.00 | $0.00 | $0.00 | $1.00 |
| 3969 | Routine Home Care w/AIDS | $255.45 | $7.66 | $9.92 | $273.03 |
| 3970 | Routine Home Care w/Escort | $165.59 | $4.97 | $9.92 | $180.48 |
| 3971 | Continuous Home Care w/AIDS Min 8 Hours | $313.55 | $9.41 | $9.92 | $332.88 |
| 3972 | Continuous Home Care w/AIDS Min 9 Hours | $352.75 | $10.58 | $9.92 | $373.25 |
| 3973 | Continuous Home Care w/AIDS Min 10 Hours | $391.94 | $11.76 | $9.92 | $413.62 |
| 3974 | Continuous Home Care w/AIDS Min 11 Hours | $431.14 | $12.93 | $9.92 | $453.99 |
| 3975 | Continuous Home Care w/AIDS Min 12 Hours | $470.33 | $14.11 | $9.92 | $494.36 |
| 3976 | Continuous Home Care w/AIDS Min 13 Hours | $509.52 | $15.29 | $9.92 | $534.73 |
| 3977 | Continuous Home Care w/AIDS Min 14 Hours | $548.72 | $16.46 | $9.92 | $575.10 |
| 3978 | Continuous Home Care w/AIDS Min 15 Hours | $587.91 | $17.64 | $9.92 | $615.47 |
| 3979 | Continuous Home Care w/AIDS Min 16 Hours | $627.11 | $18.81 | $9.92 | $655.84 |
| 3980 | Continuous Home Care w/AIDS Min 17 Hours | $666.30 | $19.99 | $9.92 | $696.21 |
| 3981 | Continuous Home Care w/AIDS Min 18 Hours | $705.50 | $21.17 | $9.92 | $736.59 |
| 3982 | Continuous Home Care w/AIDS Min 19 Hours | $744.69 | $22.34 | $9.92 | $776.95 |
| 3983 | Continuous Home Care w/AIDS Min 20 Hours | $783.88 | $23.52 | $9.92 | $817.32 |
| 3984 | Continuous Home Care w/AIDS Min 21 Hours | $823.08 | $24.69 | $9.92 | $857.69 |
| 3985 | Continuous Home Care w/AIDS Min 22 Hours | $862.27 | $25.87 | $9.92 | $898.06 |
| 3986 | Continuous Home Care w/AIDS Min 23 Hours | $901.47 | $27.04 | $9.92 | $938.43 |
| 3987 | Continuous Home Care w/AIDS Min 24 Hours | $940.66 | $28.22 | $9.92 | $978.80 |
| 3988 | General Inpatient w/ AIDS | $758.66 | $22.76 | $9.92 | $791.34 |
| 3989 | Routine Home Care w/ AIDS Escort | $273.58 | $8.21 | $9.92 | $291.71 |
| 3991 | Service Intensity Add–on | $38.44 | $1.15 | $0.00 | $39.59 |
* 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 |
|---|---|---|---|---|---|
| 3945 | Routine Home Care | $171.02 | $5.13 | $9.92 | $186.07 |
| 3946 | Inpatient Respite | $190.34 | $5.71 | $9.92 | $205.97 |
| 3947 | General Inpatient Care | $782.62 | $23.48 | $9.92 | $816.02 |
| 3948 | Continuous Home Care – Min 8 Hours | $344.15 | $10.32 | $9.92 | $364.39 |
| 3949 | Continuous Home Care – Min 9 Hours | $387.17 | $11.62 | $9.92 | $408.71 |
| 3950 | Continuous Home Care – Min 10 Hours | $430.19 | $12.91 | $9.92 | $453.02 |
| 3951 | Continuous Home Care – Min 11 Hours | $473.21 | $14.20 | $9.92 | $497.33 |
| 3952 | Continuous Home Care – Min 12 Hours | $516.23 | $15.49 | $9.92 | $541.64 |
| 3953 | Continuous Home Care – Min 13 Hours | $559.25 | $16.78 | $9.92 | $585.95 |
| 3954 | Continuous Home Care – Min 14 Hours | $602.27 | $18.07 | $9.92 | $630.26 |
| 3955 | Continuous Home Care – Min 15 Hours | $645.29 | $19.36 | $9.92 | $674.57 |
| 3956 | Continuous Home Care – Min 16 Hours | $688.31 | $20.65 | $9.92 | $718.88 |
| 3957 | Continuous Home Care – Min 17 Hours | $731.33 | $21.94 | $9.92 | $763.19 |
| 3958 | Continuous Home Care – Min 18 Hours | $774.35 | $23.23 | $9.92 | $807.50 |
| 3959 | Continuous Home Care – Min 19 Hours | $817.36 | $24.52 | $9.92 | $851.80 |
| 3960 | Continuous Home Care – Min 20 Hours | $860.38 | $25.81 | $9.92 | $896.11 |
| 3961 | Continuous Home Care – Min 21 Hours | $903.40 | $27.10 | $9.92 | $940.42 |
| 3962 | Continuous Home Care – Min 22 Hours | $946.42 | $28.39 | $9.92 | $984.73 |
| 3963 | Continuous Home Care – Min 23 Hours | $989.44 | $29.68 | $9.92 | $1,029.04 |
| 3964 | Continuous Home Care – Min 24 Hours | $1,032.46 | $30.97 | $9.92 | $1,073.35 |
| 3965 | Hospice Inpatient Respite Care Coinsurance Rate – | ||||
| 5% of 3946 | $8.51 | $0.26 | $0.50 | $9.27 | |
| 3966 | Drugs Coinsurance Rate | $1.00 | $0.00 | $0.00 | $1.00 |
| 3969 | Routine Home Care w/AIDS | $296.25 | $8.89 | $9.92 | $315.06 |
| 3970 | Routine Home Care w/Escort | $189.17 | $5.68 | $9.92 | $204.77 |
| 3971 | Continuous Home Care w/AIDS Min 8 Hours | $383.18 | $11.50 | $9.92 | $404.60 |
| 3972 | Continuous Home Care w/AIDS Min 9 Hours | $431.07 | $12.93 | $9.92 | $453.92 |
| 3973 | Continuous Home Care w/AIDS Min 10 Hours | $478.97 | $14.37 | $9.92 | $503.26 |
| 3974 | Continuous Home Care w/AIDS Min 11 Hours | $526.87 | $15.81 | $9.92 | $552.60 |
| 3975 | Continuous Home Care w/AIDS Min 12 Hours | $574.77 | $17.24 | $9.92 | $601.93 |
| 3976 | Continuous Home Care w/AIDS Min 13 Hours | $622.66 | $18.68 | $9.92 | $651.26 |
| 3977 | Continuous Home Care w/AIDS Min 14 Hours | $670.56 | $20.12 | $9.92 | $700.60 |
| 3978 | Continuous Home Care w/AIDS Min 15 Hours | $718.46 | $21.55 | $9.92 | $749.93 |
| 3979 | Continuous Home Care w/AIDS Min 16 Hours | $766.35 | $22.99 | $9.92 | $799.26 |
| 3980 | Continuous Home Care w/AIDS Min 17 Hours | $814.25 | $24.43 | $9.92 | $848.60 |
| 3981 | Continuous Home Care w/AIDS Min 18 Hours | $862.15 | $25.86 | $9.92 | $897.93 |
| 3982 | Continuous Home Care w/AIDS Min 19 Hours | $910.04 | $27.30 | $9.92 | $947.26 |
| 3983 | Continuous Home Care w/AIDS Min 20 Hours | $957.94 | $28.74 | $9.92 | $996.60 |
| 3984 | Continuous Home Care w/AIDS Min 21 Hours | $1,005.84 | $30.18 | $9.92 | $1,045.94 |
| 3985 | Continuous Home Care w/AIDS Min 22 Hours | $1,053.74 | $31.61 | $9.92 | $1,095.27 |
| 3986 | Continuous Home Care w/AIDS Min 23 Hours | $1,101.63 | $33.05 | $9.92 | $1,144.60 |
| 3987 | Continuous Home Care w/AIDS Min 24 Hours | $1,149.53 | $34.49 | $9.92 | $1,193.94 |
| 3988 | General Inpatient w/ AIDS | $869.80 | $26.09 | $9.92 | $905.81 |
| 3989 | Routine Home Care w/ AIDS Escort | $314.40 | $9.43 | $9.92 | $333.75 |
| 3991 | Service Intensity Add–on | $44.58 | $1.34 | $0.00 | $45.92 |
* 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 |
|---|---|---|---|---|---|
| 3945 | Routine Home Care | $148.26 | $4.45 | $9.92 | $162.63 |
| 3946 | Inpatient Respite | $170.25 | $5.11 | $9.92 | $185.28 |
| 3947 | General Inpatient Care | $685.38 | $20.56 | $9.92 | $715.86 |
| 3948 | Continuous Home Care – Min 8 Hours | $298.36 | $8.95 | $9.92 | $317.23 |
| 3949 | Continuous Home Care – Min 9 Hours | $335.65 | $10.07 | $9.92 | $355.64 |
| 3950 | Continuous Home Care – Min 10 Hours | $372.95 | $11.19 | $9.92 | $394.06 |
| 3951 | Continuous Home Care – Min 11 Hours | $410.24 | $12.31 | $9.92 | $432.47 |
| 3952 | Continuous Home Care – Min 12 Hours | $447.54 | $13.43 | $9.92 | $470.89 |
| 3953 | Continuous Home Care – Min 13 Hours | $484.83 | $14.54 | $9.92 | $509.29 |
| 3954 | Continuous Home Care – Min 14 Hours | $522.12 | $15.66 | $9.92 | $547.70 |
| 3955 | Continuous Home Care – Min 15 Hours | $559.42 | $16.78 | $9.92 | $586.12 |
| 3956 | Continuous Home Care – Min 16 Hours | $596.71 | $17.90 | $9.92 | $624.53 |
| 3957 | Continuous Home Care – Min 17 Hours | $634.01 | $19.02 | $9.92 | $662.95 |
| 3958 | Continuous Home Care – Min 18 Hours | $671.30 | $20.14 | $9.92 | $701.36 |
| 3959 | Continuous Home Care – Min 19 Hours | $708.60 | $21.26 | $9.92 | $739.78 |
| 3960 | Continuous Home Care – Min 20 Hours | $745.89 | $22.38 | $9.92 | $778.19 |
| 3961 | Continuous Home Care – Min 21 Hours | $783.19 | $23.50 | $9.92 | $816.61 |
| 3962 | Continuous Home Care – Min 22 Hours | $820.48 | $24.61 | $9.92 | $855.01 |
| 3963 | Continuous Home Care – Min 23 Hours | $857.78 | $25.73 | $9.92 | $893.43 |
| 3964 | Continuous Home Care – Min 24 Hours | $895.07 | $26.85 | $9.92 | $931.84 |
| 3965 | Hospice Inpatient Respite Care Coinsurance Rate – | ||||
| 5% of 3946 | $8.51 | $0.26 | $0.50 | $9.27 | |
| 3966 | Drugs Coinsurance Rate | $1.00 | $0.00 | $0.00 | $1.00 |
| 3969 | Routine Home Care w/AIDS | $256.83 | $7.70 | $9.92 | $274.45 |
| 3970 | Routine Home Care w/Escort | $166.41 | $4.99 | $9.92 | $181.32 |
| 3971 | Continuous Home Care w/AIDS Min 8 Hours | $315.51 | $9.47 | $9.92 | $334.90 |
| 3972 | Continuous Home Care w/AIDS Min 9 Hours | $354.95 | $10.65 | $9.92 | $375.52 |
| 3973 | Continuous Home Care w/AIDS Min 10 Hours | $394.38 | $11.83 | $9.92 | $416.13 |
| 3974 | Continuous Home Care w/AIDS Min 11 Hours | $433.82 | $13.01 | $9.92 | $456.75 |
| 3975 | Continuous Home Care w/AIDS Min 12 Hours | $473.26 | $14.20 | $9.92 | $497.38 |
| 3976 | Continuous Home Care w/AIDS Min 13 Hours | $512.70 | $15.38 | $9.92 | $538.00 |
| 3977 | Continuous Home Care w/AIDS Min 14 Hours | $552.14 | $16.56 | $9.92 | $578.62 |
| 3978 | Continuous Home Care w/AIDS Min 15 Hours | $591.58 | $17.75 | $9.92 | $619.25 |
| 3979 | Continuous Home Care w/AIDS Min 16 Hours | $631.01 | $18.93 | $9.92 | $659.86 |
| 3980 | Continuous Home Care w/AIDS Min 17 Hours | $670.45 | $20.11 | $9.92 | $700.48 |
| 3981 | Continuous Home Care w/AIDS Min 18 Hours | $709.89 | $21.30 | $9.92 | $741.11 |
| 3982 | Continuous Home Care w/AIDS Min 19 Hours | $749.33 | $22.48 | $9.92 | $781.73 |
| 3983 | Continuous Home Care w/AIDS Min 20 Hours | $788.77 | $23.66 | $9.92 | $822.35 |
| 3984 | Continuous Home Care w/AIDS Min 21 Hours | $828.21 | $24.85 | $9.92 | $862.98 |
| 3985 | Continuous Home Care w/AIDS Min 22 Hours | $867.64 | $26.03 | $9.92 | $903.59 |
| 3986 | Continuous Home Care w/AIDS Min 23 Hours | $907.08 | $27.21 | $9.92 | $944.21 |
| 3987 | Continuous Home Care w/AIDS Min 24 Hours | $946.52 | $28.40 | $9.92 | $984.84 |
| 3988 | General Inpatient w/ AIDS | $761.73 | $22.85 | $9.92 | $794.50 |
| 3989 | Routine Home Care w/ AIDS Escort | $274.98 | $8.25 | $9.92 | $293.15 |
| 3991 | Service Intensity Add–on | $38.65 | $1.16 | $0.00 | $39.81 |
* 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 |
|---|---|---|---|---|---|
| 3945 | Routine Home Care | $146.60 | $4.40 | $9.92 | $160.92 |
| 3946 | Inpatient Respite | $168.78 | $5.06 | $9.92 | $183.76 |
| 3947 | General Inpatient Care | $678.30 | $20.35 | $9.92 | $708.57 |
| 3948 | Continuous Home Care – Min 8 Hours | $295.02 | $8.85 | $9.92 | $313.79 |
| 3949 | Continuous Home Care – Min 9 Hours | $331.90 | $9.96 | $9.92 | $351.78 |
| 3950 | Continuous Home Care – Min 10 Hours | $368.78 | $11.06 | $9.92 | $389.76 |
| 3951 | Continuous Home Care – Min 11 Hours | $405.65 | $12.17 | $9.92 | $427.74 |
| 3952 | Continuous Home Care – Min 12 Hours | $442.53 | $13.28 | $9.92 | $465.73 |
| 3953 | Continuous Home Care – Min 13 Hours | $479.41 | $14.38 | $9.92 | $503.71 |
| 3954 | Continuous Home Care – Min 14 Hours | $516.29 | $15.49 | $9.92 | $541.70 |
| 3955 | Continuous Home Care – Min 15 Hours | $553.16 | $16.59 | $9.92 | $579.67 |
| 3956 | Continuous Home Care – Min 16 Hours | $590.04 | $17.70 | $9.92 | $617.66 |
| 3957 | Continuous Home Care – Min 17 Hours | $626.92 | $18.81 | $9.92 | $655.65 |
| 3958 | Continuous Home Care – Min 18 Hours | $663.80 | $19.91 | $9.92 | $693.63 |
| 3959 | Continuous Home Care – Min 19 Hours | $700.67 | $21.02 | $9.92 | $731.61 |
| 3960 | Continuous Home Care – Min 20 Hours | $737.55 | $22.13 | $9.92 | $769.60 |
| 3961 | Continuous Home Care – Min 21 Hours | $774.43 | $23.23 | $9.92 | $807.58 |
| 3962 | Continuous Home Care – Min 22 Hours | $811.31 | $24.34 | $9.92 | $845.57 |
| 3963 | Continuous Home Care – Min 23 Hours | $848.18 | $25.45 | $9.92 | $883.55 |
| 3964 | Continuous Home Care – Min 24 Hours | $885.06 | $26.55 | $9.92 | $921.53 |
| 3965 | Hospice Inpatient Respite Care Coinsurance Rate – | ||||
| 5% of 3946 | $8.51 | $0.26 | $0.50 | $9.27 | |
| 3966 | Drugs Coinsurance Rate | $1.00 | $0.00 | $0.00 | $1.00 |
| 3969 | Routine Home Care w/AIDS | $253.96 | $7.62 | $9.92 | $271.50 |
| 3970 | Routine Home Care w/Escort | $164.75 | $4.94 | $9.92 | $179.61 |
| 3971 | Continuous Home Care w/AIDS Min 8 Hours | $310.58 | $9.32 | $9.92 | $329.82 |
| 3972 | Continuous Home Care w/AIDS Min 9 Hours | $349.40 | $10.48 | $9.92 | $369.80 |
| 3973 | Continuous Home Care w/AIDS Min 10 Hours | $388.22 | $11.65 | $9.92 | $409.79 |
| 3974 | Continuous Home Care w/AIDS Min 11 Hours | $427.04 | $12.81 | $9.92 | $449.77 |
| 3975 | Continuous Home Care w/AIDS Min 12 Hours | $465.87 | $13.98 | $9.92 | $489.77 |
| 3976 | Continuous Home Care w/AIDS Min 13 Hours | $504.69 | $15.14 | $9.92 | $529.75 |
| 3977 | Continuous Home Care w/AIDS Min 14 Hours | $543.51 | $16.31 | $9.92 | $569.74 |
| 3978 | Continuous Home Care w/AIDS Min 15 Hours | $582.33 | $17.47 | $9.92 | $609.72 |
| 3979 | Continuous Home Care w/AIDS Min 16 Hours | $621.15 | $18.63 | $9.92 | $649.70 |
| 3980 | Continuous Home Care w/AIDS Min 17 Hours | $659.98 | $19.80 | $9.92 | $689.70 |
| 3981 | Continuous Home Care w/AIDS Min 18 Hours | $698.80 | $20.96 | $9.92 | $729.68 |
| 3982 | Continuous Home Care w/AIDS Min 19 Hours | $737.62 | $22.13 | $9.92 | $769.67 |
| 3983 | Continuous Home Care w/AIDS Min 20 Hours | $776.44 | $23.29 | $9.92 | $809.65 |
| 3984 | Continuous Home Care w/AIDS Min 21 Hours | $815.26 | $24.46 | $9.92 | $849.64 |
| 3985 | Continuous Home Care w/AIDS Min 22 Hours | $854.09 | $25.62 | $9.92 | $889.63 |
| 3986 | Continuous Home Care w/AIDS Min 23 Hours | $892.91 | $26.79 | $9.92 | $929.62 |
| 3987 | Continuous Home Care w/AIDS Min 24 Hours | $931.73 | $27.95 | $9.92 | $969.60 |
| 3988 | General Inpatient w/ AIDS | $753.86 | $22.62 | $9.92 | $786.40 |
| 3989 | Routine Home Care w/ AIDS Escort | $272.11 | $8.16 | $9.92 | $290.19 |
| 3991 | Service Intensity Add–on | $38.21 | $1.15 | $0.00 | $39.36 |
* 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 |
|---|---|---|---|---|---|
| 3945 | Routine Home Care | $196.85 | $5.91 | $9.92 | $212.68 |
| 3946 | Inpatient Respite | $213.16 | $6.39 | $9.92 | $229.47 |
| 3947 | General Inpatient Care | $893.02 | $26.79 | $9.92 | $929.73 |
| 3948 | Continuous Home Care – Min 8 Hours | $396.14 | $11.88 | $9.92 | $417.94 |
| 3949 | Continuous Home Care – Min 9 Hours | $445.66 | $13.37 | $9.92 | $468.95 |
| 3950 | Continuous Home Care – Min 10 Hours | $495.18 | $14.86 | $9.92 | $519.96 |
| 3951 | Continuous Home Care – Min 11 Hours | $544.70 | $16.34 | $9.92 | $570.96 |
| 3952 | Continuous Home Care – Min 12 Hours | $594.22 | $17.83 | $9.92 | $621.97 |
| 3953 | Continuous Home Care – Min 13 Hours | $643.73 | $19.31 | $9.92 | $672.96 |
| 3954 | Continuous Home Care – Min 14 Hours | $693.25 | $20.80 | $9.92 | $723.97 |
| 3955 | Continuous Home Care – Min 15 Hours | $742.77 | $22.28 | $9.92 | $774.97 |
| 3956 | Continuous Home Care – Min 16 Hours | $792.29 | $23.77 | $9.92 | $825.98 |
| 3957 | Continuous Home Care – Min 17 Hours | $841.80 | $25.25 | $9.92 | $876.97 |
| 3958 | Continuous Home Care – Min 18 Hours | $891.32 | $26.74 | $9.92 | $927.98 |
| 3959 | Continuous Home Care – Min 19 Hours | $940.84 | $28.23 | $9.92 | $978.99 |
| 3960 | Continuous Home Care – Min 20 Hours | $990.36 | $29.71 | $9.92 | $1,029.99 |
| 3961 | Continuous Home Care – Min 21 Hours | $1,039.88 | $31.20 | $9.92 | $1,081.00 |
| 3962 | Continuous Home Care – Min 22 Hours | $1,089.39 | $32.68 | $9.92 | $1,131.99 |
| 3963 | Continuous Home Care – Min 23 Hours | $1,138.91 | $34.17 | $9.92 | $1,183.00 |
| 3964 | Continuous Home Care – Min 24 Hours | $1,188.43 | $35.65 | $9.92 | $1,234.00 |
| 3965 | Hospice Inpatient Respite Care Coinsurance Rate – | ||||
| 5% of 3946 | $8.51 | $0.26 | $0.50 | $9.27 | |
| 3966 | Drugs Coinsurance Rate | $1.00 | $0.00 | $0.00 | $1.00 |
| 3969 | Routine Home Care w/AIDS | $341.01 | $10.23 | $9.92 | $361.16 |
| 3970 | Routine Home Care w/Escort | $215.00 | $6.45 | $9.92 | $231.37 |
| 3971 | Continuous Home Care w/AIDS Min 8 Hours | $460.00 | $13.80 | $9.92 | $483.72 |
| 3972 | Continuous Home Care w/AIDS Min 9 Hours | $517.50 | $15.53 | $9.92 | $542.95 |
| 3973 | Continuous Home Care w/AIDS Min 10 Hours | $575.00 | $17.25 | $9.92 | $602.17 |
| 3974 | Continuous Home Care w/AIDS Min 11 Hours | $632.50 | $18.98 | $9.92 | $661.40 |
| 3975 | Continuous Home Care w/AIDS Min 12 Hours | $690.00 | $20.70 | $9.92 | $720.62 |
| 3976 | Continuous Home Care w/AIDS Min 13 Hours | $747.50 | $22.43 | $9.92 | $779.85 |
| 3977 | Continuous Home Care w/AIDS Min 14 Hours | $805.00 | $24.15 | $9.92 | $839.07 |
| 3978 | Continuous Home Care w/AIDS Min 15 Hours | $862.50 | $25.88 | $9.92 | $898.30 |
| 3979 | Continuous Home Care w/AIDS Min 16 Hours | $920.00 | $27.60 | $9.92 | $957.52 |
| 3980 | Continuous Home Care w/AIDS Min 17 Hours | $977.50 | $29.33 | $9.92 | $1,016.75 |
| 3981 | Continuous Home Care w/AIDS Min 18 Hours | $1,035.00 | $31.05 | $9.92 | $1,075.97 |
| 3982 | Continuous Home Care w/AIDS Min 19 Hours | $1,092.50 | $32.78 | $9.92 | $1,135.20 |
| 3983 | Continuous Home Care w/AIDS Min 20 Hours | $1,150.00 | $34.50 | $9.92 | $1,194.42 |
| 3984 | Continuous Home Care w/AIDS Min 21 Hours | $1,207.50 | $36.23 | $9.92 | $1,253.65 |
| 3985 | Continuous Home Care w/AIDS Min 22 Hours | $1,265.00 | $37.95 | $9.92 | $1,312.87 |
| 3986 | Continuous Home Care w/AIDS Min 23 Hours | $1,322.50 | $39.68 | $9.92 | $1,372.10 |
| 3987 | Continuous Home Care w/AIDS Min 24 Hours | $1,380.00 | $41.40 | $9.92 | $1,431.32 |
| 3988 | General Inpatient w/ AIDS | $992.50 | $29.78 | $9.92 | $1,032.20 |
| 3989 | Routine Home Care w/ AIDS Escort | $359.16 | $10.77 | $9.92 | $379.85 |
| 3991 | Service Intensity Add–on | $51.31 | $1.54 | $0.00 | $52.85 |
* 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 |
|---|---|---|---|---|---|
| 3945 | Routine Home Care | $197.21 | $5.92 | $9.92 | $213.05 |
| 3946 | Inpatient Respite | $213.48 | $6.40 | $9.92 | $229.80 |
| 3947 | General Inpatient Care | $894.57 | $26.84 | $9.92 | $931.33 |
| 3948 | Continuous Home Care – Min 8 Hours | $396.87 | $11.91 | $9.92 | $418.70 |
| 3949 | Continuous Home Care – Min 9 Hours | $446.48 | $13.39 | $9.92 | $469.79 |
| 3950 | Continuous Home Care – Min 10 Hours | $496.09 | $14.88 | $9.92 | $520.89 |
| 3951 | Continuous Home Care – Min 11 Hours | $545.70 | $16.37 | $9.92 | $571.99 |
| 3952 | Continuous Home Care – Min 12 Hours | $595.31 | $17.86 | $9.92 | $623.09 |
| 3953 | Continuous Home Care – Min 13 Hours | $644.92 | $19.35 | $9.92 | $674.19 |
| 3954 | Continuous Home Care – Min 14 Hours | $694.53 | $20.84 | $9.92 | $725.29 |
| 3955 | Continuous Home Care – Min 15 Hours | $744.14 | $22.32 | $9.92 | $776.38 |
| 3956 | Continuous Home Care – Min 16 Hours | $793.75 | $23.81 | $9.92 | $827.48 |
| 3957 | Continuous Home Care – Min 17 Hours | $843.36 | $25.30 | $9.92 | $878.58 |
| 3958 | Continuous Home Care – Min 18 Hours | $892.97 | $26.79 | $9.92 | $929.68 |
| 3959 | Continuous Home Care – Min 19 Hours | $942.57 | $28.28 | $9.92 | $980.77 |
| 3960 | Continuous Home Care – Min 20 Hours | $992.18 | $29.77 | $9.92 | $1,031.87 |
| 3961 | Continuous Home Care – Min 21 Hours | $1,041.79 | $31.25 | $9.92 | $1,082.96 |
| 3962 | Continuous Home Care – Min 22 Hours | $1,091.40 | $32.74 | $9.92 | $1,134.06 |
| 3963 | Continuous Home Care – Min 23 Hours | $1,141.01 | $34.23 | $9.92 | $1,185.16 |
| 3964 | Continuous Home Care – Min 24 Hours | $1,190.62 | $35.72 | $9.92 | $1,236.26 |
| 3965 | Hospice Inpatient Respite Care Coinsurance Rate – | ||||
| 5% of 3946 | $8.51 | $0.26 | $0.50 | $9.27 | |
| 3966 | Drugs Coinsurance Rate | $1.00 | $0.00 | $0.00 | $1.00 |
| 3969 | Routine Home Care w/AIDS | $341.64 | $10.25 | $9.92 | $361.81 |
| 3970 | Routine Home Care w/Escort | $215.36 | $6.46 | $9.92 | $231.74 |
| 3971 | Continuous Home Care w/AIDS Min 8 Hours | $461.08 | $13.83 | $9.92 | $484.83 |
| 3972 | Continuous Home Care w/AIDS Min 9 Hours | $518.72 | $15.56 | $9.92 | $544.20 |
| 3973 | Continuous Home Care w/AIDS Min 10 Hours | $576.35 | $17.29 | $9.92 | $603.56 |
| 3974 | Continuous Home Care w/AIDS Min 11 Hours | $633.99 | $19.02 | $9.92 | $662.93 |
| 3975 | Continuous Home Care w/AIDS Min 12 Hours | $691.62 | $20.75 | $9.92 | $722.29 |
| 3976 | Continuous Home Care w/AIDS Min 13 Hours | $749.26 | $22.48 | $9.92 | $781.66 |
| 3977 | Continuous Home Care w/AIDS Min 14 Hours | $806.89 | $24.21 | $9.92 | $841.02 |
| 3978 | Continuous Home Care w/AIDS Min 15 Hours | $864.53 | $25.94 | $9.92 | $900.39 |
| 3979 | Continuous Home Care w/AIDS Min 16 Hours | $922.16 | $27.66 | $9.92 | $959.74 |
| 3980 | Continuous Home Care w/AIDS Min 17 Hours | $979.80 | $29.39 | $9.92 | $1,019.11 |
| 3981 | Continuous Home Care w/AIDS Min 18 Hours | $1,037.43 | $31.12 | $9.92 | $1,078.47 |
| 3982 | Continuous Home Care w/AIDS Min 19 Hours | $1,095.07 | $32.85 | $9.92 | $1,137.84 |
| 3983 | Continuous Home Care w/AIDS Min 20 Hours | $1,152.70 | $34.58 | $9.92 | $1,197.20 |
| 3984 | Continuous Home Care w/AIDS Min 21 Hours | $1,210.34 | $36.31 | $9.92 | $1,256.57 |
| 3985 | Continuous Home Care w/AIDS Min 22 Hours | $1,267.97 | $38.04 | $9.92 | $1,315.93 |
| 3986 | Continuous Home Care w/AIDS Min 23 Hours | $1,325.61 | $39.77 | $9.92 | $1,375.30 |
| 3987 | Continuous Home Care w/AIDS Min 24 Hours | $1,383.24 | $41.50 | $9.92 | $1,434.66 |
| 3988 | General Inpatient w/ AIDS | $994.23 | $29.83 | $9.92 | $1,033.98 |
| 3989 | Routine Home Care w/ AIDS Escort | $359.79 | $10.79 | $9.92 | $380.50 |
| 3991 | Service Intensity Add–on | $51.41 | $1.54 | $0.00 | $52.95 |
* 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 |
|---|---|---|---|---|---|
| 3945 | Routine Home Care | $172.04 | $5.16 | $9.92 | $187.12 |
| 3946 | Inpatient Respite | $191.25 | $5.74 | $9.92 | $206.91 |
| 3947 | General Inpatient Care | $786.99 | $23.61 | $9.92 | $820.52 |
| 3948 | Continuous Home Care – Min 8 Hours | $346.21 | $10.39 | $9.92 | $366.52 |
| 3949 | Continuous Home Care – Min 9 Hours | $389.49 | $11.68 | $9.92 | $411.09 |
| 3950 | Continuous Home Care – Min 10 Hours | $432.76 | $12.98 | $9.92 | $455.66 |
| 3951 | Continuous Home Care – Min 11 Hours | $476.04 | $14.28 | $9.92 | $500.24 |
| 3952 | Continuous Home Care – Min 12 Hours | $519.32 | $15.58 | $9.92 | $544.82 |
| 3953 | Continuous Home Care – Min 13 Hours | $562.59 | $16.88 | $9.92 | $589.39 |
| 3954 | Continuous Home Care – Min 14 Hours | $605.87 | $18.18 | $9.92 | $633.97 |
| 3955 | Continuous Home Care – Min 15 Hours | $649.14 | $19.47 | $9.92 | $678.53 |
| 3956 | Continuous Home Care – Min 16 Hours | $692.42 | $20.77 | $9.92 | $723.11 |
| 3957 | Continuous Home Care – Min 17 Hours | $735.70 | $22.07 | $9.92 | $767.69 |
| 3958 | Continuous Home Care – Min 18 Hours | $778.97 | $23.37 | $9.92 | $812.26 |
| 3959 | Continuous Home Care – Min 19 Hours | $822.25 | $24.67 | $9.92 | $856.84 |
| 3960 | Continuous Home Care – Min 20 Hours | $865.53 | $25.97 | $9.92 | $901.42 |
| 3961 | Continuous Home Care – Min 21 Hours | $908.80 | $27.26 | $9.92 | $945.98 |
| 3962 | Continuous Home Care – Min 22 Hours | $952.08 | $28.56 | $9.92 | $990.56 |
| 3963 | Continuous Home Care – Min 23 Hours | $995.35 | $29.86 | $9.92 | $1,035.13 |
| 3964 | Continuous Home Care – Min 24 Hours | $1,038.63 | $31.16 | $9.92 | $1,079.71 |
| 3965 | Hospice Inpatient Respite Care Coinsurance Rate – | ||||
| 5% of 3946 | $8.51 | $0.26 | $0.50 | $9.27 | |
| 3966 | Drugs Coinsurance Rate | $1.00 | $0.00 | $0.00 | $1.00 |
| 3969 | Routine Home Care w/AIDS | $298.02 | $8.94 | $9.92 | $316.88 |
| 3970 | Routine Home Care w/Escort | $190.19 | $5.71 | $9.92 | $205.82 |
| 3971 | Continuous Home Care w/AIDS Min 8 Hours | $386.22 | $11.59 | $9.92 | $407.73 |
| 3972 | Continuous Home Care w/AIDS Min 9 Hours | $434.49 | $13.03 | $9.92 | $457.44 |
| 3973 | Continuous Home Care w/AIDS Min 10 Hours | $482.77 | $14.48 | $9.92 | $507.17 |
| 3974 | Continuous Home Care w/AIDS Min 11 Hours | $531.05 | $15.93 | $9.92 | $556.90 |
| 3975 | Continuous Home Care w/AIDS Min 12 Hours | $579.33 | $17.38 | $9.92 | $606.63 |
| 3976 | Continuous Home Care w/AIDS Min 13 Hours | $627.60 | $18.83 | $9.92 | $656.35 |
| 3977 | Continuous Home Care w/AIDS Min 14 Hours | $675.88 | $20.28 | $9.92 | $706.08 |
| 3978 | Continuous Home Care w/AIDS Min 15 Hours | $724.16 | $21.72 | $9.92 | $755.80 |
| 3979 | Continuous Home Care w/AIDS Min 16 Hours | $772.43 | $23.17 | $9.92 | $805.52 |
| 3980 | Continuous Home Care w/AIDS Min 17 Hours | $820.71 | $24.62 | $9.92 | $855.25 |
| 3981 | Continuous Home Care w/AIDS Min 18 Hours | $868.99 | $26.07 | $9.92 | $904.98 |
| 3982 | Continuous Home Care w/AIDS Min 19 Hours | $917.26 | $27.52 | $9.92 | $954.70 |
| 3983 | Continuous Home Care w/AIDS Min 20 Hours | $965.54 | $28.97 | $9.92 | $1,004.43 |
| 3984 | Continuous Home Care w/AIDS Min 21 Hours | $1,013.82 | $30.41 | $9.92 | $1,054.15 |
| 3985 | Continuous Home Care w/AIDS Min 22 Hours | $1,062.10 | $31.86 | $9.92 | $1,103.88 |
| 3986 | Continuous Home Care w/AIDS Min 23 Hours | $1,110.37 | $33.31 | $9.92 | $1,153.60 |
| 3987 | Continuous Home Care w/AIDS Min 24 Hours | $1,158.65 | $34.76 | $9.92 | $1,203.33 |
| 3988 | General Inpatient w/ AIDS | $874.66 | $26.24 | $9.92 | $910.82 |
| 3989 | Routine Home Care w/ AIDS Escort | $316.17 | $9.49 | $9.92 | $335.58 |
| 3991 | Service Intensity Add–on | $44.84 | $1.35 | $0.00 | $46.19 |
* 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 |
|---|---|---|---|---|---|
| 3945 | Routine Home Care | $197.21 | $5.92 | $9.92 | $213.05 |
| 3946 | Inpatient Respite | $213.48 | $6.40 | $9.92 | $229.80 |
| 3947 | General Inpatient Care | $894.57 | $26.84 | $9.92 | $931.33 |
| 3948 | Continuous Home Care – Min 8 Hours | $396.87 | $11.91 | $9.92 | $418.70 |
| 3949 | Continuous Home Care – Min 9 Hours | $446.48 | $13.39 | $9.92 | $469.79 |
| 3950 | Continuous Home Care – Min 10 Hours | $496.09 | $14.88 | $9.92 | $520.89 |
| 3951 | Continuous Home Care – Min 11 Hours | $545.70 | $16.37 | $9.92 | $571.99 |
| 3952 | Continuous Home Care – Min 12 Hours | $595.31 | $17.86 | $9.92 | $623.09 |
| 3953 | Continuous Home Care – Min 13 Hours | $644.92 | $19.35 | $9.92 | $674.19 |
| 3954 | Continuous Home Care – Min 14 Hours | $694.53 | $20.84 | $9.92 | $725.29 |
| 3955 | Continuous Home Care – Min 15 Hours | $744.14 | $22.32 | $9.92 | $776.38 |
| 3956 | Continuous Home Care – Min 16 Hours | $793.75 | $23.81 | $9.92 | $827.48 |
| 3957 | Continuous Home Care – Min 17 Hours | $843.36 | $25.30 | $9.92 | $878.58 |
| 3958 | Continuous Home Care – Min 18 Hours | $892.97 | $26.79 | $9.92 | $929.68 |
| 3959 | Continuous Home Care – Min 19 Hours | $942.57 | $28.28 | $9.92 | $980.77 |
| 3960 | Continuous Home Care – Min 20 Hours | $992.18 | $29.77 | $9.92 | $1,031.87 |
| 3961 | Continuous Home Care – Min 21 Hours | $1,041.79 | $31.25 | $9.92 | $1,082.96 |
| 3962 | Continuous Home Care – Min 22 Hours | $1,091.40 | $32.74 | $9.92 | $1,134.06 |
| 3963 | Continuous Home Care – Min 23 Hours | $1,141.01 | $34.23 | $9.92 | $1,185.16 |
| 3964 | Continuous Home Care – Min 24 Hours | $1,190.62 | $35.72 | $9.92 | $1,236.26 |
| 3965 | Hospice Inpatient Respite Care Coinsurance Rate – | ||||
| 5% of 3946 | $8.51 | $0.26 | $0.50 | $9.27 | |
| 3966 | Drugs Coinsurance Rate | $1.00 | $0.00 | $0.00 | $1.00 |
| 3969 | Routine Home Care w/AIDS | $341.64 | $10.25 | $9.92 | $361.81 |
| 3970 | Routine Home Care w/Escort | $215.36 | $6.46 | $9.92 | $231.74 |
| 3971 | Continuous Home Care w/AIDS Min 8 Hours | $461.08 | $13.83 | $9.92 | $484.83 |
| 3972 | Continuous Home Care w/AIDS Min 9 Hours | $518.72 | $15.56 | $9.92 | $544.20 |
| 3973 | Continuous Home Care w/AIDS Min 10 Hours | $576.35 | $17.29 | $9.92 | $603.56 |
| 3974 | Continuous Home Care w/AIDS Min 11 Hours | $633.99 | $19.02 | $9.92 | $662.93 |
| 3975 | Continuous Home Care w/AIDS Min 12 Hours | $691.62 | $20.75 | $9.92 | $722.29 |
| 3976 | Continuous Home Care w/AIDS Min 13 Hours | $749.26 | $22.48 | $9.92 | $781.66 |
| 3977 | Continuous Home Care w/AIDS Min 14 Hours | $806.89 | $24.21 | $9.92 | $841.02 |
| 3978 | Continuous Home Care w/AIDS Min 15 Hours | $864.53 | $25.94 | $9.92 | $900.39 |
| 3979 | Continuous Home Care w/AIDS Min 16 Hours | $922.16 | $27.66 | $9.92 | $959.74 |
| 3980 | Continuous Home Care w/AIDS Min 17 Hours | $979.80 | $29.39 | $9.92 | $1,019.11 |
| 3981 | Continuous Home Care w/AIDS Min 18 Hours | $1,037.43 | $31.12 | $9.92 | $1,078.47 |
| 3982 | Continuous Home Care w/AIDS Min 19 Hours | $1,095.07 | $32.85 | $9.92 | $1,137.84 |
| 3983 | Continuous Home Care w/AIDS Min 20 Hours | $1,152.70 | $34.58 | $9.92 | $1,197.20 |
| 3984 | Continuous Home Care w/AIDS Min 21 Hours | $1,210.34 | $36.31 | $9.92 | $1,256.57 |
| 3985 | Continuous Home Care w/AIDS Min 22 Hours | $1,267.97 | $38.04 | $9.92 | $1,315.93 |
| 3986 | Continuous Home Care w/AIDS Min 23 Hours | $1,325.61 | $39.77 | $9.92 | $1,375.30 |
| 3987 | Continuous Home Care w/AIDS Min 24 Hours | $1,383.24 | $41.50 | $9.92 | $1,434.66 |
| 3988 | General Inpatient w/ AIDS | $994.23 | $29.83 | $9.92 | $1,033.98 |
| 3989 | Routine Home Care w/ AIDS Escort | $359.79 | $10.79 | $9.92 | $380.50 |
| 3991 | Service Intensity Add–on | $51.41 | $1.54 | $0.00 | $52.95 |
* 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 |
|---|---|---|---|---|---|
| 3945 | Routine Home Care | $178.95 | $5.37 | $9.92 | $194.24 |
| 3946 | Inpatient Respite | $197.35 | $5.92 | $9.92 | $213.19 |
| 3947 | General Inpatient Care | $816.54 | $24.50 | $9.92 | $850.96 |
| 3948 | Continuous Home Care – Min 8 Hours | $360.13 | $10.80 | $9.92 | $380.85 |
| 3949 | Continuous Home Care – Min 9 Hours | $405.14 | $12.15 | $9.92 | $427.21 |
| 3950 | Continuous Home Care – Min 10 Hours | $450.16 | $13.50 | $9.92 | $473.58 |
| 3951 | Continuous Home Care – Min 11 Hours | $495.17 | $14.86 | $9.92 | $519.95 |
| 3952 | Continuous Home Care – Min 12 Hours | $540.19 | $16.21 | $9.92 | $566.32 |
| 3953 | Continuous Home Care – Min 13 Hours | $585.21 | $17.56 | $9.92 | $612.69 |
| 3954 | Continuous Home Care – Min 14 Hours | $630.22 | $18.91 | $9.92 | $659.05 |
| 3955 | Continuous Home Care – Min 15 Hours | $675.24 | $20.26 | $9.92 | $705.42 |
| 3956 | Continuous Home Care – Min 16 Hours | $720.25 | $21.61 | $9.92 | $751.78 |
| 3957 | Continuous Home Care – Min 17 Hours | $765.27 | $22.96 | $9.92 | $798.15 |
| 3958 | Continuous Home Care – Min 18 Hours | $810.29 | $24.31 | $9.92 | $844.52 |
| 3959 | Continuous Home Care – Min 19 Hours | $855.30 | $25.66 | $9.92 | $890.88 |
| 3960 | Continuous Home Care – Min 20 Hours | $900.32 | $27.01 | $9.92 | $937.25 |
| 3961 | Continuous Home Care – Min 21 Hours | $945.33 | $28.36 | $9.92 | $983.61 |
| 3962 | Continuous Home Care – Min 22 Hours | $990.35 | $29.71 | $9.92 | $1,029.98 |
| 3963 | Continuous Home Care – Min 23 Hours | $1,035.36 | $31.06 | $9.92 | $1,076.34 |
| 3964 | Continuous Home Care – Min 24 Hours | $1,080.38 | $32.41 | $9.92 | $1,122.71 |
| 3965 | Hospice Inpatient Respite Care Coinsurance Rate – | ||||
| 5% of 3946 | $8.51 | $0.26 | $0.50 | $9.27 | |
| 3966 | Drugs Coinsurance Rate | $1.00 | $0.00 | $0.00 | $1.00 |
| 3969 | Routine Home Care w/AIDS | $310.00 | $9.30 | $9.92 | $329.22 |
| 3970 | Routine Home Care w/Escort | $197.10 | $5.91 | $9.92 | $212.93 |
| 3971 | Continuous Home Care w/AIDS Min 8 Hours | $406.78 | $12.20 | $9.92 | $428.90 |
| 3972 | Continuous Home Care w/AIDS Min 9 Hours | $457.63 | $13.73 | $9.92 | $481.28 |
| 3973 | Continuous Home Care w/AIDS Min 10 Hours | $508.48 | $15.25 | $9.92 | $533.65 |
| 3974 | Continuous Home Care w/AIDS Min 11 Hours | $559.32 | $16.78 | $9.92 | $586.02 |
| 3975 | Continuous Home Care w/AIDS Min 12 Hours | $610.17 | $18.31 | $9.92 | $638.40 |
| 3976 | Continuous Home Care w/AIDS Min 13 Hours | $661.02 | $19.83 | $9.92 | $690.77 |
| 3977 | Continuous Home Care w/AIDS Min 14 Hours | $711.87 | $21.36 | $9.92 | $743.15 |
| 3978 | Continuous Home Care w/AIDS Min 15 Hours | $762.71 | $22.88 | $9.92 | $795.51 |
| 3979 | Continuous Home Care w/AIDS Min 16 Hours | $813.56 | $24.41 | $9.92 | $847.89 |
| 3980 | Continuous Home Care w/AIDS Min 17 Hours | $864.41 | $25.93 | $9.92 | $900.26 |
| 3981 | Continuous Home Care w/AIDS Min 18 Hours | $915.26 | $27.46 | $9.92 | $952.64 |
| 3982 | Continuous Home Care w/AIDS Min 19 Hours | $966.10 | $28.98 | $9.92 | $1,005.00 |
| 3983 | Continuous Home Care w/AIDS Min 20 Hours | $1,016.95 | $30.51 | $9.92 | $1,057.38 |
| 3984 | Continuous Home Care w/AIDS Min 21 Hours | $1,067.80 | $32.03 | $9.92 | $1,109.75 |
| 3985 | Continuous Home Care w/AIDS Min 22 Hours | $1,118.65 | $33.56 | $9.92 | $1,162.13 |
| 3986 | Continuous Home Care w/AIDS Min 23 Hours | $1,169.49 | $35.08 | $9.92 | $1,214.49 |
| 3987 | Continuous Home Care w/AIDS Min 24 Hours | $1,220.34 | $36.61 | $9.92 | $1,266.87 |
| 3988 | General Inpatient w/ AIDS | $907.50 | $27.23 | $9.92 | $944.65 |
| 3989 | Routine Home Care w/ AIDS Escort | $328.15 | $9.84 | $9.92 | $347.91 |
| 3991 | Service Intensity Add–on | $46.65 | $1.40 | $0.00 | $48.05 |
* 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 |
|---|---|---|---|---|---|
| 3945 | Routine Home Care | $151.44 | $4.54 | $9.92 | $165.90 |
| 3946 | Inpatient Respite | $173.05 | $5.19 | $9.92 | $188.16 |
| 3947 | General Inpatient Care | $698.97 | $20.97 | $9.92 | $729.86 |
| 3948 | Continuous Home Care – Min 8 Hours | $304.76 | $9.14 | $9.92 | $323.82 |
| 3949 | Continuous Home Care – Min 9 Hours | $342.85 | $10.29 | $9.92 | $363.06 |
| 3950 | Continuous Home Care – Min 10 Hours | $380.95 | $11.43 | $9.92 | $402.30 |
| 3951 | Continuous Home Care – Min 11 Hours | $419.04 | $12.57 | $9.92 | $441.53 |
| 3952 | Continuous Home Care – Min 12 Hours | $457.14 | $13.71 | $9.92 | $480.77 |
| 3953 | Continuous Home Care – Min 13 Hours | $495.23 | $14.86 | $9.92 | $520.01 |
| 3954 | Continuous Home Care – Min 14 Hours | $533.32 | $16.00 | $9.92 | $559.24 |
| 3955 | Continuous Home Care – Min 15 Hours | $571.42 | $17.14 | $9.92 | $598.48 |
| 3956 | Continuous Home Care – Min 16 Hours | $609.51 | $18.29 | $9.92 | $637.72 |
| 3957 | Continuous Home Care – Min 17 Hours | $647.61 | $19.43 | $9.92 | $676.96 |
| 3958 | Continuous Home Care – Min 18 Hours | $685.70 | $20.57 | $9.92 | $716.19 |
| 3959 | Continuous Home Care – Min 19 Hours | $723.80 | $21.71 | $9.92 | $755.43 |
| 3960 | Continuous Home Care – Min 20 Hours | $761.89 | $22.86 | $9.92 | $794.67 |
| 3961 | Continuous Home Care – Min 21 Hours | $799.99 | $24.00 | $9.92 | $833.91 |
| 3962 | Continuous Home Care – Min 22 Hours | $838.08 | $25.14 | $9.92 | $873.14 |
| 3963 | Continuous Home Care – Min 23 Hours | $876.18 | $26.29 | $9.92 | $912.39 |
| 3964 | Continuous Home Care – Min 24 Hours | $914.27 | $27.43 | $9.92 | $951.62 |
| 3965 | Hospice Inpatient Respite Care Coinsurance Rate – | ||||
| 5% of 3946 | $8.51 | $0.26 | $0.50 | $9.27 | |
| 3966 | Drugs Coinsurance Rate | $1.00 | $0.00 | $0.00 | $1.00 |
| 3969 | Routine Home Care w/AIDS | $262.34 | $7.87 | $9.92 | $280.13 |
| 3970 | Routine Home Care w/Escort | $169.59 | $5.09 | $9.92 | $184.60 |
| 3971 | Continuous Home Care w/AIDS Min 8 Hours | $324.96 | $9.75 | $9.92 | $344.63 |
| 3972 | Continuous Home Care w/AIDS Min 9 Hours | $365.58 | $10.97 | $9.92 | $386.47 |
| 3973 | Continuous Home Care w/AIDS Min 10 Hours | $406.20 | $12.19 | $9.92 | $428.31 |
| 3974 | Continuous Home Care w/AIDS Min 11 Hours | $446.82 | $13.40 | $9.92 | $470.14 |
| 3975 | Continuous Home Care w/AIDS Min 12 Hours | $487.44 | $14.62 | $9.92 | $511.98 |
| 3976 | Continuous Home Care w/AIDS Min 13 Hours | $528.06 | $15.84 | $9.92 | $553.82 |
| 3977 | Continuous Home Care w/AIDS Min 14 Hours | $568.68 | $17.06 | $9.92 | $595.66 |
| 3978 | Continuous Home Care w/AIDS Min 15 Hours | $609.30 | $18.28 | $9.92 | $637.50 |
| 3979 | Continuous Home Care w/AIDS Min 16 Hours | $649.92 | $19.50 | $9.92 | $679.34 |
| 3980 | Continuous Home Care w/AIDS Min 17 Hours | $690.54 | $20.72 | $9.92 | $721.18 |
| 3981 | Continuous Home Care w/AIDS Min 18 Hours | $731.16 | $21.93 | $9.92 | $763.01 |
| 3982 | Continuous Home Care w/AIDS Min 19 Hours | $771.78 | $23.15 | $9.92 | $804.85 |
| 3983 | Continuous Home Care w/AIDS Min 20 Hours | $812.40 | $24.37 | $9.92 | $846.69 |
| 3984 | Continuous Home Care w/AIDS Min 21 Hours | $853.02 | $25.59 | $9.92 | $888.53 |
| 3985 | Continuous Home Care w/AIDS Min 22 Hours | $893.64 | $26.81 | $9.92 | $930.37 |
| 3986 | Continuous Home Care w/AIDS Min 23 Hours | $934.26 | $28.03 | $9.92 | $972.21 |
| 3987 | Continuous Home Care w/AIDS Min 24 Hours | $974.88 | $29.25 | $9.92 | $1,014.05 |
| 3988 | General Inpatient w/ AIDS | $776.84 | $23.31 | $9.92 | $810.07 |
| 3989 | Routine Home Care w/ AIDS Escort | $280.49 | $8.41 | $9.92 | $298.82 |
| 3991 | Service Intensity Add–on | $39.47 | $1.18 | $0.00 | $40.65 |
* 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 |
|---|---|---|---|---|---|
| 3945 | Routine Home Care | $165.51 | $4.97 | $9.92 | $180.40 |
| 3946 | Inpatient Respite | $185.48 | $5.56 | $9.92 | $200.96 |
| 3947 | General Inpatient Care | $759.09 | $22.77 | $9.92 | $791.78 |
| 3948 | Continuous Home Care – Min 8 Hours | $333.07 | $9.99 | $9.92 | $352.98 |
| 3949 | Continuous Home Care – Min 9 Hours | $374.70 | $11.24 | $9.92 | $395.86 |
| 3950 | Continuous Home Care – Min 10 Hours | $416.34 | $12.49 | $9.92 | $438.75 |
| 3951 | Continuous Home Care – Min 11 Hours | $457.97 | $13.74 | $9.92 | $481.63 |
| 3952 | Continuous Home Care – Min 12 Hours | $499.61 | $14.99 | $9.92 | $524.52 |
| 3953 | Continuous Home Care – Min 13 Hours | $541.24 | $16.24 | $9.92 | $567.40 |
| 3954 | Continuous Home Care – Min 14 Hours | $582.87 | $17.49 | $9.92 | $610.28 |
| 3955 | Continuous Home Care – Min 15 Hours | $624.51 | $18.74 | $9.92 | $653.17 |
| 3956 | Continuous Home Care – Min 16 Hours | $666.14 | $19.98 | $9.92 | $696.04 |
| 3957 | Continuous Home Care – Min 17 Hours | $707.77 | $21.23 | $9.92 | $738.92 |
| 3958 | Continuous Home Care – Min 18 Hours | $749.41 | $22.48 | $9.92 | $781.81 |
| 3959 | Continuous Home Care – Min 19 Hours | $791.04 | $23.73 | $9.92 | $824.69 |
| 3960 | Continuous Home Care – Min 20 Hours | $832.68 | $24.98 | $9.92 | $867.58 |
| 3961 | Continuous Home Care – Min 21 Hours | $874.31 | $26.23 | $9.92 | $910.46 |
| 3962 | Continuous Home Care – Min 22 Hours | $915.94 | $27.48 | $9.92 | $953.34 |
| 3963 | Continuous Home Care – Min 23 Hours | $957.58 | $28.73 | $9.92 | $996.23 |
| 3964 | Continuous Home Care – Min 24 Hours | $999.21 | $29.98 | $9.92 | $1,039.11 |
| 3965 | Hospice Inpatient Respite Care Coinsurance Rate – | ||||
| 5% of 3946 | $8.51 | $0.26 | $0.50 | $9.27 | |
| 3966 | Drugs Coinsurance Rate | $1.00 | $0.00 | $0.00 | $1.00 |
| 3969 | Routine Home Care w/AIDS | $286.71 | $8.60 | $9.92 | $305.23 |
| 3970 | Routine Home Care w/Escort | $183.66 | $5.51 | $9.92 | $199.09 |
| 3971 | Continuous Home Care w/AIDS Min 8 Hours | $366.80 | $11.00 | $9.92 | $387.72 |
| 3972 | Continuous Home Care w/AIDS Min 9 Hours | $412.65 | $12.38 | $9.92 | $434.95 |
| 3973 | Continuous Home Care w/AIDS Min 10 Hours | $458.50 | $13.76 | $9.92 | $482.18 |
| 3974 | Continuous Home Care w/AIDS Min 11 Hours | $504.35 | $15.13 | $9.92 | $529.40 |
| 3975 | Continuous Home Care w/AIDS Min 12 Hours | $550.20 | $16.51 | $9.92 | $576.63 |
| 3976 | Continuous Home Care w/AIDS Min 13 Hours | $596.05 | $17.88 | $9.92 | $623.85 |
| 3977 | Continuous Home Care w/AIDS Min 14 Hours | $641.90 | $19.26 | $9.92 | $671.08 |
| 3978 | Continuous Home Care w/AIDS Min 15 Hours | $687.75 | $20.63 | $9.92 | $718.30 |
| 3979 | Continuous Home Care w/AIDS Min 16 Hours | $733.60 | $22.01 | $9.92 | $765.53 |
| 3980 | Continuous Home Care w/AIDS Min 17 Hours | $779.45 | $23.38 | $9.92 | $812.75 |
| 3981 | Continuous Home Care w/AIDS Min 18 Hours | $825.30 | $24.76 | $9.92 | $859.98 |
| 3982 | Continuous Home Care w/AIDS Min 19 Hours | $871.15 | $26.13 | $9.92 | $907.20 |
| 3983 | Continuous Home Care w/AIDS Min 20 Hours | $917.00 | $27.51 | $9.92 | $954.43 |
| 3984 | Continuous Home Care w/AIDS Min 21 Hours | $962.85 | $28.89 | $9.92 | $1,001.66 |
| 3985 | Continuous Home Care w/AIDS Min 22 Hours | $1,008.70 | $30.26 | $9.92 | $1,048.88 |
| 3986 | Continuous Home Care w/AIDS Min 23 Hours | $1,054.55 | $31.64 | $9.92 | $1,096.11 |
| 3987 | Continuous Home Care w/AIDS Min 24 Hours | $1,100.40 | $33.01 | $9.92 | $1,143.33 |
| 3988 | General Inpatient w/ AIDS | $843.65 | $25.31 | $9.92 | $878.88 |
| 3989 | Routine Home Care w/ AIDS Escort | $304.86 | $9.15 | $9.92 | $323.93 |
| 3991 | Service Intensity Add–on | $43.14 | $1.29 | $0.00 | $44.43 |
* 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: MADISON, ONONDAGA, OSWEGO
| Rate Code |
Description | Base Rate | WRP Add–on * |
RTR Add–on * |
Total w/ addons |
|---|---|---|---|---|---|
| 3945 | Routine Home Care | $157.56 | $4.73 | $9.92 | $172.21 |
| 3946 | Inpatient Respite | $178.46 | $5.35 | $9.92 | $193.73 |
| 3947 | General Inpatient Care | $725.12 | $21.75 | $9.92 | $756.79 |
| 3948 | Continuous Home Care – Min 8 Hours | $317.07 | $9.51 | $9.92 | $336.50 |
| 3949 | Continuous Home Care – Min 9 Hours | $356.71 | $10.70 | $9.92 | $377.33 |
| 3950 | Continuous Home Care – Min 10 Hours | $396.34 | $11.89 | $9.92 | $418.15 |
| 3951 | Continuous Home Care – Min 11 Hours | $435.98 | $13.08 | $9.92 | $458.98 |
| 3952 | Continuous Home Care – Min 12 Hours | $475.61 | $14.27 | $9.92 | $499.80 |
| 3953 | Continuous Home Care – Min 13 Hours | $515.24 | $15.46 | $9.92 | $540.62 |
| 3954 | Continuous Home Care – Min 14 Hours | $554.88 | $16.65 | $9.92 | $581.45 |
| 3955 | Continuous Home Care – Min 15 Hours | $594.51 | $17.84 | $9.92 | $622.27 |
| 3956 | Continuous Home Care – Min 16 Hours | $634.15 | $19.02 | $9.92 | $663.09 |
| 3957 | Continuous Home Care – Min 17 Hours | $673.78 | $20.21 | $9.92 | $703.91 |
| 3958 | Continuous Home Care – Min 18 Hours | $713.42 | $21.40 | $9.92 | $744.74 |
| 3959 | Continuous Home Care – Min 19 Hours | $753.05 | $22.59 | $9.92 | $785.56 |
| 3960 | Continuous Home Care – Min 20 Hours | $792.68 | $23.78 | $9.92 | $826.38 |
| 3961 | Continuous Home Care – Min 21 Hours | $832.32 | $24.97 | $9.92 | $867.21 |
| 3962 | Continuous Home Care – Min 22 Hours | $871.95 | $26.16 | $9.92 | $908.03 |
| 3963 | Continuous Home Care – Min 23 Hours | $911.59 | $27.35 | $9.92 | $948.86 |
| 3964 | Continuous Home Care – Min 24 Hours | $951.22 | $28.54 | $9.92 | $989.68 |
| 3965 | Hospice Inpatient Respite Care Coinsurance Rate – | ||||
| 5% of 3946 | $8.51 | $0.26 | $0.50 | $9.27 | |
| 3966 | Drugs Coinsurance Rate | $1.00 | $0.00 | $0.00 | $1.00 |
| 3969 | Routine Home Care w/AIDS | $272.94 | $8.19 | $9.92 | $291.05 |
| 3970 | Routine Home Care w/Escort | $175.71 | $5.27 | $9.92 | $190.90 |
| 3971 | Continuous Home Care w/AIDS Min 8 Hours | $343.16 | $10.29 | $9.92 | $363.37 |
| 3972 | Continuous Home Care w/AIDS Min 9 Hours | $386.06 | $11.58 | $9.92 | $407.56 |
| 3973 | Continuous Home Care w/AIDS Min 10 Hours | $428.95 | $12.87 | $9.92 | $451.74 |
| 3974 | Continuous Home Care w/AIDS Min 11 Hours | $471.85 | $14.16 | $9.92 | $495.93 |
| 3975 | Continuous Home Care w/AIDS Min 12 Hours | $514.74 | $15.44 | $9.92 | $540.10 |
| 3976 | Continuous Home Care w/AIDS Min 13 Hours | $557.64 | $16.73 | $9.92 | $584.29 |
| 3977 | Continuous Home Care w/AIDS Min 14 Hours | $600.53 | $18.02 | $9.92 | $628.47 |
| 3978 | Continuous Home Care w/AIDS Min 15 Hours | $643.43 | $19.30 | $9.92 | $672.65 |
| 3979 | Continuous Home Care w/AIDS Min 16 Hours | $686.32 | $20.59 | $9.92 | $716.83 |
| 3980 | Continuous Home Care w/AIDS Min 17 Hours | $729.22 | $21.88 | $9.92 | $761.02 |
| 3981 | Continuous Home Care w/AIDS Min 18 Hours | $772.11 | $23.16 | $9.92 | $805.19 |
| 3982 | Continuous Home Care w/AIDS Min 19 Hours | $815.01 | $24.45 | $9.92 | $849.38 |
| 3983 | Continuous Home Care w/AIDS Min 20 Hours | $857.90 | $25.74 | $9.92 | $893.56 |
| 3984 | Continuous Home Care w/AIDS Min 21 Hours | $900.80 | $27.02 | $9.92 | $937.74 |
| 3985 | Continuous Home Care w/AIDS Min 22 Hours | $943.69 | $28.31 | $9.92 | $981.92 |
| 3986 | Continuous Home Care w/AIDS Min 23 Hours | $986.59 | $29.60 | $9.92 | $1,026.11 |
| 3987 | Continuous Home Care w/AIDS Min 24 Hours | $1,029.48 | $30.88 | $9.92 | $1,070.28 |
| 3988 | General Inpatient w/ AIDS | $805.90 | $24.18 | $9.92 | $840.00 |
| 3989 | Routine Home Care w/ AIDS Escort | $291.09 | $8.73 | $9.92 | $309.74 |
| 3991 | Service Intensity Add–on | $41.07 | $1.23 | $0.00 | $42.30 |
* 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 |
|---|---|---|---|---|---|
| 3945 | Routine Home Care | $148.22 | $4.45 | $9.92 | $162.59 |
| 3946 | Inpatient Respite | $170.22 | $5.11 | $9.92 | $185.25 |
| 3947 | General Inpatient Care | $685.24 | $20.56 | $9.92 | $715.72 |
| 3948 | Continuous Home Care – Min 8 Hours | $298.29 | $8.95 | $9.92 | $317.16 |
| 3949 | Continuous Home Care – Min 9 Hours | $335.58 | $10.07 | $9.92 | $355.57 |
| 3950 | Continuous Home Care – Min 10 Hours | $372.86 | $11.19 | $9.92 | $393.97 |
| 3951 | Continuous Home Care – Min 11 Hours | $410.15 | $12.30 | $9.92 | $432.37 |
| 3952 | Continuous Home Care – Min 12 Hours | $447.44 | $13.42 | $9.92 | $470.78 |
| 3953 | Continuous Home Care – Min 13 Hours | $484.72 | $14.54 | $9.92 | $509.18 |
| 3954 | Continuous Home Care – Min 14 Hours | $522.01 | $15.66 | $9.92 | $547.59 |
| 3955 | Continuous Home Care – Min 15 Hours | $559.29 | $16.78 | $9.92 | $585.99 |
| 3956 | Continuous Home Care – Min 16 Hours | $596.58 | $17.90 | $9.92 | $624.40 |
| 3957 | Continuous Home Care – Min 17 Hours | $633.87 | $19.02 | $9.92 | $662.81 |
| 3958 | Continuous Home Care – Min 18 Hours | $671.15 | $20.13 | $9.92 | $701.20 |
| 3959 | Continuous Home Care – Min 19 Hours | $708.44 | $21.25 | $9.92 | $739.61 |
| 3960 | Continuous Home Care – Min 20 Hours | $745.73 | $22.37 | $9.92 | $778.02 |
| 3961 | Continuous Home Care – Min 21 Hours | $783.01 | $23.49 | $9.92 | $816.42 |
| 3962 | Continuous Home Care – Min 22 Hours | $820.30 | $24.61 | $9.92 | $854.83 |
| 3963 | Continuous Home Care – Min 23 Hours | $857.58 | $25.73 | $9.92 | $893.23 |
| 3964 | Continuous Home Care – Min 24 Hours | $894.87 | $26.85 | $9.92 | $931.64 |
| 3965 | Hospice Inpatient Respite Care Coinsurance Rate – | ||||
| 5% of 3946 | $8.51 | $0.26 | $0.50 | $9.27 | |
| 3966 | Drugs Coinsurance Rate | $1.00 | $0.00 | $0.00 | $1.00 |
| 3969 | Routine Home Care w/AIDS | $256.77 | $7.70 | $9.92 | $274.39 |
| 3970 | Routine Home Care w/Escort | $166.37 | $4.99 | $9.92 | $181.28 |
| 3971 | Continuous Home Care w/AIDS Min 8 Hours | $315.40 | $9.46 | $9.92 | $334.78 |
| 3972 | Continuous Home Care w/AIDS Min 9 Hours | $354.83 | $10.64 | $9.92 | $375.39 |
| 3973 | Continuous Home Care w/AIDS Min 10 Hours | $394.25 | $11.83 | $9.92 | $416.00 |
| 3974 | Continuous Home Care w/AIDS Min 11 Hours | $433.68 | $13.01 | $9.92 | $456.61 |
| 3975 | Continuous Home Care w/AIDS Min 12 Hours | $473.11 | $14.19 | $9.92 | $497.22 |
| 3976 | Continuous Home Care w/AIDS Min 13 Hours | $512.53 | $15.38 | $9.92 | $537.83 |
| 3977 | Continuous Home Care w/AIDS Min 14 Hours | $551.96 | $16.56 | $9.92 | $578.44 |
| 3978 | Continuous Home Care w/AIDS Min 15 Hours | $591.38 | $17.74 | $9.92 | $619.04 |
| 3979 | Continuous Home Care w/AIDS Min 16 Hours | $630.81 | $18.92 | $9.92 | $659.65 |
| 3980 | Continuous Home Care w/AIDS Min 17 Hours | $670.23 | $20.11 | $9.92 | $700.26 |
| 3981 | Continuous Home Care w/AIDS Min 18 Hours | $709.66 | $21.29 | $9.92 | $740.87 |
| 3982 | Continuous Home Care w/AIDS Min 19 Hours | $749.08 | $22.47 | $9.92 | $781.47 |
| 3983 | Continuous Home Care w/AIDS Min 20 Hours | $788.51 | $23.66 | $9.92 | $822.09 |
| 3984 | Continuous Home Care w/AIDS Min 21 Hours | $827.93 | $24.84 | $9.92 | $862.69 |
| 3985 | Continuous Home Care w/AIDS Min 22 Hours | $867.36 | $26.02 | $9.92 | $903.30 |
| 3986 | Continuous Home Care w/AIDS Min 23 Hours | $906.78 | $27.20 | $9.92 | $943.90 |
| 3987 | Continuous Home Care w/AIDS Min 24 Hours | $946.21 | $28.39 | $9.92 | $984.52 |
| 3988 | General Inpatient w/ AIDS | $761.58 | $22.85 | $9.92 | $794.35 |
| 3989 | Routine Home Care w/ AIDS Escort | $274.92 | $8.25 | $9.92 | $293.09 |
| 3991 | Service Intensity Add–on | $38.64 | $1.16 | $0.00 | $39.80 |
* WRR =´Worker Recruitment and Retention addon´ if applicable
* RTR =´Recruitment, Training and Retention addon´ if applicable
