Certified Hospice Program
Medicaid Rate Sheet
Effective: 10/01/2019 - 09/30/2020
- 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 | WRR Add-on * |
RTR Add-on * |
Total w/ addons |
|---|---|---|---|---|---|
| 3945 | Routine Home Care | $171.19 | $5.14 | $9.92 | $186.25 |
| 3946 | Inpatient Respite | $428.63 | $12.86 | $9.92 | $451.41 |
| 3947 | General Inpatient Care | $906.13 | $27.18 | $9.92 | $943.23 |
| 3948 | Continuous Home Care - Min 8 Hours | $409.08 | $12.27 | $9.92 | $431.27 |
| 3949 | Continuous Home Care - Min 9 Hours | $460.22 | $13.81 | $9.92 | $483.95 |
| 3950 | Continuous Home Care - Min 10 Hours | $511.35 | $15.34 | $9.92 | $536.61 |
| 3951 | Continuous Home Care - Min 11 Hours | $562.49 | $16.87 | $9.92 | $589.28 |
| 3952 | Continuous Home Care - Min 12 Hours | $613.62 | $18.41 | $9.92 | $641.95 |
| 3953 | Continuous Home Care - Min 13 Hours | $664.76 | $19.94 | $9.92 | $694.62 |
| 3954 | Continuous Home Care - Min 14 Hours | $715.89 | $21.48 | $9.92 | $747.29 |
| 3955 | Continuous Home Care - Min 15 Hours | $767.03 | $23.01 | $9.92 | $799.96 |
| 3956 | Continuous Home Care - Min 16 Hours | $818.16 | $24.54 | $9.92 | $852.62 |
| 3957 | Continuous Home Care - Min 17 Hours | $869.30 | $26.08 | $9.92 | $905.30 |
| 3958 | Continuous Home Care - Min 18 Hours | $920.43 | $27.61 | $9.92 | $957.96 |
| 3959 | Continuous Home Care - Min 19 Hours | $971.57 | $29.15 | $9.92 | $1,010.64 |
| 3960 | Continuous Home Care - Min 20 Hours | $1,022.70 | $30.68 | $9.92 | $1,063.30 |
| 3961 | Continuous Home Care - Min 21 Hours | $1,073.84 | $32.22 | $9.92 | $1,115.98 |
| 3962 | Continuous Home Care - Min 22 Hours | $1,124.97 | $33.75 | $9.92 | $1,168.64 |
| 3963 | Continuous Home Care - Min 23 Hours | $1,176.11 | $35.28 | $9.92 | $1,221.31 |
| 3964 | Continuous Home Care - Min 24 Hours | $1,227.24 | $36.82 | $9.92 | $1,273.98 |
| 3965 | Hospice Inpatient Respite Care Coinsurance Rate - 5% of 3946 | $21.43 | $0.64 | $0.50 | $22.57 |
| 3966 | Drugs Coinsurance Rate | $1.00 | $0.00 | $0.00 | $1.00 |
| 3969 | Routine Home Care w/AIDS | $279.80 | $8.39 | $9.92 | $298.11 |
| 3970 | Routine Home Care w/Escort | $189.72 | $5.69 | $9.92 | $205.33 |
| 3971 | Continuous Home Care w/AIDS Min 8 Hours | $418.44 | $12.55 | $9.92 | $440.91 |
| 3972 | Continuous Home Care w/AIDS Min 9 Hours | $470.75 | $14.12 | $9.92 | $494.79 |
| 3973 | Continuous Home Care w/AIDS Min 10 Hours | $523.05 | $15.69 | $9.92 | $548.66 |
| 3974 | Continuous Home Care w/AIDS Min 11 Hours | $575.36 | $17.26 | $9.92 | $602.54 |
| 3975 | Continuous Home Care w/AIDS Min 12 Hours | $627.67 | $18.83 | $9.92 | $656.42 |
| 3976 | Continuous Home Care w/AIDS Min 13 Hours | $679.97 | $20.40 | $9.92 | $710.29 |
| 3977 | Continuous Home Care w/AIDS Min 14 Hours | $732.28 | $21.97 | $9.92 | $764.17 |
| 3978 | Continuous Home Care w/AIDS Min 15 Hours | $784.58 | $23.54 | $9.92 | $818.04 |
| 3979 | Continuous Home Care w/AIDS Min 16 Hours | $836.89 | $25.11 | $9.92 | $871.92 |
| 3980 | Continuous Home Care w/AIDS Min 17 Hours | $889.19 | $26.68 | $9.92 | $925.79 |
| 3981 | Continuous Home Care w/AIDS Min 18 Hours | $941.50 | $28.25 | $9.92 | $979.67 |
| 3982 | Continuous Home Care w/AIDS Min 19 Hours | $925.76 | $27.77 | $9.92 | $963.45 |
| 3983 | Continuous Home Care w/AIDS Min 20 Hours | $993.80 | $29.81 | $9.92 | $1,033.53 |
| 3984 | Continuous Home Care w/AIDS Min 21 Hours | $1,098.41 | $32.95 | $9.92 | $1,141.28 |
| 3985 | Continuous Home Care w/AIDS Min 22 Hours | $1,150.72 | $34.52 | $9.92 | $1,195.16 |
| 3986 | Continuous Home Care w/AIDS Min 23 Hours | $1,203.02 | $36.09 | $9.92 | $1,249.03 |
| 3987 | Continuous Home Care w/AIDS Min 24 Hours | $1,255.33 | $37.66 | $9.92 | $1,302.91 |
| 3988 | General Inpatient w/ AIDS | $1,007.07 | $30.21 | $9.92 | $1,047.20 |
| 3989 | Routine Home Care w/ AIDS Escort | $298.33 | $8.95 | $9.92 | $317.20 |
| 3991 | Service Intensity Add-on | $51.13 | $1.53 | $0.00 | $52.66 |
* 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 | $173.46 | $5.20 | $9.92 | $188.58 |
| 3946 | Inpatient Respite | $432.99 | $12.99 | $9.92 | $455.90 |
| 3947 | General Inpatient Care | $917.25 | $27.52 | $9.92 | $954.69 |
| 3948 | Continuous Home Care - Min 8 Hours | $414.51 | $12.44 | $9.92 | $436.87 |
| 3949 | Continuous Home Care - Min 9 Hours | $466.33 | $13.99 | $9.92 | $490.24 |
| 3950 | Continuous Home Care - Min 10 Hours | $518.14 | $15.54 | $9.92 | $543.60 |
| 3951 | Continuous Home Care - Min 11 Hours | $569.96 | $17.10 | $9.92 | $596.98 |
| 3952 | Continuous Home Care - Min 12 Hours | $621.77 | $18.65 | $9.92 | $650.34 |
| 3953 | Continuous Home Care - Min 13 Hours | $673.58 | $20.21 | $9.92 | $703.71 |
| 3954 | Continuous Home Care - Min 14 Hours | $725.40 | $21.76 | $9.92 | $757.08 |
| 3955 | Continuous Home Care - Min 15 Hours | $777.21 | $23.32 | $9.92 | $810.45 |
| 3956 | Continuous Home Care - Min 16 Hours | $829.03 | $24.87 | $9.92 | $863.82 |
| 3957 | Continuous Home Care - Min 17 Hours | $880.84 | $26.43 | $9.92 | $917.19 |
| 3958 | Continuous Home Care - Min 18 Hours | $932.66 | $27.98 | $9.92 | $970.56 |
| 3959 | Continuous Home Care - Min 19 Hours | $984.47 | $29.53 | $9.92 | $1,023.92 |
| 3960 | Continuous Home Care - Min 20 Hours | $1,036.28 | $31.09 | $9.92 | $1,077.29 |
| 3961 | Continuous Home Care - Min 21 Hours | $1,088.10 | $32.64 | $9.92 | $1,130.66 |
| 3962 | Continuous Home Care - Min 22 Hours | $1,139.91 | $34.20 | $9.92 | $1,184.03 |
| 3963 | Continuous Home Care - Min 23 Hours | $1,191.73 | $35.75 | $9.92 | $1,237.40 |
| 3964 | Continuous Home Care - Min 24 Hours | $1,243.54 | $37.31 | $9.92 | $1,290.77 |
| 3965 | Hospice Inpatient Respite Care Coinsurance Rate - 5% of 3946 | $21.65 | $0.65 | $0.50 | $22.80 |
| 3966 | Drugs Coinsurance Rate | $1.00 | $0.00 | $0.00 | $1.00 |
| 3969 | Routine Home Care w/AIDS | $283.52 | $8.51 | $9.92 | $301.95 |
| 3970 | Routine Home Care w/Escort | $191.99 | $5.76 | $9.92 | $207.67 |
| 3971 | Continuous Home Care w/AIDS Min 8 Hours | $426.28 | $12.79 | $9.92 | $448.99 |
| 3972 | Continuous Home Care w/AIDS Min 9 Hours | $479.56 | $14.39 | $9.92 | $503.87 |
| 3973 | Continuous Home Care w/AIDS Min 10 Hours | $532.85 | $15.99 | $9.92 | $558.76 |
| 3974 | Continuous Home Care w/AIDS Min 11 Hours | $586.13 | $17.58 | $9.92 | $613.63 |
| 3975 | Continuous Home Care w/AIDS Min 12 Hours | $639.42 | $19.18 | $9.92 | $668.52 |
| 3976 | Continuous Home Care w/AIDS Min 13 Hours | $692.70 | $20.78 | $9.92 | $723.40 |
| 3977 | Continuous Home Care w/AIDS Min 14 Hours | $745.98 | $22.38 | $9.92 | $778.28 |
| 3978 | Continuous Home Care w/AIDS Min 15 Hours | $799.27 | $23.98 | $9.92 | $833.17 |
| 3979 | Continuous Home Care w/AIDS Min 16 Hours | $852.55 | $25.58 | $9.92 | $888.05 |
| 3980 | Continuous Home Care w/AIDS Min 17 Hours | $905.84 | $27.18 | $9.92 | $942.94 |
| 3981 | Continuous Home Care w/AIDS Min 18 Hours | $959.12 | $28.77 | $9.92 | $997.81 |
| 3982 | Continuous Home Care w/AIDS Min 19 Hours | $1,012.41 | $30.37 | $9.92 | $1,052.70 |
| 3983 | Continuous Home Care w/AIDS Min 20 Hours | $1,065.69 | $31.97 | $9.92 | $1,107.58 |
| 3984 | Continuous Home Care w/AIDS Min 21 Hours | $1,118.98 | $33.57 | $9.92 | $1,162.47 |
| 3985 | Continuous Home Care w/AIDS Min 22 Hours | $1,172.26 | $35.17 | $9.92 | $1,217.35 |
| 3986 | Continuous Home Care w/AIDS Min 23 Hours | $1,225.55 | $36.77 | $9.92 | $1,272.24 |
| 3987 | Continuous Home Care w/AIDS Min 24 Hours | $1,278.83 | $38.36 | $9.92 | $1,327.11 |
| 3988 | General Inpatient w/ AIDS | $1,019.43 | $30.58 | $9.92 | $1,059.93 |
| 3989 | Routine Home Care w/ AIDS Escort | $302.05 | $9.06 | $9.92 | $321.03 |
| 3991 | Service Intensity Add-on | $51.81 | $1.55 | $0.00 | $53.36 |
* 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 | $201.27 | $6.04 | $9.92 | $217.23 |
| 3946 | Inpatient Respite | $486.28 | $14.59 | $9.92 | $510.79 |
| 3947 | General Inpatient Care | $1,053.09 | $31.59 | $9.92 | $1,094.60 |
| 3948 | Continuous Home Care - Min 8 Hours | $480.96 | $14.43 | $9.92 | $505.31 |
| 3949 | Continuous Home Care - Min 9 Hours | $541.08 | $16.23 | $9.92 | $567.23 |
| 3950 | Continuous Home Care - Min 10 Hours | $601.20 | $18.04 | $9.92 | $629.16 |
| 3951 | Continuous Home Care - Min 11 Hours | $661.32 | $19.84 | $9.92 | $691.08 |
| 3952 | Continuous Home Care - Min 12 Hours | $721.45 | $21.64 | $9.92 | $753.01 |
| 3953 | Continuous Home Care - Min 13 Hours | $781.57 | $23.45 | $9.92 | $814.94 |
| 3954 | Continuous Home Care - Min 14 Hours | $841.69 | $25.25 | $9.92 | $876.86 |
| 3955 | Continuous Home Care - Min 15 Hours | $901.81 | $27.05 | $9.92 | $938.78 |
| 3956 | Continuous Home Care - Min 16 Hours | $961.93 | $28.86 | $9.92 | $1,000.71 |
| 3957 | Continuous Home Care - Min 17 Hours | $1,022.05 | $30.66 | $9.92 | $1,062.63 |
| 3958 | Continuous Home Care - Min 18 Hours | $1,082.17 | $32.47 | $9.92 | $1,124.56 |
| 3959 | Continuous Home Care - Min 19 Hours | $1,142.29 | $34.27 | $9.92 | $1,186.48 |
| 3960 | Continuous Home Care - Min 20 Hours | $1,202.41 | $36.07 | $9.92 | $1,248.40 |
| 3961 | Continuous Home Care - Min 21 Hours | $1,262.53 | $37.88 | $9.92 | $1,310.33 |
| 3962 | Continuous Home Care - Min 22 Hours | $1,322.65 | $39.68 | $9.92 | $1,372.25 |
| 3963 | Continuous Home Care - Min 23 Hours | $1,382.77 | $41.48 | $9.92 | $1,434.17 |
| 3964 | Continuous Home Care - Min 24 Hours | $1,442.89 | $43.29 | $9.92 | $1,496.10 |
| 3965 | Hospice Inpatient Respite Care Coinsurance Rate - 5% of 3946 | $24.31 | $0.73 | $0.50 | $25.54 |
| 3966 | Drugs Coinsurance Rate | $1.00 | $0.00 | $0.00 | $1.00 |
| 3969 | Routine Home Care w/AIDS | $328.97 | $9.87 | $9.92 | $348.76 |
| 3970 | Routine Home Care w/Escort | $219.80 | $6.59 | $9.92 | $236.31 |
| 3971 | Continuous Home Care w/AIDS Min 8 Hours | $522.04 | $15.66 | $9.92 | $547.62 |
| 3972 | Continuous Home Care w/AIDS Min 9 Hours | $587.29 | $17.62 | $9.92 | $614.83 |
| 3973 | Continuous Home Care w/AIDS Min 10 Hours | $652.55 | $19.58 | $9.92 | $682.05 |
| 3974 | Continuous Home Care w/AIDS Min 11 Hours | $717.80 | $21.53 | $9.92 | $749.25 |
| 3975 | Continuous Home Care w/AIDS Min 12 Hours | $783.06 | $23.49 | $9.92 | $816.47 |
| 3976 | Continuous Home Care w/AIDS Min 13 Hours | $848.31 | $25.45 | $9.92 | $883.68 |
| 3977 | Continuous Home Care w/AIDS Min 14 Hours | $913.56 | $27.41 | $9.92 | $950.89 |
| 3978 | Continuous Home Care w/AIDS Min 15 Hours | $978.82 | $29.36 | $9.92 | $1,018.10 |
| 3979 | Continuous Home Care w/AIDS Min 16 Hours | $1,044.07 | $31.32 | $9.92 | $1,085.31 |
| 3980 | Continuous Home Care w/AIDS Min 17 Hours | $1,109.33 | $33.28 | $9.92 | $1,152.53 |
| 3981 | Continuous Home Care w/AIDS Min 18 Hours | $1,174.58 | $35.24 | $9.92 | $1,219.74 |
| 3982 | Continuous Home Care w/AIDS Min 19 Hours | $1,239.84 | $37.20 | $9.92 | $1,286.96 |
| 3983 | Continuous Home Care w/AIDS Min 20 Hours | $1,305.09 | $39.15 | $9.92 | $1,354.16 |
| 3984 | Continuous Home Care w/AIDS Min 21 Hours | $1,370.35 | $41.11 | $9.92 | $1,421.38 |
| 3985 | Continuous Home Care w/AIDS Min 22 Hours | $1,435.60 | $43.07 | $9.92 | $1,488.59 |
| 3986 | Continuous Home Care w/AIDS Min 23 Hours | $1,500.86 | $45.03 | $9.92 | $1,555.81 |
| 3987 | Continuous Home Care w/AIDS Min 24 Hours | $1,566.11 | $46.98 | $9.92 | $1,623.01 |
| 3988 | General Inpatient w/ AIDS | $1,170.40 | $35.11 | $9.92 | $1,215.43 |
| 3989 | Routine Home Care w/ AIDS Escort | $347.50 | $10.43 | $9.92 | $367.85 |
| 3991 | Service Intensity Add-on | $60.12 | $1.80 | $0.00 | $61.92 |
* 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 | $175.64 | $5.27 | $9.92 | $190.83 |
| 3946 | Inpatient Respite | $437.17 | $13.12 | $9.92 | $460.21 |
| 3947 | General Inpatient Care | $927.90 | $27.84 | $9.92 | $965.66 |
| 3948 | Continuous Home Care - Min 8 Hours | $419.73 | $12.59 | $9.92 | $442.24 |
| 3949 | Continuous Home Care - Min 9 Hours | $472.19 | $14.17 | $9.92 | $496.28 |
| 3950 | Continuous Home Care - Min 10 Hours | $524.66 | $15.74 | $9.92 | $550.32 |
| 3951 | Continuous Home Care - Min 11 Hours | $577.12 | $17.31 | $9.92 | $604.35 |
| 3952 | Continuous Home Care - Min 12 Hours | $629.59 | $18.89 | $9.92 | $658.40 |
| 3953 | Continuous Home Care - Min 13 Hours | $682.06 | $20.46 | $9.92 | $712.44 |
| 3954 | Continuous Home Care - Min 14 Hours | $734.52 | $22.04 | $9.92 | $766.48 |
| 3955 | Continuous Home Care - Min 15 Hours | $786.99 | $23.61 | $9.92 | $820.52 |
| 3956 | Continuous Home Care - Min 16 Hours | $839.45 | $25.18 | $9.92 | $874.55 |
| 3957 | Continuous Home Care - Min 17 Hours | $891.92 | $26.76 | $9.92 | $928.60 |
| 3958 | Continuous Home Care - Min 18 Hours | $944.39 | $28.33 | $9.92 | $982.64 |
| 3959 | Continuous Home Care - Min 19 Hours | $996.85 | $29.91 | $9.92 | $1,036.68 |
| 3960 | Continuous Home Care - Min 20 Hours | $1,049.32 | $31.48 | $9.92 | $1,090.72 |
| 3961 | Continuous Home Care - Min 21 Hours | $1,101.78 | $33.05 | $9.92 | $1,144.75 |
| 3962 | Continuous Home Care - Min 22 Hours | $1,154.25 | $34.63 | $9.92 | $1,198.80 |
| 3963 | Continuous Home Care - Min 23 Hours | $1,206.71 | $36.20 | $9.92 | $1,252.83 |
| 3964 | Continuous Home Care - Min 24 Hours | $1,259.18 | $37.78 | $9.92 | $1,306.88 |
| 3965 | Hospice Inpatient Respite Care Coinsurance Rate - 5% of 3946 | $21.86 | $0.66 | $0.50 | $23.02 |
| 3966 | Drugs Coinsurance Rate | $1.00 | $0.00 | $0.00 | $1.00 |
| 3969 | Routine Home Care w/AIDS | $287.09 | $8.61 | $9.92 | $305.62 |
| 3970 | Routine Home Care w/Escort | $194.17 | $5.83 | $9.92 | $209.92 |
| 3971 | Continuous Home Care w/AIDS Min 8 Hours | $433.79 | $13.01 | $9.92 | $456.72 |
| 3972 | Continuous Home Care w/AIDS Min 9 Hours | $488.01 | $14.64 | $9.92 | $512.57 |
| 3973 | Continuous Home Care w/AIDS Min 10 Hours | $542.23 | $16.27 | $9.92 | $568.42 |
| 3974 | Continuous Home Care w/AIDS Min 11 Hours | $596.46 | $17.89 | $9.92 | $624.27 |
| 3975 | Continuous Home Care w/AIDS Min 12 Hours | $650.68 | $19.52 | $9.92 | $680.12 |
| 3976 | Continuous Home Care w/AIDS Min 13 Hours | $704.90 | $21.15 | $9.92 | $735.97 |
| 3977 | Continuous Home Care w/AIDS Min 14 Hours | $759.13 | $22.77 | $9.92 | $791.82 |
| 3978 | Continuous Home Care w/AIDS Min 15 Hours | $813.35 | $24.40 | $9.92 | $847.67 |
| 3979 | Continuous Home Care w/AIDS Min 16 Hours | $867.57 | $26.03 | $9.92 | $903.52 |
| 3980 | Continuous Home Care w/AIDS Min 17 Hours | $921.80 | $27.65 | $9.92 | $959.37 |
| 3981 | Continuous Home Care w/AIDS Min 18 Hours | $976.02 | $29.28 | $9.92 | $1,015.22 |
| 3982 | Continuous Home Care w/AIDS Min 19 Hours | $1,030.24 | $30.91 | $9.92 | $1,071.07 |
| 3983 | Continuous Home Care w/AIDS Min 20 Hours | $1,084.47 | $32.53 | $9.92 | $1,126.92 |
| 3984 | Continuous Home Care w/AIDS Min 21 Hours | $1,138.69 | $34.16 | $9.92 | $1,182.77 |
| 3985 | Continuous Home Care w/AIDS Min 22 Hours | $1,192.91 | $35.79 | $9.92 | $1,238.62 |
| 3986 | Continuous Home Care w/AIDS Min 23 Hours | $1,247.14 | $37.41 | $9.92 | $1,294.47 |
| 3987 | Continuous Home Care w/AIDS Min 24 Hours | $1,301.36 | $39.04 | $9.92 | $1,350.32 |
| 3988 | General Inpatient w/ AIDS | $1,031.27 | $30.94 | $9.92 | $1,072.13 |
| 3989 | Routine Home Care w/ AIDS Escort | $305.62 | $9.17 | $9.92 | $324.71 |
| 3991 | Service Intensity Add-on | $52.46 | $1.57 | $0.00 | $54.03 |
* 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 | $168.47 | $5.05 | $9.92 | $183.44 |
| 3946 | Inpatient Respite | $423.42 | $12.70 | $9.92 | $446.04 |
| 3947 | General Inpatient Care | $892.86 | $26.79 | $9.92 | $929.57 |
| 3948 | Continuous Home Care - Min 8 Hours | $402.59 | $12.08 | $9.92 | $424.59 |
| 3949 | Continuous Home Care - Min 9 Hours | $452.91 | $13.59 | $9.92 | $476.42 |
| 3950 | Continuous Home Care - Min 10 Hours | $503.23 | $15.10 | $9.92 | $528.25 |
| 3951 | Continuous Home Care - Min 11 Hours | $553.56 | $16.61 | $9.92 | $580.09 |
| 3952 | Continuous Home Care - Min 12 Hours | $603.88 | $18.12 | $9.92 | $631.92 |
| 3953 | Continuous Home Care - Min 13 Hours | $654.20 | $19.63 | $9.92 | $683.75 |
| 3954 | Continuous Home Care - Min 14 Hours | $704.53 | $21.14 | $9.92 | $735.59 |
| 3955 | Continuous Home Care - Min 15 Hours | $754.85 | $22.65 | $9.92 | $787.42 |
| 3956 | Continuous Home Care - Min 16 Hours | $805.17 | $24.16 | $9.92 | $839.25 |
| 3957 | Continuous Home Care - Min 17 Hours | $855.50 | $25.67 | $9.92 | $891.09 |
| 3958 | Continuous Home Care - Min 18 Hours | $905.82 | $27.17 | $9.92 | $942.91 |
| 3959 | Continuous Home Care - Min 19 Hours | $956.14 | $28.68 | $9.92 | $994.74 |
| 3960 | Continuous Home Care - Min 20 Hours | $1,006.47 | $30.19 | $9.92 | $1,046.58 |
| 3961 | Continuous Home Care - Min 21 Hours | $1,056.79 | $31.70 | $9.92 | $1,098.41 |
| 3962 | Continuous Home Care - Min 22 Hours | $1,107.11 | $33.21 | $9.92 | $1,150.24 |
| 3963 | Continuous Home Care - Min 23 Hours | $1,157.44 | $34.72 | $9.92 | $1,202.08 |
| 3964 | Continuous Home Care - Min 24 Hours | $1,207.76 | $36.23 | $9.92 | $1,253.91 |
| 3965 | Hospice Inpatient Respite Care Coinsurance Rate - 5% of 3946 | $21.17 | $0.64 | $0.50 | $22.31 |
| 3966 | Drugs Coinsurance Rate | $1.00 | $0.00 | $0.00 | $1.00 |
| 3969 | Routine Home Care w/AIDS | $275.36 | $8.26 | $9.92 | $293.54 |
| 3970 | Routine Home Care w/Escort | $187.00 | $5.61 | $9.92 | $202.53 |
| 3971 | Continuous Home Care w/AIDS Min 8 Hours | $409.09 | $12.27 | $9.92 | $431.28 |
| 3972 | Continuous Home Care w/AIDS Min 9 Hours | $460.22 | $13.81 | $9.92 | $483.95 |
| 3973 | Continuous Home Care w/AIDS Min 10 Hours | $511.36 | $15.34 | $9.92 | $536.62 |
| 3974 | Continuous Home Care w/AIDS Min 11 Hours | $562.49 | $16.87 | $9.92 | $589.28 |
| 3975 | Continuous Home Care w/AIDS Min 12 Hours | $613.63 | $18.41 | $9.92 | $641.96 |
| 3976 | Continuous Home Care w/AIDS Min 13 Hours | $664.77 | $19.94 | $9.92 | $694.63 |
| 3977 | Continuous Home Care w/AIDS Min 14 Hours | $715.90 | $21.48 | $9.92 | $747.30 |
| 3978 | Continuous Home Care w/AIDS Min 15 Hours | $767.04 | $23.01 | $9.92 | $799.97 |
| 3979 | Continuous Home Care w/AIDS Min 16 Hours | $818.17 | $24.55 | $9.92 | $852.64 |
| 3980 | Continuous Home Care w/AIDS Min 17 Hours | $869.31 | $26.08 | $9.92 | $905.31 |
| 3981 | Continuous Home Care w/AIDS Min 18 Hours | $920.45 | $27.61 | $9.92 | $957.98 |
| 3982 | Continuous Home Care w/AIDS Min 19 Hours | $971.58 | $29.15 | $9.92 | $1,010.65 |
| 3983 | Continuous Home Care w/AIDS Min 20 Hours | $1,022.72 | $30.68 | $9.92 | $1,063.32 |
| 3984 | Continuous Home Care w/AIDS Min 21 Hours | $1,073.85 | $32.22 | $9.92 | $1,115.99 |
| 3985 | Continuous Home Care w/AIDS Min 22 Hours | $1,124.99 | $33.75 | $9.92 | $1,168.66 |
| 3986 | Continuous Home Care w/AIDS Min 23 Hours | $1,176.12 | $35.28 | $9.92 | $1,221.32 |
| 3987 | Continuous Home Care w/AIDS Min 24 Hours | $1,227.26 | $36.82 | $9.92 | $1,274.00 |
| 3988 | General Inpatient w/ AIDS | $992.32 | $29.77 | $9.92 | $1,032.01 |
| 3989 | Routine Home Care w/ AIDS Escort | $293.89 | $8.82 | $9.92 | $312.63 |
| 3991 | Service Intensity Add-on | $50.32 | $1.51 | $0.00 | $51.83 |
* 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 | $233.21 | $7.00 | $9.92 | $250.13 |
| 3946 | Inpatient Respite | $547.50 | $16.43 | $9.92 | $573.85 |
| 3947 | General Inpatient Care | $1,209.12 | $36.27 | $9.92 | $1,255.31 |
| 3948 | Continuous Home Care - Min 8 Hours | $557.29 | $16.72 | $9.92 | $583.93 |
| 3949 | Continuous Home Care - Min 9 Hours | $626.96 | $18.81 | $9.92 | $655.69 |
| 3950 | Continuous Home Care - Min 10 Hours | $696.62 | $20.90 | $9.92 | $727.44 |
| 3951 | Continuous Home Care - Min 11 Hours | $766.28 | $22.99 | $9.92 | $799.19 |
| 3952 | Continuous Home Care - Min 12 Hours | $835.94 | $25.08 | $9.92 | $870.94 |
| 3953 | Continuous Home Care - Min 13 Hours | $905.60 | $27.17 | $9.92 | $942.69 |
| 3954 | Continuous Home Care - Min 14 Hours | $975.26 | $29.26 | $9.92 | $1,014.44 |
| 3955 | Continuous Home Care - Min 15 Hours | $1,044.93 | $31.35 | $9.92 | $1,086.20 |
| 3956 | Continuous Home Care - Min 16 Hours | $1,114.59 | $33.44 | $9.92 | $1,157.95 |
| 3957 | Continuous Home Care - Min 17 Hours | $1,184.25 | $35.53 | $9.92 | $1,229.70 |
| 3958 | Continuous Home Care - Min 18 Hours | $1,253.91 | $37.62 | $9.92 | $1,301.45 |
| 3959 | Continuous Home Care - Min 19 Hours | $1,323.57 | $39.71 | $9.92 | $1,373.20 |
| 3960 | Continuous Home Care - Min 20 Hours | $1,393.23 | $41.80 | $9.92 | $1,444.95 |
| 3961 | Continuous Home Care - Min 21 Hours | $1,462.90 | $43.89 | $9.92 | $1,516.71 |
| 3962 | Continuous Home Care - Min 22 Hours | $1,532.56 | $45.98 | $9.92 | $1,588.46 |
| 3963 | Continuous Home Care - Min 23 Hours | $1,602.22 | $48.07 | $9.92 | $1,660.21 |
| 3964 | Continuous Home Care - Min 24 Hours | $1,671.88 | $50.16 | $9.92 | $1,731.96 |
| 3965 | Hospice Inpatient Respite Care Coinsurance Rate - 5% of 3946 | $27.38 | $0.82 | $0.50 | $28.70 |
| 3966 | Drugs Coinsurance Rate | $1.00 | $0.00 | $0.00 | $1.00 |
| 3969 | Routine Home Care w/AIDS | $381.18 | $11.44 | $9.92 | $402.54 |
| 3970 | Routine Home Care w/Escort | $251.74 | $7.55 | $9.92 | $269.21 |
| 3971 | Continuous Home Care w/AIDS Min 8 Hours | $632.03 | $18.96 | $9.92 | $660.91 |
| 3972 | Continuous Home Care w/AIDS Min 9 Hours | $711.04 | $21.33 | $9.92 | $742.29 |
| 3973 | Continuous Home Care w/AIDS Min 10 Hours | $790.04 | $23.70 | $9.92 | $823.66 |
| 3974 | Continuous Home Care w/AIDS Min 11 Hours | $869.05 | $26.07 | $9.92 | $905.04 |
| 3975 | Continuous Home Care w/AIDS Min 12 Hours | $948.05 | $28.44 | $9.92 | $986.41 |
| 3976 | Continuous Home Care w/AIDS Min 13 Hours | $1,027.05 | $30.81 | $9.92 | $1,067.78 |
| 3977 | Continuous Home Care w/AIDS Min 14 Hours | $1,106.06 | $33.18 | $9.92 | $1,149.16 |
| 3978 | Continuous Home Care w/AIDS Min 15 Hours | $1,185.06 | $35.55 | $9.92 | $1,230.53 |
| 3979 | Continuous Home Care w/AIDS Min 16 Hours | $1,264.07 | $37.92 | $9.92 | $1,311.91 |
| 3980 | Continuous Home Care w/AIDS Min 17 Hours | $1,343.07 | $40.29 | $9.92 | $1,393.28 |
| 3981 | Continuous Home Care w/AIDS Min 18 Hours | $1,422.08 | $42.66 | $9.92 | $1,474.66 |
| 3982 | Continuous Home Care w/AIDS Min 19 Hours | $1,501.08 | $45.03 | $9.92 | $1,556.03 |
| 3983 | Continuous Home Care w/AIDS Min 20 Hours | $1,580.08 | $47.40 | $9.92 | $1,637.40 |
| 3984 | Continuous Home Care w/AIDS Min 21 Hours | $1,659.09 | $49.77 | $9.92 | $1,718.78 |
| 3985 | Continuous Home Care w/AIDS Min 22 Hours | $1,738.09 | $52.14 | $9.92 | $1,800.15 |
| 3986 | Continuous Home Care w/AIDS Min 23 Hours | $1,817.10 | $54.51 | $9.92 | $1,881.53 |
| 3987 | Continuous Home Care w/AIDS Min 24 Hours | $1,896.10 | $56.88 | $9.92 | $1,962.90 |
| 3988 | General Inpatient w/ AIDS | $1,343.82 | $40.31 | $9.92 | $1,394.05 |
| 3989 | Routine Home Care w/ AIDS Escort | $399.71 | $11.99 | $9.92 | $421.62 |
| 3991 | Service Intensity Add-on | $69.66 | $2.09 | $0.00 | $71.75 |
* 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 | $231.48 | $6.94 | $9.92 | $248.34 |
| 3946 | Inpatient Respite | $544.19 | $16.33 | $9.92 | $570.44 |
| 3947 | General Inpatient Care | $1,200.69 | $36.02 | $9.92 | $1,246.63 |
| 3948 | Continuous Home Care - Min 8 Hours | $553.17 | $16.60 | $9.92 | $579.69 |
| 3949 | Continuous Home Care - Min 9 Hours | $622.31 | $18.67 | $9.92 | $650.90 |
| 3950 | Continuous Home Care - Min 10 Hours | $691.46 | $20.74 | $9.92 | $722.12 |
| 3951 | Continuous Home Care - Min 11 Hours | $760.60 | $22.82 | $9.92 | $793.34 |
| 3952 | Continuous Home Care - Min 12 Hours | $829.75 | $24.89 | $9.92 | $864.56 |
| 3953 | Continuous Home Care - Min 13 Hours | $898.90 | $26.97 | $9.92 | $935.79 |
| 3954 | Continuous Home Care - Min 14 Hours | $968.04 | $29.04 | $9.92 | $1,007.00 |
| 3955 | Continuous Home Care - Min 15 Hours | $1,037.19 | $31.12 | $9.92 | $1,078.23 |
| 3956 | Continuous Home Care - Min 16 Hours | $1,106.33 | $33.19 | $9.92 | $1,149.44 |
| 3957 | Continuous Home Care - Min 17 Hours | $1,175.48 | $35.26 | $9.92 | $1,220.66 |
| 3958 | Continuous Home Care - Min 18 Hours | $1,244.63 | $37.34 | $9.92 | $1,291.89 |
| 3959 | Continuous Home Care - Min 19 Hours | $1,313.77 | $39.41 | $9.92 | $1,363.10 |
| 3960 | Continuous Home Care - Min 20 Hours | $1,382.92 | $41.49 | $9.92 | $1,434.33 |
| 3961 | Continuous Home Care - Min 21 Hours | $1,452.06 | $43.56 | $9.92 | $1,505.54 |
| 3962 | Continuous Home Care - Min 22 Hours | $1,521.21 | $45.64 | $9.92 | $1,576.77 |
| 3963 | Continuous Home Care - Min 23 Hours | $1,590.35 | $47.71 | $9.92 | $1,647.98 |
| 3964 | Continuous Home Care - Min 24 Hours | $1,659.50 | $49.79 | $9.92 | $1,719.21 |
| 3965 | Hospice Inpatient Respite Care Coinsurance Rate - 5% of 3946 | $27.21 | $0.82 | $0.50 | $28.53 |
| 3966 | Drugs Coinsurance Rate | $1.00 | $0.00 | $0.00 | $1.00 |
| 3969 | Routine Home Care w/AIDS | $378.36 | $11.35 | $9.92 | $399.63 |
| 3970 | Routine Home Care w/Escort | $250.01 | $7.50 | $9.92 | $267.43 |
| 3971 | Continuous Home Care w/AIDS Min 8 Hours | $626.09 | $18.78 | $9.92 | $654.79 |
| 3972 | Continuous Home Care w/AIDS Min 9 Hours | $704.35 | $21.13 | $9.92 | $735.40 |
| 3973 | Continuous Home Care w/AIDS Min 10 Hours | $782.61 | $23.48 | $9.92 | $816.01 |
| 3974 | Continuous Home Care w/AIDS Min 11 Hours | $860.87 | $25.83 | $9.92 | $896.62 |
| 3975 | Continuous Home Care w/AIDS Min 12 Hours | $939.14 | $28.17 | $9.92 | $977.23 |
| 3976 | Continuous Home Care w/AIDS Min 13 Hours | $1,017.40 | $30.52 | $9.92 | $1,057.84 |
| 3977 | Continuous Home Care w/AIDS Min 14 Hours | $1,095.66 | $32.87 | $9.92 | $1,138.45 |
| 3978 | Continuous Home Care w/AIDS Min 15 Hours | $1,173.92 | $35.22 | $9.92 | $1,219.06 |
| 3979 | Continuous Home Care w/AIDS Min 16 Hours | $1,252.18 | $37.57 | $9.92 | $1,299.67 |
| 3980 | Continuous Home Care w/AIDS Min 17 Hours | $1,330.44 | $39.91 | $9.92 | $1,380.27 |
| 3981 | Continuous Home Care w/AIDS Min 18 Hours | $1,408.70 | $42.26 | $9.92 | $1,460.88 |
| 3982 | Continuous Home Care w/AIDS Min 19 Hours | $1,486.96 | $44.61 | $9.92 | $1,541.49 |
| 3983 | Continuous Home Care w/AIDS Min 20 Hours | $1,565.23 | $46.96 | $9.92 | $1,622.11 |
| 3984 | Continuous Home Care w/AIDS Min 21 Hours | $1,643.49 | $49.30 | $9.92 | $1,702.71 |
| 3985 | Continuous Home Care w/AIDS Min 22 Hours | $1,721.75 | $51.65 | $9.92 | $1,783.32 |
| 3986 | Continuous Home Care w/AIDS Min 23 Hours | $1,800.01 | $54.00 | $9.92 | $1,863.93 |
| 3987 | Continuous Home Care w/AIDS Min 24 Hours | $1,878.27 | $56.35 | $9.92 | $1,944.54 |
| 3988 | General Inpatient w/ AIDS | $1,334.45 | $40.03 | $9.92 | $1,384.40 |
| 3989 | Routine Home Care w/ AIDS Escort | $396.89 | $11.91 | $9.92 | $418.72 |
| 3991 | Service Intensity Add-on | $69.14 | $2.07 | $0.00 | $71.21 |
* 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 | $201.27 | $6.04 | $9.92 | $217.23 |
| 3946 | Inpatient Respite | $486.28 | $14.59 | $9.92 | $510.79 |
| 3947 | General Inpatient Care | $1,053.09 | $31.59 | $9.92 | $1,094.60 |
| 3948 | Continuous Home Care - Min 8 Hours | $480.96 | $14.43 | $9.92 | $505.31 |
| 3949 | Continuous Home Care - Min 9 Hours | $541.08 | $16.23 | $9.92 | $567.23 |
| 3950 | Continuous Home Care - Min 10 Hours | $601.20 | $18.04 | $9.92 | $629.16 |
| 3951 | Continuous Home Care - Min 11 Hours | $661.32 | $19.84 | $9.92 | $691.08 |
| 3952 | Continuous Home Care - Min 12 Hours | $721.45 | $21.64 | $9.92 | $753.01 |
| 3953 | Continuous Home Care - Min 13 Hours | $781.57 | $23.45 | $9.92 | $814.94 |
| 3954 | Continuous Home Care - Min 14 Hours | $841.69 | $25.25 | $9.92 | $876.86 |
| 3955 | Continuous Home Care - Min 15 Hours | $901.81 | $27.05 | $9.92 | $938.78 |
| 3956 | Continuous Home Care - Min 16 Hours | $961.93 | $28.86 | $9.92 | $1,000.71 |
| 3957 | Continuous Home Care - Min 17 Hours | $1,022.05 | $30.66 | $9.92 | $1,062.63 |
| 3958 | Continuous Home Care - Min 18 Hours | $1,082.17 | $32.47 | $9.92 | $1,124.56 |
| 3959 | Continuous Home Care - Min 19 Hours | $1,142.29 | $34.27 | $9.92 | $1,186.48 |
| 3960 | Continuous Home Care - Min 20 Hours | $1,202.41 | $36.07 | $9.92 | $1,248.40 |
| 3961 | Continuous Home Care - Min 21 Hours | $1,262.53 | $37.88 | $9.92 | $1,310.33 |
| 3962 | Continuous Home Care - Min 22 Hours | $1,322.65 | $39.68 | $9.92 | $1,372.25 |
| 3963 | Continuous Home Care - Min 23 Hours | $1,382.77 | $41.48 | $9.92 | $1,434.17 |
| 3964 | Continuous Home Care - Min 24 Hours | $1,442.89 | $43.29 | $9.92 | $1,496.10 |
| 3965 | Hospice Inpatient Respite Care Coinsurance Rate - 5% of 3946 | $24.31 | $0.73 | $0.50 | $25.54 |
| 3966 | Drugs Coinsurance Rate | $1.00 | $0.00 | $0.00 | $1.00 |
| 3969 | Routine Home Care w/AIDS | $328.97 | $9.87 | $9.92 | $348.76 |
| 3970 | Routine Home Care w/Escort | $219.80 | $6.59 | $9.92 | $236.31 |
| 3971 | Continuous Home Care w/AIDS Min 8 Hours | $522.04 | $15.66 | $9.92 | $547.62 |
| 3972 | Continuous Home Care w/AIDS Min 9 Hours | $587.29 | $17.62 | $9.92 | $614.83 |
| 3973 | Continuous Home Care w/AIDS Min 10 Hours | $652.55 | $19.58 | $9.92 | $682.05 |
| 3974 | Continuous Home Care w/AIDS Min 11 Hours | $717.80 | $21.53 | $9.92 | $749.25 |
| 3975 | Continuous Home Care w/AIDS Min 12 Hours | $783.06 | $23.49 | $9.92 | $816.47 |
| 3976 | Continuous Home Care w/AIDS Min 13 Hours | $848.31 | $25.45 | $9.92 | $883.68 |
| 3977 | Continuous Home Care w/AIDS Min 14 Hours | $913.56 | $27.41 | $9.92 | $950.89 |
| 3978 | Continuous Home Care w/AIDS Min 15 Hours | $978.82 | $29.36 | $9.92 | $1,018.10 |
| 3979 | Continuous Home Care w/AIDS Min 16 Hours | $1,044.07 | $31.32 | $9.92 | $1,085.31 |
| 3980 | Continuous Home Care w/AIDS Min 17 Hours | $1,109.33 | $33.28 | $9.92 | $1,152.53 |
| 3981 | Continuous Home Care w/AIDS Min 18 Hours | $1,174.58 | $35.24 | $9.92 | $1,219.74 |
| 3982 | Continuous Home Care w/AIDS Min 19 Hours | $1,239.84 | $37.20 | $9.92 | $1,286.96 |
| 3983 | Continuous Home Care w/AIDS Min 20 Hours | $1,305.09 | $39.15 | $9.92 | $1,354.16 |
| 3984 | Continuous Home Care w/AIDS Min 21 Hours | $1,370.35 | $41.11 | $9.92 | $1,421.38 |
| 3985 | Continuous Home Care w/AIDS Min 22 Hours | $1,435.60 | $43.07 | $9.92 | $1,488.59 |
| 3986 | Continuous Home Care w/AIDS Min 23 Hours | $1,500.86 | $45.03 | $9.92 | $1,555.81 |
| 3987 | Continuous Home Care w/AIDS Min 24 Hours | $1,566.11 | $46.98 | $9.92 | $1,623.01 |
| 3988 | General Inpatient w/ AIDS | $1,170.40 | $35.11 | $9.92 | $1,215.43 |
| 3989 | Routine Home Care w/ AIDS Escort | $347.50 | $10.43 | $9.92 | $367.85 |
| 3991 | Service Intensity Add-on | $60.12 | $1.80 | $0.00 | $61.92 |
* 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 | $231.48 | $6.94 | $9.92 | $248.34 |
| 3946 | Inpatient Respite | $544.19 | $16.33 | $9.92 | $570.44 |
| 3947 | General Inpatient Care | $1,200.69 | $36.02 | $9.92 | $1,246.63 |
| 3948 | Continuous Home Care - Min 8 Hours | $553.17 | $16.60 | $9.92 | $579.69 |
| 3949 | Continuous Home Care - Min 9 Hours | $622.31 | $18.67 | $9.92 | $650.90 |
| 3950 | Continuous Home Care - Min 10 Hours | $691.46 | $20.74 | $9.92 | $722.12 |
| 3951 | Continuous Home Care - Min 11 Hours | $760.60 | $22.82 | $9.92 | $793.34 |
| 3952 | Continuous Home Care - Min 12 Hours | $829.75 | $24.89 | $9.92 | $864.56 |
| 3953 | Continuous Home Care - Min 13 Hours | $898.90 | $26.97 | $9.92 | $935.79 |
| 3954 | Continuous Home Care - Min 14 Hours | $968.04 | $29.04 | $9.92 | $1,007.00 |
| 3955 | Continuous Home Care - Min 15 Hours | $1,037.19 | $31.12 | $9.92 | $1,078.23 |
| 3956 | Continuous Home Care - Min 16 Hours | $1,106.33 | $33.19 | $9.92 | $1,149.44 |
| 3957 | Continuous Home Care - Min 17 Hours | $1,175.48 | $35.26 | $9.92 | $1,220.66 |
| 3958 | Continuous Home Care - Min 18 Hours | $1,244.63 | $37.34 | $9.92 | $1,291.89 |
| 3959 | Continuous Home Care - Min 19 Hours | $1,313.77 | $39.41 | $9.92 | $1,363.10 |
| 3960 | Continuous Home Care - Min 20 Hours | $1,382.92 | $41.49 | $9.92 | $1,434.33 |
| 3961 | Continuous Home Care - Min 21 Hours | $1,452.06 | $43.56 | $9.92 | $1,505.54 |
| 3962 | Continuous Home Care - Min 22 Hours | $1,521.21 | $45.64 | $9.92 | $1,576.77 |
| 3963 | Continuous Home Care - Min 23 Hours | $1,590.35 | $47.71 | $9.92 | $1,647.98 |
| 3964 | Continuous Home Care - Min 24 Hours | $1,659.50 | $49.79 | $9.92 | $1,719.21 |
| 3965 | Hospice Inpatient Respite Care Coinsurance Rate - 5% of 3946 | $27.21 | $0.82 | $0.50 | $28.53 |
| 3966 | Drugs Coinsurance Rate | $1.00 | $0.00 | $0.00 | $1.00 |
| 3969 | Routine Home Care w/AIDS | $378.36 | $11.35 | $9.92 | $399.63 |
| 3970 | Routine Home Care w/Escort | $250.01 | $7.50 | $9.92 | $267.43 |
| 3971 | Continuous Home Care w/AIDS Min 8 Hours | $626.09 | $18.78 | $9.92 | $654.79 |
| 3972 | Continuous Home Care w/AIDS Min 9 Hours | $704.35 | $21.13 | $9.92 | $735.40 |
| 3973 | Continuous Home Care w/AIDS Min 10 Hours | $782.61 | $23.48 | $9.92 | $816.01 |
| 3974 | Continuous Home Care w/AIDS Min 11 Hours | $860.87 | $25.83 | $9.92 | $896.62 |
| 3975 | Continuous Home Care w/AIDS Min 12 Hours | $939.14 | $28.17 | $9.92 | $977.23 |
| 3976 | Continuous Home Care w/AIDS Min 13 Hours | $1,017.40 | $30.52 | $9.92 | $1,057.84 |
| 3977 | Continuous Home Care w/AIDS Min 14 Hours | $1,095.66 | $32.87 | $9.92 | $1,138.45 |
| 3978 | Continuous Home Care w/AIDS Min 15 Hours | $1,173.92 | $35.22 | $9.92 | $1,219.06 |
| 3979 | Continuous Home Care w/AIDS Min 16 Hours | $1,252.18 | $37.57 | $9.92 | $1,299.67 |
| 3980 | Continuous Home Care w/AIDS Min 17 Hours | $1,330.44 | $39.91 | $9.92 | $1,380.27 |
| 3981 | Continuous Home Care w/AIDS Min 18 Hours | $1,408.70 | $42.26 | $9.92 | $1,460.88 |
| 3982 | Continuous Home Care w/AIDS Min 19 Hours | $1,486.96 | $44.61 | $9.92 | $1,541.49 |
| 3983 | Continuous Home Care w/AIDS Min 20 Hours | $1,565.23 | $46.96 | $9.92 | $1,622.11 |
| 3984 | Continuous Home Care w/AIDS Min 21 Hours | $1,643.49 | $49.30 | $9.92 | $1,702.71 |
| 3985 | Continuous Home Care w/AIDS Min 22 Hours | $1,721.75 | $51.65 | $9.92 | $1,783.32 |
| 3986 | Continuous Home Care w/AIDS Min 23 Hours | $1,800.01 | $54.00 | $9.92 | $1,863.93 |
| 3987 | Continuous Home Care w/AIDS Min 24 Hours | $1,878.27 | $56.35 | $9.92 | $1,944.54 |
| 3988 | General Inpatient w/ AIDS | $1,334.45 | $40.03 | $9.92 | $1,384.40 |
| 3989 | Routine Home Care w/ AIDS Escort | $396.89 | $11.91 | $9.92 | $418.72 |
| 3991 | Service Intensity Add-on | $69.14 | $2.07 | $0.00 | $71.21 |
* 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 | $228.91 | $6.87 | $9.92 | $245.70 |
| 3946 | Inpatient Respite | $539.26 | $16.18 | $9.92 | $565.36 |
| 3947 | General Inpatient Care | $1,188.14 | $35.64 | $9.92 | $1,233.70 |
| 3948 | Continuous Home Care - Min 8 Hours | $547.03 | $16.41 | $9.92 | $573.36 |
| 3949 | Continuous Home Care - Min 9 Hours | $615.41 | $18.46 | $9.92 | $643.79 |
| 3950 | Continuous Home Care - Min 10 Hours | $683.78 | $20.51 | $9.92 | $714.21 |
| 3951 | Continuous Home Care - Min 11 Hours | $752.16 | $22.56 | $9.92 | $784.64 |
| 3952 | Continuous Home Care - Min 12 Hours | $820.54 | $24.62 | $9.92 | $855.08 |
| 3953 | Continuous Home Care - Min 13 Hours | $888.92 | $26.67 | $9.92 | $925.51 |
| 3954 | Continuous Home Care - Min 14 Hours | $957.30 | $28.72 | $9.92 | $995.94 |
| 3955 | Continuous Home Care - Min 15 Hours | $1,025.68 | $30.77 | $9.92 | $1,066.37 |
| 3956 | Continuous Home Care - Min 16 Hours | $1,094.05 | $32.82 | $9.92 | $1,136.79 |
| 3957 | Continuous Home Care - Min 17 Hours | $1,162.43 | $34.87 | $9.92 | $1,207.22 |
| 3958 | Continuous Home Care - Min 18 Hours | $1,230.81 | $36.92 | $9.92 | $1,277.65 |
| 3959 | Continuous Home Care - Min 19 Hours | $1,299.19 | $38.98 | $9.92 | $1,348.09 |
| 3960 | Continuous Home Care - Min 20 Hours | $1,367.57 | $41.03 | $9.92 | $1,418.52 |
| 3961 | Continuous Home Care - Min 21 Hours | $1,435.95 | $43.08 | $9.92 | $1,488.95 |
| 3962 | Continuous Home Care - Min 22 Hours | $1,504.32 | $45.13 | $9.92 | $1,559.37 |
| 3963 | Continuous Home Care - Min 23 Hours | $1,572.70 | $47.18 | $9.92 | $1,629.80 |
| 3964 | Continuous Home Care - Min 24 Hours | $1,641.08 | $49.23 | $9.92 | $1,700.23 |
| 3965 | Hospice Inpatient Respite Care Coinsurance Rate - 5% of 3946 | $26.96 | $0.81 | $0.50 | $28.27 |
| 3966 | Drugs Coinsurance Rate | $1.00 | $0.00 | $0.00 | $1.00 |
| 3969 | Routine Home Care w/AIDS | $374.16 | $11.22 | $9.92 | $395.30 |
| 3970 | Routine Home Care w/Escort | $247.44 | $7.42 | $9.92 | $264.78 |
| 3971 | Continuous Home Care w/AIDS Min 8 Hours | $617.24 | $18.52 | $9.92 | $645.68 |
| 3972 | Continuous Home Care w/AIDS Min 9 Hours | $694.40 | $20.83 | $9.92 | $725.15 |
| 3973 | Continuous Home Care w/AIDS Min 10 Hours | $771.55 | $23.15 | $9.92 | $804.62 |
| 3974 | Continuous Home Care w/AIDS Min 11 Hours | $848.71 | $25.46 | $9.92 | $884.09 |
| 3975 | Continuous Home Care w/AIDS Min 12 Hours | $925.86 | $27.78 | $9.92 | $963.56 |
| 3976 | Continuous Home Care w/AIDS Min 13 Hours | $1,003.02 | $30.09 | $9.92 | $1,043.03 |
| 3977 | Continuous Home Care w/AIDS Min 14 Hours | $1,080.17 | $32.41 | $9.92 | $1,122.50 |
| 3978 | Continuous Home Care w/AIDS Min 15 Hours | $1,157.33 | $34.72 | $9.92 | $1,201.97 |
| 3979 | Continuous Home Care w/AIDS Min 16 Hours | $1,234.48 | $37.03 | $9.92 | $1,281.43 |
| 3980 | Continuous Home Care w/AIDS Min 17 Hours | $1,311.64 | $39.35 | $9.92 | $1,360.91 |
| 3981 | Continuous Home Care w/AIDS Min 18 Hours | $1,388.79 | $41.66 | $9.92 | $1,440.37 |
| 3982 | Continuous Home Care w/AIDS Min 19 Hours | $1,465.95 | $43.98 | $9.92 | $1,519.85 |
| 3983 | Continuous Home Care w/AIDS Min 20 Hours | $1,543.10 | $46.29 | $9.92 | $1,599.31 |
| 3984 | Continuous Home Care w/AIDS Min 21 Hours | $1,620.26 | $48.61 | $9.92 | $1,678.79 |
| 3985 | Continuous Home Care w/AIDS Min 22 Hours | $1,697.41 | $50.92 | $9.92 | $1,758.25 |
| 3986 | Continuous Home Care w/AIDS Min 23 Hours | $1,774.57 | $53.24 | $9.92 | $1,837.73 |
| 3987 | Continuous Home Care w/AIDS Min 24 Hours | $1,851.72 | $55.55 | $9.92 | $1,917.19 |
| 3988 | General Inpatient w/ AIDS | $1,320.50 | $39.62 | $9.92 | $1,370.04 |
| 3989 | Routine Home Care w/ AIDS Escort | $392.69 | $11.78 | $9.92 | $414.39 |
| 3991 | Service Intensity Add-on | $68.37 | $2.05 | $0.00 | $70.42 |
* 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 | $174.22 | $5.23 | $9.92 | $189.37 |
| 3946 | Inpatient Respite | $434.45 | $13.03 | $9.92 | $457.40 |
| 3947 | General Inpatient Care | $920.97 | $27.63 | $9.92 | $958.52 |
| 3948 | Continuous Home Care - Min 8 Hours | $416.34 | $12.49 | $9.92 | $438.75 |
| 3949 | Continuous Home Care - Min 9 Hours | $468.38 | $14.05 | $9.92 | $492.35 |
| 3950 | Continuous Home Care - Min 10 Hours | $520.42 | $15.61 | $9.92 | $545.95 |
| 3951 | Continuous Home Care - Min 11 Hours | $572.46 | $17.17 | $9.92 | $599.55 |
| 3952 | Continuous Home Care - Min 12 Hours | $624.51 | $18.74 | $9.92 | $653.17 |
| 3953 | Continuous Home Care - Min 13 Hours | $676.55 | $20.30 | $9.92 | $706.77 |
| 3954 | Continuous Home Care - Min 14 Hours | $728.59 | $21.86 | $9.92 | $760.37 |
| 3955 | Continuous Home Care - Min 15 Hours | $780.63 | $23.42 | $9.92 | $813.97 |
| 3956 | Continuous Home Care - Min 16 Hours | $832.67 | $24.98 | $9.92 | $867.57 |
| 3957 | Continuous Home Care - Min 17 Hours | $884.72 | $26.54 | $9.92 | $921.18 |
| 3958 | Continuous Home Care - Min 18 Hours | $936.76 | $28.10 | $9.92 | $974.78 |
| 3959 | Continuous Home Care - Min 19 Hours | $988.80 | $29.66 | $9.92 | $1,028.38 |
| 3960 | Continuous Home Care - Min 20 Hours | $1,040.84 | $31.23 | $9.92 | $1,081.99 |
| 3961 | Continuous Home Care - Min 21 Hours | $1,092.88 | $32.79 | $9.92 | $1,135.59 |
| 3962 | Continuous Home Care - Min 22 Hours | $1,144.93 | $34.35 | $9.92 | $1,189.20 |
| 3963 | Continuous Home Care - Min 23 Hours | $1,196.97 | $35.91 | $9.92 | $1,242.80 |
| 3964 | Continuous Home Care - Min 24 Hours | $1,249.01 | $37.47 | $9.92 | $1,296.40 |
| 3965 | Hospice Inpatient Respite Care Coinsurance Rate - 5% of 3946 | $21.72 | $0.65 | $0.50 | $22.87 |
| 3966 | Drugs Coinsurance Rate | $1.00 | $0.00 | $0.00 | $1.00 |
| 3969 | Routine Home Care w/AIDS | $284.77 | $8.54 | $9.92 | $303.23 |
| 3970 | Routine Home Care w/Escort | $192.75 | $5.78 | $9.92 | $208.45 |
| 3971 | Continuous Home Care w/AIDS Min 8 Hours | $428.90 | $12.87 | $9.92 | $451.69 |
| 3972 | Continuous Home Care w/AIDS Min 9 Hours | $482.52 | $14.48 | $9.92 | $506.92 |
| 3973 | Continuous Home Care w/AIDS Min 10 Hours | $536.13 | $16.08 | $9.92 | $562.13 |
| 3974 | Continuous Home Care w/AIDS Min 11 Hours | $589.74 | $17.69 | $9.92 | $617.35 |
| 3975 | Continuous Home Care w/AIDS Min 12 Hours | $643.36 | $19.30 | $9.92 | $672.58 |
| 3976 | Continuous Home Care w/AIDS Min 13 Hours | $696.97 | $20.91 | $9.92 | $727.80 |
| 3977 | Continuous Home Care w/AIDS Min 14 Hours | $750.58 | $22.52 | $9.92 | $783.02 |
| 3978 | Continuous Home Care w/AIDS Min 15 Hours | $804.19 | $24.13 | $9.92 | $838.24 |
| 3979 | Continuous Home Care w/AIDS Min 16 Hours | $857.81 | $25.73 | $9.92 | $893.46 |
| 3980 | Continuous Home Care w/AIDS Min 17 Hours | $911.42 | $27.34 | $9.92 | $948.68 |
| 3981 | Continuous Home Care w/AIDS Min 18 Hours | $965.03 | $28.95 | $9.92 | $1,003.90 |
| 3982 | Continuous Home Care w/AIDS Min 19 Hours | $1,018.65 | $30.56 | $9.92 | $1,059.13 |
| 3983 | Continuous Home Care w/AIDS Min 20 Hours | $1,072.26 | $32.17 | $9.92 | $1,114.35 |
| 3984 | Continuous Home Care w/AIDS Min 21 Hours | $1,125.87 | $33.78 | $9.92 | $1,169.57 |
| 3985 | Continuous Home Care w/AIDS Min 22 Hours | $1,179.48 | $35.38 | $9.92 | $1,224.78 |
| 3986 | Continuous Home Care w/AIDS Min 23 Hours | $1,233.10 | $36.99 | $9.92 | $1,280.01 |
| 3987 | Continuous Home Care w/AIDS Min 24 Hours | $1,286.71 | $38.60 | $9.92 | $1,335.23 |
| 3988 | General Inpatient w/ AIDS | $1,023.57 | $30.71 | $9.92 | $1,064.20 |
| 3989 | Routine Home Care w/ AIDS Escort | $303.30 | $9.10 | $9.92 | $322.32 |
| 3991 | Service Intensity Add-on | $52.04 | $1.56 | $0.00 | $53.60 |
* 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 | $196.84 | $5.91 | $9.92 | $212.67 |
| 3946 | Inpatient Respite | $477.79 | $14.33 | $9.92 | $502.04 |
| 3947 | General Inpatient Care | $1,031.45 | $30.94 | $9.92 | $1,072.31 |
| 3948 | Continuous Home Care - Min 8 Hours | $470.38 | $14.11 | $9.92 | $494.41 |
| 3949 | Continuous Home Care - Min 9 Hours | $529.18 | $15.88 | $9.92 | $554.98 |
| 3950 | Continuous Home Care - Min 10 Hours | $587.98 | $17.64 | $9.92 | $615.54 |
| 3951 | Continuous Home Care - Min 11 Hours | $646.77 | $19.40 | $9.92 | $676.09 |
| 3952 | Continuous Home Care - Min 12 Hours | $705.57 | $21.17 | $9.92 | $736.66 |
| 3953 | Continuous Home Care - Min 13 Hours | $764.37 | $22.93 | $9.92 | $797.22 |
| 3954 | Continuous Home Care - Min 14 Hours | $823.17 | $24.70 | $9.92 | $857.79 |
| 3955 | Continuous Home Care - Min 15 Hours | $881.96 | $26.46 | $9.92 | $918.34 |
| 3956 | Continuous Home Care - Min 16 Hours | $940.76 | $28.22 | $9.92 | $978.90 |
| 3957 | Continuous Home Care - Min 17 Hours | $999.56 | $29.99 | $9.92 | $1,039.47 |
| 3958 | Continuous Home Care - Min 18 Hours | $1,058.36 | $31.75 | $9.92 | $1,100.03 |
| 3959 | Continuous Home Care - Min 19 Hours | $1,117.15 | $33.51 | $9.92 | $1,160.58 |
| 3960 | Continuous Home Care - Min 20 Hours | $1,175.95 | $35.28 | $9.92 | $1,221.15 |
| 3961 | Continuous Home Care - Min 21 Hours | $1,234.75 | $37.04 | $9.92 | $1,281.71 |
| 3962 | Continuous Home Care - Min 22 Hours | $1,293.55 | $38.81 | $9.92 | $1,342.28 |
| 3963 | Continuous Home Care - Min 23 Hours | $1,352.34 | $40.57 | $9.92 | $1,402.83 |
| 3964 | Continuous Home Care - Min 24 Hours | $1,411.14 | $42.33 | $9.92 | $1,463.39 |
| 3965 | Hospice Inpatient Respite Care Coinsurance Rate - 5% of 3946 | $23.89 | $0.72 | $0.50 | $25.11 |
| 3966 | Drugs Coinsurance Rate | $1.00 | $0.00 | $0.00 | $1.00 |
| 3969 | Routine Home Care w/AIDS | $321.73 | $9.65 | $9.92 | $341.30 |
| 3970 | Routine Home Care w/Escort | $215.37 | $6.46 | $9.92 | $231.75 |
| 3971 | Continuous Home Care w/AIDS Min 8 Hours | $506.78 | $15.20 | $9.92 | $531.90 |
| 3972 | Continuous Home Care w/AIDS Min 9 Hours | $570.13 | $17.10 | $9.92 | $597.15 |
| 3973 | Continuous Home Care w/AIDS Min 10 Hours | $633.48 | $19.00 | $9.92 | $662.40 |
| 3974 | Continuous Home Care w/AIDS Min 11 Hours | $696.83 | $20.90 | $9.92 | $727.65 |
| 3975 | Continuous Home Care w/AIDS Min 12 Hours | $760.18 | $22.81 | $9.92 | $792.91 |
| 3976 | Continuous Home Care w/AIDS Min 13 Hours | $823.52 | $24.71 | $9.92 | $858.15 |
| 3977 | Continuous Home Care w/AIDS Min 14 Hours | $26.61 | $24.78 | $9.92 | $61.31 |
| 3978 | Continuous Home Care w/AIDS Min 15 Hours | $950.22 | $28.51 | $9.92 | $988.65 |
| 3979 | Continuous Home Care w/AIDS Min 16 Hours | $1,013.57 | $30.41 | $9.92 | $1,053.90 |
| 3980 | Continuous Home Care w/AIDS Min 17 Hours | $1,076.91 | $32.31 | $9.92 | $1,119.14 |
| 3981 | Continuous Home Care w/AIDS Min 18 Hours | $1,140.26 | $34.21 | $9.92 | $1,184.39 |
| 3982 | Continuous Home Care w/AIDS Min 19 Hours | $1,203.61 | $36.11 | $9.92 | $1,249.64 |
| 3983 | Continuous Home Care w/AIDS Min 20 Hours | $1,266.96 | $38.01 | $9.92 | $1,314.89 |
| 3984 | Continuous Home Care w/AIDS Min 21 Hours | $1,330.31 | $39.91 | $9.92 | $1,380.14 |
| 3985 | Continuous Home Care w/AIDS Min 22 Hours | $1,393.65 | $41.81 | $9.92 | $1,445.38 |
| 3986 | Continuous Home Care w/AIDS Min 23 Hours | $1,457.00 | $43.71 | $9.92 | $1,510.63 |
| 3987 | Continuous Home Care w/AIDS Min 24 Hours | $1,520.35 | $45.61 | $9.92 | $1,575.88 |
| 3988 | General Inpatient w/ AIDS | $1,146.35 | $34.39 | $9.92 | $1,190.66 |
| 3989 | Routine Home Care w/ AIDS Escort | $340.26 | $10.21 | $9.92 | $360.39 |
| 3991 | Service Intensity Add-on | $58.79 | $1.76 | $0.00 | $60.55 |
* 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: HERKIMER, ONEIDA
| Rate Code |
Description | Base Rate | WRP Add-on * |
RTR Add-on * |
Total w/ addons |
|---|---|---|---|---|---|
| 3945 | Routine Home Care | $184.37 | $5.53 | $9.92 | $199.82 |
| 3946 | Inpatient Respite | $453.89 | $13.62 | $9.92 | $477.43 |
| 3947 | General Inpatient Care | $970.52 | $29.12 | $9.92 | $1,009.56 |
| 3948 | Continuous Home Care - Min 8 Hours | $440.58 | $13.22 | $9.92 | $463.72 |
| 3949 | Continuous Home Care - Min 9 Hours | $495.65 | $14.87 | $9.92 | $520.44 |
| 3950 | Continuous Home Care - Min 10 Hours | $550.72 | $16.52 | $9.92 | $577.16 |
| 3951 | Continuous Home Care - Min 11 Hours | $605.79 | $18.17 | $9.92 | $633.88 |
| 3952 | Continuous Home Care - Min 12 Hours | $660.87 | $19.83 | $9.92 | $690.62 |
| 3953 | Continuous Home Care - Min 13 Hours | $715.94 | $21.48 | $9.92 | $747.34 |
| 3954 | Continuous Home Care - Min 14 Hours | $771.01 | $23.13 | $9.92 | $804.06 |
| 3955 | Continuous Home Care - Min 15 Hours | $826.08 | $24.78 | $9.92 | $860.78 |
| 3956 | Continuous Home Care - Min 16 Hours | $881.15 | $26.43 | $9.92 | $917.50 |
| 3957 | Continuous Home Care - Min 17 Hours | $936.23 | $28.09 | $9.92 | $974.24 |
| 3958 | Continuous Home Care - Min 18 Hours | $991.30 | $29.74 | $9.92 | $1,030.96 |
| 3959 | Continuous Home Care - Min 19 Hours | $1,046.37 | $31.39 | $9.92 | $1,087.68 |
| 3960 | Continuous Home Care - Min 20 Hours | $1,101.44 | $33.04 | $9.92 | $1,144.40 |
| 3961 | Continuous Home Care - Min 21 Hours | $1,156.51 | $34.70 | $9.92 | $1,201.13 |
| 3962 | Continuous Home Care - Min 22 Hours | $1,211.59 | $36.35 | $9.92 | $1,257.86 |
| 3963 | Continuous Home Care - Min 23 Hours | $1,266.66 | $38.00 | $9.92 | $1,314.58 |
| 3964 | Continuous Home Care - Min 24 Hours | $1,321.73 | $39.65 | $9.92 | $1,371.30 |
| 3965 | Hospice Inpatient Respite Care Coinsurance Rate - 5% of 3946 | $22.69 | $0.68 | $0.50 | $23.87 |
| 3966 | Drugs Coinsurance Rate | $1.00 | $0.00 | $0.00 | $1.00 |
| 3969 | Routine Home Care w/AIDS | $301.35 | $9.04 | $9.92 | $320.31 |
| 3970 | Routine Home Care w/Escort | $202.90 | $6.09 | $9.92 | $218.91 |
| 3971 | Continuous Home Care w/AIDS Min 8 Hours | $463.83 | $13.91 | $9.92 | $487.66 |
| 3972 | Continuous Home Care w/AIDS Min 9 Hours | $521.81 | $15.65 | $9.92 | $547.38 |
| 3973 | Continuous Home Care w/AIDS Min 10 Hours | $579.79 | $17.39 | $9.92 | $607.10 |
| 3974 | Continuous Home Care w/AIDS Min 11 Hours | $637.77 | $19.13 | $9.92 | $666.82 |
| 3975 | Continuous Home Care w/AIDS Min 12 Hours | $695.75 | $20.87 | $9.92 | $726.54 |
| 3976 | Continuous Home Care w/AIDS Min 13 Hours | $753.73 | $22.61 | $9.92 | $786.26 |
| 3977 | Continuous Home Care w/AIDS Min 14 Hours | $811.71 | $24.35 | $9.92 | $845.98 |
| 3978 | Continuous Home Care w/AIDS Min 15 Hours | $869.69 | $26.09 | $9.92 | $905.70 |
| 3979 | Continuous Home Care w/AIDS Min 16 Hours | $927.67 | $27.83 | $9.92 | $965.42 |
| 3980 | Continuous Home Care w/AIDS Min 17 Hours | $985.65 | $29.57 | $9.92 | $1,025.14 |
| 3981 | Continuous Home Care w/AIDS Min 18 Hours | $1,043.63 | $31.31 | $9.92 | $1,084.86 |
| 3982 | Continuous Home Care w/AIDS Min 19 Hours | $1,101.60 | $33.05 | $9.92 | $1,144.57 |
| 3983 | Continuous Home Care w/AIDS Min 20 Hours | $1,159.58 | $34.79 | $9.92 | $1,204.29 |
| 3984 | Continuous Home Care w/AIDS Min 21 Hours | $1,217.56 | $36.53 | $9.92 | $1,264.01 |
| 3985 | Continuous Home Care w/AIDS Min 22 Hours | $1,275.54 | $38.27 | $9.92 | $1,323.73 |
| 3986 | Continuous Home Care w/AIDS Min 23 Hours | $1,333.52 | $40.01 | $9.92 | $1,383.45 |
| 3987 | Continuous Home Care w/AIDS Min 24 Hours | $1,391.50 | $41.75 | $9.92 | $1,443.17 |
| 3988 | General Inpatient w/ AIDS | $1,078.64 | $32.36 | $9.92 | $1,120.92 |
| 3989 | Routine Home Care w/ AIDS Escort | $319.88 | $9.60 | $9.92 | $339.40 |
| 3991 | Service Intensity Add-on | $55.07 | $1.65 | $0.00 | $56.72 |
* 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 | $173.98 | $5.22 | $9.92 | $189.12 |
| 3946 | Inpatient Respite | $433.99 | $13.02 | $9.92 | $456.93 |
| 3947 | General Inpatient Care | $919.80 | $27.59 | $9.92 | $957.31 |
| 3948 | Continuous Home Care - Min 8 Hours | $415.76 | $12.47 | $9.92 | $438.15 |
| 3949 | Continuous Home Care - Min 9 Hours | $467.73 | $14.03 | $9.92 | $491.68 |
| 3950 | Continuous Home Care - Min 10 Hours | $519.70 | $15.59 | $9.92 | $545.21 |
| 3951 | Continuous Home Care - Min 11 Hours | $571.67 | $17.15 | $9.92 | $598.74 |
| 3952 | Continuous Home Care - Min 12 Hours | $623.65 | $18.71 | $9.92 | $652.28 |
| 3953 | Continuous Home Care - Min 13 Hours | $675.62 | $20.27 | $9.92 | $705.81 |
| 3954 | Continuous Home Care - Min 14 Hours | $727.59 | $21.83 | $9.92 | $759.34 |
| 3955 | Continuous Home Care - Min 15 Hours | $779.56 | $23.39 | $9.92 | $812.87 |
| 3956 | Continuous Home Care - Min 16 Hours | $831.53 | $24.95 | $9.92 | $866.40 |
| 3957 | Continuous Home Care - Min 17 Hours | $883.50 | $26.51 | $9.92 | $919.93 |
| 3958 | Continuous Home Care - Min 18 Hours | $935.47 | $28.06 | $9.92 | $973.45 |
| 3959 | Continuous Home Care - Min 19 Hours | $987.44 | $29.62 | $9.92 | $1,026.98 |
| 3960 | Continuous Home Care - Min 20 Hours | $1,039.41 | $31.18 | $9.92 | $1,080.51 |
| 3961 | Continuous Home Care - Min 21 Hours | $1,091.38 | $32.74 | $9.92 | $1,134.04 |
| 3962 | Continuous Home Care - Min 22 Hours | $1,143.35 | $34.30 | $9.92 | $1,187.57 |
| 3963 | Continuous Home Care - Min 23 Hours | $1,195.32 | $35.86 | $9.92 | $1,241.10 |
| 3964 | Continuous Home Care - Min 24 Hours | $1,247.29 | $37.42 | $9.92 | $1,294.63 |
| 3965 | Hospice Inpatient Respite Care Coinsurance Rate - 5% of 3946 | $21.70 | $0.65 | $0.50 | $22.85 |
| 3966 | Drugs Coinsurance Rate | $1.00 | $0.00 | $0.00 | $1.00 |
| 3969 | Routine Home Care w/AIDS | $284.37 | $8.53 | $9.92 | $302.82 |
| 3970 | Routine Home Care w/Escort | $192.51 | $5.78 | $9.92 | $208.21 |
| 3971 | Continuous Home Care w/AIDS Min 8 Hours | $428.07 | $12.84 | $9.92 | $450.83 |
| 3972 | Continuous Home Care w/AIDS Min 9 Hours | $481.58 | $14.45 | $9.92 | $505.95 |
| 3973 | Continuous Home Care w/AIDS Min 10 Hours | $535.09 | $16.05 | $9.92 | $561.06 |
| 3974 | Continuous Home Care w/AIDS Min 11 Hours | $588.60 | $17.66 | $9.92 | $616.18 |
| 3975 | Continuous Home Care w/AIDS Min 12 Hours | $642.11 | $19.26 | $9.92 | $671.29 |
| 3976 | Continuous Home Care w/AIDS Min 13 Hours | $695.62 | $20.87 | $9.92 | $726.41 |
| 3977 | Continuous Home Care w/AIDS Min 14 Hours | $749.13 | $22.47 | $9.92 | $781.52 |
| 3978 | Continuous Home Care w/AIDS Min 15 Hours | $802.64 | $24.08 | $9.92 | $836.64 |
| 3979 | Continuous Home Care w/AIDS Min 16 Hours | $856.15 | $25.68 | $9.92 | $891.75 |
| 3980 | Continuous Home Care w/AIDS Min 17 Hours | $909.66 | $27.29 | $9.92 | $946.87 |
| 3981 | Continuous Home Care w/AIDS Min 18 Hours | $963.17 | $28.90 | $9.92 | $1,001.99 |
| 3982 | Continuous Home Care w/AIDS Min 19 Hours | $1,016.67 | $30.50 | $9.92 | $1,057.09 |
| 3983 | Continuous Home Care w/AIDS Min 20 Hours | $1,070.18 | $32.11 | $9.92 | $1,112.21 |
| 3984 | Continuous Home Care w/AIDS Min 21 Hours | $1,123.69 | $33.71 | $9.92 | $1,167.32 |
| 3985 | Continuous Home Care w/AIDS Min 22 Hours | $1,177.20 | $35.32 | $9.92 | $1,222.44 |
| 3986 | Continuous Home Care w/AIDS Min 23 Hours | $1,230.71 | $36.92 | $9.92 | $1,277.55 |
| 3987 | Continuous Home Care w/AIDS Min 24 Hours | $1,284.22 | $38.53 | $9.92 | $1,332.67 |
| 3988 | General Inpatient w/ AIDS | $1,022.27 | $30.67 | $9.92 | $1,062.86 |
| 3989 | Routine Home Care w/ AIDS Escort | $302.90 | $9.09 | $9.92 | $321.91 |
| 3991 | Service Intensity Add-on | $51.97 | $1.56 | $0.00 | $53.53 |
* WRR =´Worker Recruitment and Retention addon´ if applicable
* RTR =´Recruitment, Training and Retention addon´ if applicable
