Certified Hospice Program
Medicaid Rate Sheet
Effective: 10/01/2020 - 09/30/2021
- 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 | $151.81 | $3.42 | $9.92 | $165.15 |
| 3946 | Inpatient Respite | $439.62 | $9.89 | $9.92 | $459.43 |
| 3947 | General Inpatient Care | $929.13 | $20.91 | $9.92 | $959.96 |
| 3948 | Continuous Home Care - Min 8 Hours | $420.52 | $9.46 | $9.92 | $439.90 |
| 3949 | Continuous Home Care - Min 9 Hours | $473.08 | $10.64 | $9.92 | $493.64 |
| 3950 | Continuous Home Care - Min 10 Hours | $525.65 | $11.83 | $9.92 | $547.40 |
| 3951 | Continuous Home Care - Min 11 Hours | $578.21 | $13.01 | $9.92 | $601.14 |
| 3952 | Continuous Home Care - Min 12 Hours | $630.78 | $14.19 | $9.92 | $654.89 |
| 3953 | Continuous Home Care - Min 13 Hours | $683.34 | $15.38 | $9.92 | $708.64 |
| 3954 | Continuous Home Care - Min 14 Hours | $735.90 | $16.56 | $9.92 | $762.38 |
| 3955 | Continuous Home Care - Min 15 Hours | $788.47 | $17.74 | $9.92 | $816.13 |
| 3956 | Continuous Home Care - Min 16 Hours | $841.03 | $18.92 | $9.92 | $869.87 |
| 3957 | Continuous Home Care - Min 17 Hours | $893.60 | $20.11 | $9.92 | $923.63 |
| 3958 | Continuous Home Care - Min 18 Hours | $946.16 | $21.29 | $9.92 | $977.37 |
| 3959 | Continuous Home Care - Min 19 Hours | $998.73 | $22.47 | $9.92 | $1,031.12 |
| 3960 | Continuous Home Care - Min 20 Hours | $1,051.29 | $23.65 | $9.92 | $1,084.86 |
| 3961 | Continuous Home Care - Min 21 Hours | $1,103.86 | $24.84 | $9.92 | $1,138.62 |
| 3962 | Continuous Home Care - Min 22 Hours | $1,156.42 | $26.02 | $9.92 | $1,192.36 |
| 3963 | Continuous Home Care - Min 23 Hours | $1,208.99 | $27.20 | $9.92 | $1,246.11 |
| 3964 | Continuous Home Care - Min 24 Hours | $1,261.55 | $28.38 | $9.92 | $1,299.85 |
| 3965 | Hospice Inpatient Respite Care Coinsurance Rate - 5% of 3946 | $21.98 | $0.49 | $0.50 | $22.97 |
| 3966 | Drugs Coinsurance Rate | $1.00 | $0.00 | $0.00 | $1.00 |
| 3969 | Routine Home Care w/AIDS | $262.99 | $5.92 | $9.92 | $278.83 |
| 3970 | Routine Home Care w/Escort | $170.75 | $3.84 | $9.92 | $184.51 |
| 3971 | Continuous Home Care w/AIDS Min 8 Hours | $430.29 | $9.68 | $9.92 | $449.89 |
| 3972 | Continuous Home Care w/AIDS Min 9 Hours | $484.08 | $10.89 | $9.92 | $504.89 |
| 3973 | Continuous Home Care w/AIDS Min 10 Hours | $537.87 | $12.10 | $9.92 | $559.89 |
| 3974 | Continuous Home Care w/AIDS Min 11 Hours | $591.65 | $13.31 | $9.92 | $614.88 |
| 3975 | Continuous Home Care w/AIDS Min 12 Hours | $645.44 | $14.52 | $9.92 | $669.88 |
| 3976 | Continuous Home Care w/AIDS Min 13 Hours | $699.23 | $15.73 | $9.92 | $724.88 |
| 3977 | Continuous Home Care w/AIDS Min 14 Hours | $753.01 | $16.94 | $9.92 | $779.87 |
| 3978 | Continuous Home Care w/AIDS Min 15 Hours | $806.80 | $18.15 | $9.92 | $834.87 |
| 3979 | Continuous Home Care w/AIDS Min 16 Hours | $860.59 | $19.36 | $9.92 | $889.87 |
| 3980 | Continuous Home Care w/AIDS Min 17 Hours | $914.37 | $20.57 | $9.92 | $944.86 |
| 3981 | Continuous Home Care w/AIDS Min 18 Hours | $968.16 | $21.78 | $9.92 | $999.86 |
| 3982 | Continuous Home Care w/AIDS Min 19 Hours | $1,021.95 | $22.99 | $9.92 | $1,054.86 |
| 3983 | Continuous Home Care w/AIDS Min 20 Hours | $1,075.73 | $24.20 | $9.92 | $1,109.85 |
| 3984 | Continuous Home Care w/AIDS Min 21 Hours | $1,129.52 | $25.41 | $9.92 | $1,164.85 |
| 3985 | Continuous Home Care w/AIDS Min 22 Hours | $1,183.31 | $26.62 | $9.92 | $1,219.85 |
| 3986 | Continuous Home Care w/AIDS Min 23 Hours | $1,237.09 | $27.83 | $9.92 | $1,274.84 |
| 3987 | Continuous Home Care w/AIDS Min 24 Hours | $1,290.88 | $29.04 | $9.92 | $1,329.84 |
| 3988 | General Inpatient w/ AIDS | $1,032.64 | $23.23 | $9.92 | $1,065.79 |
| 3989 | Routine Home Care w/ AIDS Escort | $281.93 | $6.34 | $9.92 | $298.19 |
| 3991 | Service Intensity Add-on | $52.57 | $1.18 | $0.00 | $53.75 |
* 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 | $153.87 | $3.46 | $9.92 | $167.25 |
| 3946 | Inpatient Respite | $444.19 | $9.99 | $9.92 | $464.10 |
| 3947 | General Inpatient Care | $940.78 | $21.17 | $9.92 | $971.87 |
| 3948 | Continuous Home Care - Min 8 Hours | $426.23 | $9.59 | $9.92 | $445.74 |
| 3949 | Continuous Home Care - Min 9 Hours | $479.51 | $10.79 | $9.92 | $500.22 |
| 3950 | Continuous Home Care - Min 10 Hours | $532.78 | $11.99 | $9.92 | $554.69 |
| 3951 | Continuous Home Care - Min 11 Hours | $586.06 | $13.19 | $9.92 | $609.17 |
| 3952 | Continuous Home Care - Min 12 Hours | $639.34 | $14.39 | $9.92 | $663.65 |
| 3953 | Continuous Home Care - Min 13 Hours | $692.62 | $15.58 | $9.92 | $718.12 |
| 3954 | Continuous Home Care - Min 14 Hours | $745.90 | $16.78 | $9.92 | $772.60 |
| 3955 | Continuous Home Care - Min 15 Hours | $799.18 | $17.98 | $9.92 | $827.08 |
| 3956 | Continuous Home Care - Min 16 Hours | $852.45 | $19.18 | $9.92 | $881.55 |
| 3957 | Continuous Home Care - Min 17 Hours | $905.73 | $20.38 | $9.92 | $936.03 |
| 3958 | Continuous Home Care - Min 18 Hours | $959.01 | $21.58 | $9.92 | $990.51 |
| 3959 | Continuous Home Care - Min 19 Hours | $1,012.29 | $22.78 | $9.92 | $1,044.99 |
| 3960 | Continuous Home Care - Min 20 Hours | $1,065.57 | $23.98 | $9.92 | $1,099.47 |
| 3961 | Continuous Home Care - Min 21 Hours | $1,118.85 | $25.17 | $9.92 | $1,153.94 |
| 3962 | Continuous Home Care - Min 22 Hours | $1,172.12 | $26.37 | $9.92 | $1,208.41 |
| 3963 | Continuous Home Care - Min 23 Hours | $1,225.40 | $27.57 | $9.92 | $1,262.89 |
| 3964 | Continuous Home Care - Min 24 Hours | $1,278.68 | $28.77 | $9.92 | $1,317.37 |
| 3965 | Hospice Inpatient Respite Care Coinsurance Rate - 5% of 3946 | $22.21 | $0.50 | $0.50 | $23.21 |
| 3966 | Drugs Coinsurance Rate | $1.00 | $0.00 | $0.00 | $1.00 |
| 3969 | Routine Home Care w/AIDS | $266.57 | $6.00 | $9.92 | $282.49 |
| 3970 | Routine Home Care w/Escort | $172.81 | $3.89 | $9.92 | $186.62 |
| 3971 | Continuous Home Care w/AIDS Min 8 Hours | $438.52 | $9.87 | $9.92 | $458.31 |
| 3972 | Continuous Home Care w/AIDS Min 9 Hours | $493.34 | $11.10 | $9.92 | $514.36 |
| 3973 | Continuous Home Care w/AIDS Min 10 Hours | $548.15 | $12.33 | $9.92 | $570.40 |
| 3974 | Continuous Home Care w/AIDS Min 11 Hours | $602.97 | $13.57 | $9.92 | $626.46 |
| 3975 | Continuous Home Care w/AIDS Min 12 Hours | $657.78 | $14.80 | $9.92 | $682.50 |
| 3976 | Continuous Home Care w/AIDS Min 13 Hours | $712.60 | $16.03 | $9.92 | $738.55 |
| 3977 | Continuous Home Care w/AIDS Min 14 Hours | $767.41 | $17.27 | $9.92 | $794.60 |
| 3978 | Continuous Home Care w/AIDS Min 15 Hours | $822.23 | $18.50 | $9.92 | $850.65 |
| 3979 | Continuous Home Care w/AIDS Min 16 Hours | $877.04 | $19.73 | $9.92 | $906.69 |
| 3980 | Continuous Home Care w/AIDS Min 17 Hours | $931.86 | $20.97 | $9.92 | $962.75 |
| 3981 | Continuous Home Care w/AIDS Min 18 Hours | $986.67 | $22.20 | $9.92 | $1,018.79 |
| 3982 | Continuous Home Care w/AIDS Min 19 Hours | $1,041.49 | $23.43 | $9.92 | $1,074.84 |
| 3983 | Continuous Home Care w/AIDS Min 20 Hours | $1,096.30 | $24.67 | $9.92 | $1,130.89 |
| 3984 | Continuous Home Care w/AIDS Min 21 Hours | $1,151.12 | $25.90 | $9.92 | $1,186.94 |
| 3985 | Continuous Home Care w/AIDS Min 22 Hours | $1,205.93 | $27.13 | $9.92 | $1,242.98 |
| 3986 | Continuous Home Care w/AIDS Min 23 Hours | $1,260.75 | $28.37 | $9.92 | $1,299.04 |
| 3987 | Continuous Home Care w/AIDS Min 24 Hours | $1,315.56 | $29.60 | $9.92 | $1,355.08 |
| 3988 | General Inpatient w/ AIDS | $1,045.58 | $23.53 | $9.92 | $1,079.03 |
| 3989 | Routine Home Care w/ AIDS Escort | $285.51 | $6.42 | $9.92 | $301.85 |
| 3991 | Service Intensity Add-on | $53.28 | $1.20 | $0.00 | $54.48 |
* 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 | $177.68 | $4.00 | $9.92 | $191.60 |
| 3946 | Inpatient Respite | $496.97 | $11.18 | $9.92 | $518.07 |
| 3947 | General Inpatient Care | $1,075.24 | $24.19 | $9.92 | $1,109.35 |
| 3948 | Continuous Home Care - Min 8 Hours | $492.16 | $11.07 | $9.92 | $513.15 |
| 3949 | Continuous Home Care - Min 9 Hours | $553.68 | $12.46 | $9.92 | $576.06 |
| 3950 | Continuous Home Care - Min 10 Hours | $615.20 | $13.84 | $9.92 | $638.96 |
| 3951 | Continuous Home Care - Min 11 Hours | $676.72 | $15.23 | $9.92 | $701.87 |
| 3952 | Continuous Home Care - Min 12 Hours | $738.25 | $16.61 | $9.92 | $764.78 |
| 3953 | Continuous Home Care - Min 13 Hours | $799.77 | $17.99 | $9.92 | $827.68 |
| 3954 | Continuous Home Care - Min 14 Hours | $861.29 | $19.38 | $9.92 | $890.59 |
| 3955 | Continuous Home Care - Min 15 Hours | $922.81 | $20.76 | $9.92 | $953.49 |
| 3956 | Continuous Home Care - Min 16 Hours | $984.33 | $22.15 | $9.92 | $1,016.40 |
| 3957 | Continuous Home Care - Min 17 Hours | $1,045.85 | $23.53 | $9.92 | $1,079.30 |
| 3958 | Continuous Home Care - Min 18 Hours | $1,107.37 | $24.92 | $9.92 | $1,142.21 |
| 3959 | Continuous Home Care - Min 19 Hours | $1,168.89 | $26.30 | $9.92 | $1,205.11 |
| 3960 | Continuous Home Care - Min 20 Hours | $1,230.41 | $27.68 | $9.92 | $1,268.01 |
| 3961 | Continuous Home Care - Min 21 Hours | $1,291.93 | $29.07 | $9.92 | $1,330.92 |
| 3962 | Continuous Home Care - Min 22 Hours | $1,353.45 | $30.45 | $9.92 | $1,393.82 |
| 3963 | Continuous Home Care - Min 23 Hours | $1,414.97 | $31.84 | $9.92 | $1,456.73 |
| 3964 | Continuous Home Care - Min 24 Hours | $1,476.49 | $33.22 | $9.92 | $1,519.63 |
| 3965 | Hospice Inpatient Respite Care Coinsurance Rate - 5% of 3946 | $24.85 | $0.56 | $0.50 | $25.91 |
| 3966 | Drugs Coinsurance Rate | $1.00 | $0.00 | $0.00 | $1.00 |
| 3969 | Routine Home Care w/AIDS | $307.80 | $6.93 | $9.92 | $324.65 |
| 3970 | Routine Home Care w/Escort | $196.62 | $4.42 | $9.92 | $210.96 |
| 3971 | Continuous Home Care w/AIDS Min 8 Hours | $533.51 | $12.00 | $9.92 | $555.43 |
| 3972 | Continuous Home Care w/AIDS Min 9 Hours | $600.20 | $13.50 | $9.92 | $623.62 |
| 3973 | Continuous Home Care w/AIDS Min 10 Hours | $666.89 | $15.01 | $9.92 | $691.82 |
| 3974 | Continuous Home Care w/AIDS Min 11 Hours | $733.58 | $16.51 | $9.92 | $760.01 |
| 3975 | Continuous Home Care w/AIDS Min 12 Hours | $800.27 | $18.01 | $9.92 | $828.20 |
| 3976 | Continuous Home Care w/AIDS Min 13 Hours | $866.96 | $19.51 | $9.92 | $896.39 |
| 3977 | Continuous Home Care w/AIDS Min 14 Hours | $933.65 | $21.01 | $9.92 | $964.58 |
| 3978 | Continuous Home Care w/AIDS Min 15 Hours | $1,000.34 | $22.51 | $9.92 | $1,032.77 |
| 3979 | Continuous Home Care w/AIDS Min 16 Hours | $1,067.03 | $24.01 | $9.92 | $1,100.96 |
| 3980 | Continuous Home Care w/AIDS Min 17 Hours | $1,133.72 | $25.51 | $9.92 | $1,169.15 |
| 3981 | Continuous Home Care w/AIDS Min 18 Hours | $1,200.41 | $27.01 | $9.92 | $1,237.34 |
| 3982 | Continuous Home Care w/AIDS Min 19 Hours | $1,267.09 | $28.51 | $9.92 | $1,305.52 |
| 3983 | Continuous Home Care w/AIDS Min 20 Hours | $1,333.78 | $30.01 | $9.92 | $1,373.71 |
| 3984 | Continuous Home Care w/AIDS Min 21 Hours | $1,400.47 | $31.51 | $9.92 | $1,441.90 |
| 3985 | Continuous Home Care w/AIDS Min 22 Hours | $1,467.16 | $33.01 | $9.92 | $1,510.09 |
| 3986 | Continuous Home Care w/AIDS Min 23 Hours | $1,533.85 | $34.51 | $9.92 | $1,578.28 |
| 3987 | Continuous Home Care w/AIDS Min 24 Hours | $1,600.54 | $36.01 | $9.92 | $1,646.47 |
| 3988 | General Inpatient w/ AIDS | $1,195.02 | $26.89 | $9.92 | $1,231.83 |
| 3989 | Routine Home Care w/ AIDS Escort | $326.74 | $7.35 | $9.92 | $344.01 |
| 3991 | Service Intensity Add-on | $61.52 | $1.38 | $0.00 | $62.90 |
* 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 | $157.16 | $3.54 | $9.92 | $170.62 |
| 3946 | Inpatient Respite | $451.47 | $10.16 | $9.92 | $471.55 |
| 3947 | General Inpatient Care | $959.32 | $21.58 | $9.92 | $990.82 |
| 3948 | Continuous Home Care - Min 8 Hours | $435.32 | $9.79 | $9.92 | $455.03 |
| 3949 | Continuous Home Care - Min 9 Hours | $489.74 | $11.02 | $9.92 | $510.68 |
| 3950 | Continuous Home Care - Min 10 Hours | $544.15 | $12.24 | $9.92 | $566.31 |
| 3951 | Continuous Home Care - Min 11 Hours | $598.57 | $13.47 | $9.92 | $621.96 |
| 3952 | Continuous Home Care - Min 12 Hours | $652.98 | $14.69 | $9.92 | $677.59 |
| 3953 | Continuous Home Care - Min 13 Hours | $707.40 | $15.92 | $9.92 | $733.24 |
| 3954 | Continuous Home Care - Min 14 Hours | $761.81 | $17.14 | $9.92 | $788.87 |
| 3955 | Continuous Home Care - Min 15 Hours | $816.23 | $18.37 | $9.92 | $844.52 |
| 3956 | Continuous Home Care - Min 16 Hours | $870.64 | $19.59 | $9.92 | $900.15 |
| 3957 | Continuous Home Care - Min 17 Hours | $925.06 | $20.81 | $9.92 | $955.79 |
| 3958 | Continuous Home Care - Min 18 Hours | $979.47 | $22.04 | $9.92 | $1,011.43 |
| 3959 | Continuous Home Care - Min 19 Hours | $1,033.89 | $23.26 | $9.92 | $1,067.07 |
| 3960 | Continuous Home Care - Min 20 Hours | $1,088.30 | $24.49 | $9.92 | $1,122.71 |
| 3961 | Continuous Home Care - Min 21 Hours | $1,142.72 | $25.71 | $9.92 | $1,178.35 |
| 3962 | Continuous Home Care - Min 22 Hours | $1,197.13 | $26.94 | $9.92 | $1,233.99 |
| 3963 | Continuous Home Care - Min 23 Hours | $1,251.55 | $28.16 | $9.92 | $1,289.63 |
| 3964 | Continuous Home Care - Min 24 Hours | $1,305.96 | $29.38 | $9.92 | $1,345.26 |
| 3965 | Hospice Inpatient Respite Care Coinsurance Rate - 5% of 3946 | $22.57 | $0.51 | $0.50 | $23.58 |
| 3966 | Drugs Coinsurance Rate | $1.00 | $0.00 | $0.00 | $1.00 |
| 3969 | Routine Home Care w/AIDS | $272.25 | $6.13 | $9.92 | $288.30 |
| 3970 | Routine Home Care w/Escort | $176.10 | $3.96 | $9.92 | $189.98 |
| 3971 | Continuous Home Care w/AIDS Min 8 Hours | $451.62 | $10.16 | $9.92 | $471.70 |
| 3972 | Continuous Home Care w/AIDS Min 9 Hours | $508.07 | $11.43 | $9.92 | $529.42 |
| 3973 | Continuous Home Care w/AIDS Min 10 Hours | $564.52 | $12.70 | $9.92 | $587.14 |
| 3974 | Continuous Home Care w/AIDS Min 11 Hours | $620.97 | $13.97 | $9.92 | $644.86 |
| 3975 | Continuous Home Care w/AIDS Min 12 Hours | $677.43 | $15.24 | $9.92 | $702.59 |
| 3976 | Continuous Home Care w/AIDS Min 13 Hours | $733.88 | $16.51 | $9.92 | $760.31 |
| 3977 | Continuous Home Care w/AIDS Min 14 Hours | $790.33 | $17.78 | $9.92 | $818.03 |
| 3978 | Continuous Home Care w/AIDS Min 15 Hours | $846.78 | $19.05 | $9.92 | $875.75 |
| 3979 | Continuous Home Care w/AIDS Min 16 Hours | $903.23 | $20.32 | $9.92 | $933.47 |
| 3980 | Continuous Home Care w/AIDS Min 17 Hours | $959.69 | $21.59 | $9.92 | $991.20 |
| 3981 | Continuous Home Care w/AIDS Min 18 Hours | $1,016.14 | $22.86 | $9.92 | $1,048.92 |
| 3982 | Continuous Home Care w/AIDS Min 19 Hours | $1,072.59 | $24.13 | $9.92 | $1,106.64 |
| 3983 | Continuous Home Care w/AIDS Min 20 Hours | $1,129.04 | $25.40 | $9.92 | $1,164.36 |
| 3984 | Continuous Home Care w/AIDS Min 21 Hours | $1,185.49 | $26.67 | $9.92 | $1,222.08 |
| 3985 | Continuous Home Care w/AIDS Min 22 Hours | $1,241.95 | $27.94 | $9.92 | $1,279.81 |
| 3986 | Continuous Home Care w/AIDS Min 23 Hours | $1,298.40 | $29.21 | $9.92 | $1,337.53 |
| 3987 | Continuous Home Care w/AIDS Min 24 Hours | $1,354.85 | $30.48 | $9.92 | $1,395.25 |
| 3988 | General Inpatient w/ AIDS | $1,066.19 | $23.99 | $9.92 | $1,100.10 |
| 3989 | Routine Home Care w/ AIDS Escort | $291.19 | $6.55 | $9.92 | $307.66 |
| 3991 | Service Intensity Add-on | $54.42 | $1.22 | $0.00 | $55.64 |
* 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 | $148.74 | $3.35 | $9.92 | $162.01 |
| 3946 | Inpatient Respite | $432.81 | $9.74 | $9.92 | $452.47 |
| 3947 | General Inpatient Care | $911.79 | $20.52 | $9.92 | $942.23 |
| 3948 | Continuous Home Care - Min 8 Hours | $412.02 | $9.27 | $9.92 | $431.21 |
| 3949 | Continuous Home Care - Min 9 Hours | $463.52 | $10.43 | $9.92 | $483.87 |
| 3950 | Continuous Home Care - Min 10 Hours | $515.02 | $11.59 | $9.92 | $536.53 |
| 3951 | Continuous Home Care - Min 11 Hours | $566.52 | $12.75 | $9.92 | $589.19 |
| 3952 | Continuous Home Care - Min 12 Hours | $618.03 | $13.91 | $9.92 | $641.86 |
| 3953 | Continuous Home Care - Min 13 Hours | $669.53 | $15.06 | $9.92 | $694.51 |
| 3954 | Continuous Home Care - Min 14 Hours | $721.03 | $16.22 | $9.92 | $747.17 |
| 3955 | Continuous Home Care - Min 15 Hours | $772.53 | $17.38 | $9.92 | $799.83 |
| 3956 | Continuous Home Care - Min 16 Hours | $824.03 | $18.54 | $9.92 | $852.49 |
| 3957 | Continuous Home Care - Min 17 Hours | $875.54 | $19.70 | $9.92 | $905.16 |
| 3958 | Continuous Home Care - Min 18 Hours | $927.04 | $20.86 | $9.92 | $957.82 |
| 3959 | Continuous Home Care - Min 19 Hours | $978.54 | $22.02 | $9.92 | $1,010.48 |
| 3960 | Continuous Home Care - Min 20 Hours | $1,030.04 | $23.18 | $9.92 | $1,063.14 |
| 3961 | Continuous Home Care - Min 21 Hours | $1,081.54 | $24.33 | $9.92 | $1,115.79 |
| 3962 | Continuous Home Care - Min 22 Hours | $1,133.05 | $25.49 | $9.92 | $1,168.46 |
| 3963 | Continuous Home Care - Min 23 Hours | $1,184.55 | $26.65 | $9.92 | $1,221.12 |
| 3964 | Continuous Home Care - Min 24 Hours | $1,236.05 | $27.81 | $9.92 | $1,273.78 |
| 3965 | Hospice Inpatient Respite Care Coinsurance Rate - 5% of 3946 | $21.64 | $0.49 | $0.50 | $22.63 |
| 3966 | Drugs Coinsurance Rate | $1.00 | $0.00 | $0.00 | $1.00 |
| 3969 | Routine Home Care w/AIDS | $257.68 | $5.80 | $9.92 | $273.40 |
| 3970 | Routine Home Care w/Escort | $167.68 | $3.77 | $9.92 | $181.37 |
| 3971 | Continuous Home Care w/AIDS Min 8 Hours | $418.05 | $9.41 | $9.92 | $437.38 |
| 3972 | Continuous Home Care w/AIDS Min 9 Hours | $470.30 | $10.58 | $9.92 | $490.80 |
| 3973 | Continuous Home Care w/AIDS Min 10 Hours | $522.56 | $11.76 | $9.92 | $544.24 |
| 3974 | Continuous Home Care w/AIDS Min 11 Hours | $574.81 | $12.93 | $9.92 | $597.66 |
| 3975 | Continuous Home Care w/AIDS Min 12 Hours | $627.07 | $14.11 | $9.92 | $651.10 |
| 3976 | Continuous Home Care w/AIDS Min 13 Hours | $679.33 | $15.28 | $9.92 | $704.53 |
| 3977 | Continuous Home Care w/AIDS Min 14 Hours | $731.58 | $16.46 | $9.92 | $757.96 |
| 3978 | Continuous Home Care w/AIDS Min 15 Hours | $783.84 | $17.64 | $9.92 | $811.40 |
| 3979 | Continuous Home Care w/AIDS Min 16 Hours | $836.09 | $18.81 | $9.92 | $864.82 |
| 3980 | Continuous Home Care w/AIDS Min 17 Hours | $888.35 | $19.99 | $9.92 | $918.26 |
| 3981 | Continuous Home Care w/AIDS Min 18 Hours | $940.61 | $21.16 | $9.92 | $971.69 |
| 3982 | Continuous Home Care w/AIDS Min 19 Hours | $992.86 | $22.34 | $9.92 | $1,025.12 |
| 3983 | Continuous Home Care w/AIDS Min 20 Hours | $1,045.12 | $23.52 | $9.92 | $1,078.56 |
| 3984 | Continuous Home Care w/AIDS Min 21 Hours | $1,097.37 | $24.69 | $9.92 | $1,131.98 |
| 3985 | Continuous Home Care w/AIDS Min 22 Hours | $1,149.63 | $25.87 | $9.92 | $1,185.42 |
| 3986 | Continuous Home Care w/AIDS Min 23 Hours | $1,201.88 | $27.04 | $9.92 | $1,238.84 |
| 3987 | Continuous Home Care w/AIDS Min 24 Hours | $1,254.14 | $28.22 | $9.92 | $1,292.28 |
| 3988 | General Inpatient w/ AIDS | $1,013.36 | $22.80 | $9.92 | $1,046.08 |
| 3989 | Routine Home Care w/ AIDS Escort | $276.62 | $6.22 | $9.92 | $292.76 |
| 3991 | Service Intensity Add-on | $51.50 | $1.16 | $0.00 | $52.66 |
* 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 | $209.03 | $4.70 | $9.92 | $223.65 |
| 3946 | Inpatient Respite | $566.49 | $12.75 | $9.92 | $589.16 |
| 3947 | General Inpatient Care | $1,252.35 | $28.18 | $9.92 | $1,290.45 |
| 3948 | Continuous Home Care - Min 8 Hours | $579.00 | $13.03 | $9.92 | $601.95 |
| 3949 | Continuous Home Care - Min 9 Hours | $651.38 | $14.66 | $9.92 | $675.96 |
| 3950 | Continuous Home Care - Min 10 Hours | $723.75 | $16.28 | $9.92 | $749.95 |
| 3951 | Continuous Home Care - Min 11 Hours | $796.13 | $17.91 | $9.92 | $823.96 |
| 3952 | Continuous Home Care - Min 12 Hours | $868.51 | $19.54 | $9.92 | $897.97 |
| 3953 | Continuous Home Care - Min 13 Hours | $940.88 | $21.17 | $9.92 | $971.97 |
| 3954 | Continuous Home Care - Min 14 Hours | $1,013.26 | $22.80 | $9.92 | $1,045.98 |
| 3955 | Continuous Home Care - Min 15 Hours | $1,085.63 | $24.43 | $9.92 | $1,119.98 |
| 3956 | Continuous Home Care - Min 16 Hours | $1,158.01 | $26.06 | $9.92 | $1,193.99 |
| 3957 | Continuous Home Care - Min 17 Hours | $1,230.38 | $27.68 | $9.92 | $1,267.98 |
| 3958 | Continuous Home Care - Min 18 Hours | $1,302.76 | $29.31 | $9.92 | $1,341.99 |
| 3959 | Continuous Home Care - Min 19 Hours | $1,375.13 | $30.94 | $9.92 | $1,415.99 |
| 3960 | Continuous Home Care - Min 20 Hours | $1,447.51 | $32.57 | $9.92 | $1,490.00 |
| 3961 | Continuous Home Care - Min 21 Hours | $1,519.88 | $34.20 | $9.92 | $1,564.00 |
| 3962 | Continuous Home Care - Min 22 Hours | $1,592.26 | $35.83 | $9.92 | $1,638.01 |
| 3963 | Continuous Home Care - Min 23 Hours | $1,664.63 | $37.45 | $9.92 | $1,712.00 |
| 3964 | Continuous Home Care - Min 24 Hours | $1,737.01 | $39.08 | $9.92 | $1,786.01 |
| 3965 | Hospice Inpatient Respite Care Coinsurance Rate - 5% of 3946 | $28.32 | $0.64 | $0.50 | $29.46 |
| 3966 | Drugs Coinsurance Rate | $1.00 | $0.00 | $0.00 | $1.00 |
| 3969 | Routine Home Care w/AIDS | $362.11 | $8.15 | $9.92 | $380.18 |
| 3970 | Routine Home Care w/Escort | $227.97 | $5.13 | $9.92 | $243.02 |
| 3971 | Continuous Home Care w/AIDS Min 8 Hours | $658.62 | $14.82 | $9.92 | $683.36 |
| 3972 | Continuous Home Care w/AIDS Min 9 Hours | $740.95 | $16.67 | $9.92 | $767.54 |
| 3973 | Continuous Home Care w/AIDS Min 10 Hours | $823.28 | $18.52 | $9.92 | $851.72 |
| 3974 | Continuous Home Care w/AIDS Min 11 Hours | $905.61 | $20.38 | $9.92 | $935.91 |
| 3975 | Continuous Home Care w/AIDS Min 12 Hours | $987.94 | $22.23 | $9.92 | $1,020.09 |
| 3976 | Continuous Home Care w/AIDS Min 13 Hours | $1,070.26 | $24.08 | $9.92 | $1,104.26 |
| 3977 | Continuous Home Care w/AIDS Min 14 Hours | $1,152.59 | $25.93 | $9.92 | $1,188.44 |
| 3978 | Continuous Home Care w/AIDS Min 15 Hours | $1,234.92 | $27.79 | $9.92 | $1,272.63 |
| 3979 | Continuous Home Care w/AIDS Min 16 Hours | $1,317.25 | $29.64 | $9.92 | $1,356.81 |
| 3980 | Continuous Home Care w/AIDS Min 17 Hours | $1,399.57 | $31.49 | $9.92 | $1,440.98 |
| 3981 | Continuous Home Care w/AIDS Min 18 Hours | $1,481.90 | $33.34 | $9.92 | $1,525.16 |
| 3982 | Continuous Home Care w/AIDS Min 19 Hours | $1,564.23 | $35.20 | $9.92 | $1,609.35 |
| 3983 | Continuous Home Care w/AIDS Min 20 Hours | $1,646.56 | $37.05 | $9.92 | $1,693.53 |
| 3984 | Continuous Home Care w/AIDS Min 21 Hours | $1,728.89 | $38.90 | $9.92 | $1,777.71 |
| 3985 | Continuous Home Care w/AIDS Min 22 Hours | $1,811.21 | $40.75 | $9.92 | $1,861.88 |
| 3986 | Continuous Home Care w/AIDS Min 23 Hours | $1,893.54 | $42.60 | $9.92 | $1,946.06 |
| 3987 | Continuous Home Care w/AIDS Min 24 Hours | $1,975.87 | $44.46 | $9.92 | $2,030.25 |
| 3988 | General Inpatient w/ AIDS | $1,391.86 | $31.32 | $9.92 | $1,433.10 |
| 3989 | Routine Home Care w/ AIDS Escort | $381.05 | $8.57 | $9.92 | $399.54 |
| 3991 | Service Intensity Add-on | $72.38 | $1.63 | $0.00 | $74.01 |
* 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 | $212.53 | $4.78 | $9.92 | $227.23 |
| 3946 | Inpatient Respite | $574.27 | $12.92 | $9.92 | $597.11 |
| 3947 | General Inpatient Care | $1,272.16 | $28.62 | $9.92 | $1,310.70 |
| 3948 | Continuous Home Care - Min 8 Hours | $588.72 | $13.25 | $9.92 | $611.89 |
| 3949 | Continuous Home Care - Min 9 Hours | $662.31 | $14.90 | $9.92 | $687.13 |
| 3950 | Continuous Home Care - Min 10 Hours | $735.90 | $16.56 | $9.92 | $762.38 |
| 3951 | Continuous Home Care - Min 11 Hours | $809.49 | $18.21 | $9.92 | $837.62 |
| 3952 | Continuous Home Care - Min 12 Hours | $883.08 | $19.87 | $9.92 | $912.87 |
| 3953 | Continuous Home Care - Min 13 Hours | $956.67 | $21.53 | $9.92 | $988.12 |
| 3954 | Continuous Home Care - Min 14 Hours | $1,030.26 | $23.18 | $9.92 | $1,063.36 |
| 3955 | Continuous Home Care - Min 15 Hours | $1,103.85 | $24.84 | $9.92 | $1,138.61 |
| 3956 | Continuous Home Care - Min 16 Hours | $1,177.44 | $26.49 | $9.92 | $1,213.85 |
| 3957 | Continuous Home Care - Min 17 Hours | $1,251.03 | $28.15 | $9.92 | $1,289.10 |
| 3958 | Continuous Home Care - Min 18 Hours | $1,324.62 | $29.80 | $9.92 | $1,364.34 |
| 3959 | Continuous Home Care - Min 19 Hours | $1,398.21 | $31.46 | $9.92 | $1,439.59 |
| 3960 | Continuous Home Care - Min 20 Hours | $1,471.80 | $33.12 | $9.92 | $1,514.84 |
| 3961 | Continuous Home Care - Min 21 Hours | $1,545.39 | $34.77 | $9.92 | $1,590.08 |
| 3962 | Continuous Home Care - Min 22 Hours | $1,618.98 | $36.43 | $9.92 | $1,665.33 |
| 3963 | Continuous Home Care - Min 23 Hours | $1,692.57 | $38.08 | $9.92 | $1,740.57 |
| 3964 | Continuous Home Care - Min 24 Hours | $1,766.16 | $39.74 | $9.92 | $1,815.82 |
| 3965 | Hospice Inpatient Respite Care Coinsurance Rate - 5% of 3946 | $28.71 | $0.65 | $0.50 | $29.86 |
| 3966 | Drugs Coinsurance Rate | $1.00 | $0.00 | $0.00 | $1.00 |
| 3969 | Routine Home Care w/AIDS | $368.19 | $8.28 | $9.92 | $386.39 |
| 3970 | Routine Home Care w/Escort | $231.47 | $5.21 | $9.92 | $246.60 |
| 3971 | Continuous Home Care w/AIDS Min 8 Hours | $672.62 | $15.13 | $9.92 | $697.67 |
| 3972 | Continuous Home Care w/AIDS Min 9 Hours | $756.70 | $17.03 | $9.92 | $783.65 |
| 3973 | Continuous Home Care w/AIDS Min 10 Hours | $840.78 | $18.92 | $9.92 | $869.62 |
| 3974 | Continuous Home Care w/AIDS Min 11 Hours | $924.85 | $20.81 | $9.92 | $955.58 |
| 3975 | Continuous Home Care w/AIDS Min 12 Hours | $1,008.93 | $22.70 | $9.92 | $1,041.55 |
| 3976 | Continuous Home Care w/AIDS Min 13 Hours | $1,093.01 | $24.59 | $9.92 | $1,127.52 |
| 3977 | Continuous Home Care w/AIDS Min 14 Hours | $1,177.09 | $26.48 | $9.92 | $1,213.49 |
| 3978 | Continuous Home Care w/AIDS Min 15 Hours | $1,261.16 | $28.38 | $9.92 | $1,299.46 |
| 3979 | Continuous Home Care w/AIDS Min 16 Hours | $1,345.24 | $30.27 | $9.92 | $1,385.43 |
| 3980 | Continuous Home Care w/AIDS Min 17 Hours | $1,429.32 | $32.16 | $9.92 | $1,471.40 |
| 3981 | Continuous Home Care w/AIDS Min 18 Hours | $1,513.40 | $34.05 | $9.92 | $1,557.37 |
| 3982 | Continuous Home Care w/AIDS Min 19 Hours | $1,597.47 | $35.94 | $9.92 | $1,643.33 |
| 3983 | Continuous Home Care w/AIDS Min 20 Hours | $1,681.55 | $37.83 | $9.92 | $1,729.30 |
| 3984 | Continuous Home Care w/AIDS Min 21 Hours | $1,765.63 | $39.73 | $9.92 | $1,815.28 |
| 3985 | Continuous Home Care w/AIDS Min 22 Hours | $1,849.71 | $41.62 | $9.92 | $1,901.25 |
| 3986 | Continuous Home Care w/AIDS Min 23 Hours | $1,933.78 | $43.51 | $9.92 | $1,987.21 |
| 3987 | Continuous Home Care w/AIDS Min 24 Hours | $2,017.86 | $45.40 | $9.92 | $2,073.18 |
| 3988 | General Inpatient w/ AIDS | $1,413.88 | $31.81 | $9.92 | $1,455.61 |
| 3989 | Routine Home Care w/ AIDS Escort | $387.13 | $8.71 | $9.92 | $405.76 |
| 3991 | Service Intensity Add-on | $73.59 | $1.66 | $0.00 | $75.25 |
* 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 | $177.68 | $4.00 | $9.92 | $191.60 |
| 3946 | Inpatient Respite | $496.97 | $11.18 | $9.92 | $518.07 |
| 3947 | General Inpatient Care | $1,075.24 | $24.19 | $9.92 | $1,109.35 |
| 3948 | Continuous Home Care - Min 8 Hours | $492.16 | $11.07 | $9.92 | $513.15 |
| 3949 | Continuous Home Care - Min 9 Hours | $553.68 | $12.46 | $9.92 | $576.06 |
| 3950 | Continuous Home Care - Min 10 Hours | $615.20 | $13.84 | $9.92 | $638.96 |
| 3951 | Continuous Home Care - Min 11 Hours | $676.72 | $15.23 | $9.92 | $701.87 |
| 3952 | Continuous Home Care - Min 12 Hours | $738.25 | $16.61 | $9.92 | $764.78 |
| 3953 | Continuous Home Care - Min 13 Hours | $799.77 | $17.99 | $9.92 | $827.68 |
| 3954 | Continuous Home Care - Min 14 Hours | $861.29 | $19.38 | $9.92 | $890.59 |
| 3955 | Continuous Home Care - Min 15 Hours | $922.81 | $20.76 | $9.92 | $953.49 |
| 3956 | Continuous Home Care - Min 16 Hours | $984.33 | $22.15 | $9.92 | $1,016.40 |
| 3957 | Continuous Home Care - Min 17 Hours | $1,045.85 | $23.53 | $9.92 | $1,079.30 |
| 3958 | Continuous Home Care - Min 18 Hours | $1,107.37 | $24.92 | $9.92 | $1,142.21 |
| 3959 | Continuous Home Care - Min 19 Hours | $1,168.89 | $26.30 | $9.92 | $1,205.11 |
| 3960 | Continuous Home Care - Min 20 Hours | $1,230.41 | $27.68 | $9.92 | $1,268.01 |
| 3961 | Continuous Home Care - Min 21 Hours | $1,291.93 | $29.07 | $9.92 | $1,330.92 |
| 3962 | Continuous Home Care - Min 22 Hours | $1,353.45 | $30.45 | $9.92 | $1,393.82 |
| 3963 | Continuous Home Care - Min 23 Hours | $1,414.97 | $31.84 | $9.92 | $1,456.73 |
| 3964 | Continuous Home Care - Min 24 Hours | $1,476.49 | $33.22 | $9.92 | $1,519.63 |
| 3965 | Hospice Inpatient Respite Care Coinsurance Rate - 5% of 3946 | $24.85 | $0.56 | $0.50 | $25.91 |
| 3966 | Drugs Coinsurance Rate | $1.00 | $0.00 | $0.00 | $1.00 |
| 3969 | Routine Home Care w/AIDS | $307.80 | $6.93 | $9.92 | $324.65 |
| 3970 | Routine Home Care w/Escort | $196.62 | $4.42 | $9.92 | $210.96 |
| 3971 | Continuous Home Care w/AIDS Min 8 Hours | $533.51 | $12.00 | $9.92 | $555.43 |
| 3972 | Continuous Home Care w/AIDS Min 9 Hours | $600.20 | $13.50 | $9.92 | $623.62 |
| 3973 | Continuous Home Care w/AIDS Min 10 Hours | $666.89 | $15.01 | $9.92 | $691.82 |
| 3974 | Continuous Home Care w/AIDS Min 11 Hours | $733.58 | $16.51 | $9.92 | $760.01 |
| 3975 | Continuous Home Care w/AIDS Min 12 Hours | $800.27 | $18.01 | $9.92 | $828.20 |
| 3976 | Continuous Home Care w/AIDS Min 13 Hours | $866.96 | $19.51 | $9.92 | $896.39 |
| 3977 | Continuous Home Care w/AIDS Min 14 Hours | $933.65 | $21.01 | $9.92 | $964.58 |
| 3978 | Continuous Home Care w/AIDS Min 15 Hours | $1,000.34 | $22.51 | $9.92 | $1,032.77 |
| 3979 | Continuous Home Care w/AIDS Min 16 Hours | $1,067.03 | $24.01 | $9.92 | $1,100.96 |
| 3980 | Continuous Home Care w/AIDS Min 17 Hours | $1,133.72 | $25.51 | $9.92 | $1,169.15 |
| 3981 | Continuous Home Care w/AIDS Min 18 Hours | $1,200.41 | $27.01 | $9.92 | $1,237.34 |
| 3982 | Continuous Home Care w/AIDS Min 19 Hours | $1,267.09 | $28.51 | $9.92 | $1,305.52 |
| 3983 | Continuous Home Care w/AIDS Min 20 Hours | $1,333.78 | $30.01 | $9.92 | $1,373.71 |
| 3984 | Continuous Home Care w/AIDS Min 21 Hours | $1,400.47 | $31.51 | $9.92 | $1,441.90 |
| 3985 | Continuous Home Care w/AIDS Min 22 Hours | $1,467.16 | $33.01 | $9.92 | $1,510.09 |
| 3986 | Continuous Home Care w/AIDS Min 23 Hours | $1,533.85 | $34.51 | $9.92 | $1,578.28 |
| 3987 | Continuous Home Care w/AIDS Min 24 Hours | $1,600.54 | $36.01 | $9.92 | $1,646.47 |
| 3988 | General Inpatient w/ AIDS | $1,195.02 | $26.89 | $9.92 | $1,231.83 |
| 3989 | Routine Home Care w/ AIDS Escort | $326.74 | $7.35 | $9.92 | $344.01 |
| 3991 | Service Intensity Add-on | $61.52 | $1.38 | $0.00 | $62.90 |
* 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 | $212.53 | $4.78 | $9.92 | $227.23 |
| 3946 | Inpatient Respite | $574.27 | $12.92 | $9.92 | $597.11 |
| 3947 | General Inpatient Care | $1,272.16 | $28.62 | $9.92 | $1,310.70 |
| 3948 | Continuous Home Care - Min 8 Hours | $588.72 | $13.25 | $9.92 | $611.89 |
| 3949 | Continuous Home Care - Min 9 Hours | $662.31 | $14.90 | $9.92 | $687.13 |
| 3950 | Continuous Home Care - Min 10 Hours | $735.90 | $16.56 | $9.92 | $762.38 |
| 3951 | Continuous Home Care - Min 11 Hours | $809.49 | $18.21 | $9.92 | $837.62 |
| 3952 | Continuous Home Care - Min 12 Hours | $883.08 | $19.87 | $9.92 | $912.87 |
| 3953 | Continuous Home Care - Min 13 Hours | $956.67 | $21.53 | $9.92 | $988.12 |
| 3954 | Continuous Home Care - Min 14 Hours | $1,030.26 | $23.18 | $9.92 | $1,063.36 |
| 3955 | Continuous Home Care - Min 15 Hours | $1,103.85 | $24.84 | $9.92 | $1,138.61 |
| 3956 | Continuous Home Care - Min 16 Hours | $1,177.44 | $26.49 | $9.92 | $1,213.85 |
| 3957 | Continuous Home Care - Min 17 Hours | $1,251.03 | $28.15 | $9.92 | $1,289.10 |
| 3958 | Continuous Home Care - Min 18 Hours | $1,324.62 | $29.80 | $9.92 | $1,364.34 |
| 3959 | Continuous Home Care - Min 19 Hours | $1,398.21 | $31.46 | $9.92 | $1,439.59 |
| 3960 | Continuous Home Care - Min 20 Hours | $1,471.80 | $33.12 | $9.92 | $1,514.84 |
| 3961 | Continuous Home Care - Min 21 Hours | $1,545.39 | $34.77 | $9.92 | $1,590.08 |
| 3962 | Continuous Home Care - Min 22 Hours | $1,618.98 | $36.43 | $9.92 | $1,665.33 |
| 3963 | Continuous Home Care - Min 23 Hours | $1,692.57 | $38.08 | $9.92 | $1,740.57 |
| 3964 | Continuous Home Care - Min 24 Hours | $1,766.16 | $39.74 | $9.92 | $1,815.82 |
| 3965 | Hospice Inpatient Respite Care Coinsurance Rate - 5% of 3946 | $28.71 | $0.65 | $0.50 | $29.86 |
| 3966 | Drugs Coinsurance Rate | $1.00 | $0.00 | $0.00 | $1.00 |
| 3969 | Routine Home Care w/AIDS | $368.19 | $8.28 | $9.92 | $386.39 |
| 3970 | Routine Home Care w/Escort | $231.47 | $5.21 | $9.92 | $246.60 |
| 3971 | Continuous Home Care w/AIDS Min 8 Hours | $672.62 | $15.13 | $9.92 | $697.67 |
| 3972 | Continuous Home Care w/AIDS Min 9 Hours | $756.70 | $17.03 | $9.92 | $783.65 |
| 3973 | Continuous Home Care w/AIDS Min 10 Hours | $840.78 | $18.92 | $9.92 | $869.62 |
| 3974 | Continuous Home Care w/AIDS Min 11 Hours | $924.85 | $20.81 | $9.92 | $955.58 |
| 3975 | Continuous Home Care w/AIDS Min 12 Hours | $1,008.93 | $22.70 | $9.92 | $1,041.55 |
| 3976 | Continuous Home Care w/AIDS Min 13 Hours | $1,093.01 | $24.59 | $9.92 | $1,127.52 |
| 3977 | Continuous Home Care w/AIDS Min 14 Hours | $1,177.09 | $26.48 | $9.92 | $1,213.49 |
| 3978 | Continuous Home Care w/AIDS Min 15 Hours | $1,261.16 | $28.38 | $9.92 | $1,299.46 |
| 3979 | Continuous Home Care w/AIDS Min 16 Hours | $1,345.24 | $30.27 | $9.92 | $1,385.43 |
| 3980 | Continuous Home Care w/AIDS Min 17 Hours | $1,429.32 | $32.16 | $9.92 | $1,471.40 |
| 3981 | Continuous Home Care w/AIDS Min 18 Hours | $1,513.40 | $34.05 | $9.92 | $1,557.37 |
| 3982 | Continuous Home Care w/AIDS Min 19 Hours | $1,597.47 | $35.94 | $9.92 | $1,643.33 |
| 3983 | Continuous Home Care w/AIDS Min 20 Hours | $1,681.55 | $37.83 | $9.92 | $1,729.30 |
| 3984 | Continuous Home Care w/AIDS Min 21 Hours | $1,765.63 | $39.73 | $9.92 | $1,815.28 |
| 3985 | Continuous Home Care w/AIDS Min 22 Hours | $1,849.71 | $41.62 | $9.92 | $1,901.25 |
| 3986 | Continuous Home Care w/AIDS Min 23 Hours | $1,933.78 | $43.51 | $9.92 | $1,987.21 |
| 3987 | Continuous Home Care w/AIDS Min 24 Hours | $2,017.86 | $45.40 | $9.92 | $2,073.18 |
| 3988 | General Inpatient w/ AIDS | $1,413.88 | $31.81 | $9.92 | $1,455.61 |
| 3989 | Routine Home Care w/ AIDS Escort | $387.13 | $8.71 | $9.92 | $405.76 |
| 3991 | Service Intensity Add-on | $73.59 | $1.66 | $0.00 | $75.25 |
* 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 | $197.42 | $4.44 | $9.92 | $211.78 |
| 3946 | Inpatient Respite | $540.74 | $12.17 | $9.92 | $562.83 |
| 3947 | General Inpatient Care | $1,186.75 | $26.70 | $9.92 | $1,223.37 |
| 3948 | Continuous Home Care - Min 8 Hours | $546.84 | $12.30 | $9.92 | $569.06 |
| 3949 | Continuous Home Care - Min 9 Hours | $615.20 | $13.84 | $9.92 | $638.96 |
| 3950 | Continuous Home Care - Min 10 Hours | $683.55 | $15.38 | $9.92 | $708.85 |
| 3951 | Continuous Home Care - Min 11 Hours | $751.91 | $16.92 | $9.92 | $778.75 |
| 3952 | Continuous Home Care - Min 12 Hours | $820.26 | $18.46 | $9.92 | $848.64 |
| 3953 | Continuous Home Care - Min 13 Hours | $888.62 | $19.99 | $9.92 | $918.53 |
| 3954 | Continuous Home Care - Min 14 Hours | $956.97 | $21.53 | $9.92 | $988.42 |
| 3955 | Continuous Home Care - Min 15 Hours | $1,025.33 | $23.07 | $9.92 | $1,058.32 |
| 3956 | Continuous Home Care - Min 16 Hours | $1,093.68 | $24.61 | $9.92 | $1,128.21 |
| 3957 | Continuous Home Care - Min 17 Hours | $1,162.04 | $26.15 | $9.92 | $1,198.11 |
| 3958 | Continuous Home Care - Min 18 Hours | $1,230.39 | $27.68 | $9.92 | $1,267.99 |
| 3959 | Continuous Home Care - Min 19 Hours | $1,298.75 | $29.22 | $9.92 | $1,337.89 |
| 3960 | Continuous Home Care - Min 20 Hours | $1,367.10 | $30.76 | $9.92 | $1,407.78 |
| 3961 | Continuous Home Care - Min 21 Hours | $1,435.46 | $32.30 | $9.92 | $1,477.68 |
| 3962 | Continuous Home Care - Min 22 Hours | $1,503.81 | $33.84 | $9.92 | $1,547.57 |
| 3963 | Continuous Home Care - Min 23 Hours | $1,572.17 | $35.37 | $9.92 | $1,617.46 |
| 3964 | Continuous Home Care - Min 24 Hours | $1,640.52 | $36.91 | $9.92 | $1,687.35 |
| 3965 | Hospice Inpatient Respite Care Coinsurance Rate - 5% of 3946 | $27.04 | $0.61 | $0.50 | $28.15 |
| 3966 | Drugs Coinsurance Rate | $1.00 | $0.00 | $0.00 | $1.00 |
| 3969 | Routine Home Care w/AIDS | $342.00 | $7.70 | $9.92 | $359.62 |
| 3970 | Routine Home Care w/Escort | $216.36 | $4.87 | $9.92 | $231.15 |
| 3971 | Continuous Home Care w/AIDS Min 8 Hours | $612.29 | $13.78 | $9.92 | $635.99 |
| 3972 | Continuous Home Care w/AIDS Min 9 Hours | $688.82 | $15.50 | $9.92 | $714.24 |
| 3973 | Continuous Home Care w/AIDS Min 10 Hours | $765.36 | $17.22 | $9.92 | $792.50 |
| 3974 | Continuous Home Care w/AIDS Min 11 Hours | $841.89 | $18.94 | $9.92 | $870.75 |
| 3975 | Continuous Home Care w/AIDS Min 12 Hours | $918.43 | $20.66 | $9.92 | $949.01 |
| 3976 | Continuous Home Care w/AIDS Min 13 Hours | $994.97 | $22.39 | $9.92 | $1,027.28 |
| 3977 | Continuous Home Care w/AIDS Min 14 Hours | $1,071.50 | $24.11 | $9.92 | $1,105.53 |
| 3978 | Continuous Home Care w/AIDS Min 15 Hours | $1,148.04 | $25.83 | $9.92 | $1,183.79 |
| 3979 | Continuous Home Care w/AIDS Min 16 Hours | $1,224.57 | $27.55 | $9.92 | $1,262.04 |
| 3980 | Continuous Home Care w/AIDS Min 17 Hours | $1,301.11 | $29.27 | $9.92 | $1,340.30 |
| 3981 | Continuous Home Care w/AIDS Min 18 Hours | $1,377.65 | $31.00 | $9.92 | $1,418.57 |
| 3982 | Continuous Home Care w/AIDS Min 19 Hours | $1,454.18 | $32.72 | $9.92 | $1,496.82 |
| 3983 | Continuous Home Care w/AIDS Min 20 Hours | $1,530.72 | $34.44 | $9.92 | $1,575.08 |
| 3984 | Continuous Home Care w/AIDS Min 21 Hours | $1,607.25 | $36.16 | $9.92 | $1,653.33 |
| 3985 | Continuous Home Care w/AIDS Min 22 Hours | $1,683.79 | $37.89 | $9.92 | $1,731.60 |
| 3986 | Continuous Home Care w/AIDS Min 23 Hours | $1,760.32 | $39.61 | $9.92 | $1,809.85 |
| 3987 | Continuous Home Care w/AIDS Min 24 Hours | $1,836.86 | $41.33 | $9.92 | $1,888.11 |
| 3988 | General Inpatient w/ AIDS | $1,318.95 | $29.68 | $9.92 | $1,358.55 |
| 3989 | Routine Home Care w/ AIDS Escort | $360.94 | $8.12 | $9.92 | $378.98 |
| 3991 | Service Intensity Add-on | $68.36 | $1.54 | $0.00 | $69.90 |
* 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 | $159.67 | $3.59 | $9.92 | $173.18 |
| 3946 | Inpatient Respite | $457.04 | $10.28 | $9.92 | $477.24 |
| 3947 | General Inpatient Care | $973.51 | $21.90 | $9.92 | $1,005.33 |
| 3948 | Continuous Home Care - Min 8 Hours | $442.28 | $9.95 | $9.92 | $462.15 |
| 3949 | Continuous Home Care - Min 9 Hours | $497.56 | $11.20 | $9.92 | $518.68 |
| 3950 | Continuous Home Care - Min 10 Hours | $552.85 | $12.44 | $9.92 | $575.21 |
| 3951 | Continuous Home Care - Min 11 Hours | $608.13 | $13.68 | $9.92 | $631.73 |
| 3952 | Continuous Home Care - Min 12 Hours | $663.42 | $14.93 | $9.92 | $688.27 |
| 3953 | Continuous Home Care - Min 13 Hours | $718.70 | $16.17 | $9.92 | $744.79 |
| 3954 | Continuous Home Care - Min 14 Hours | $773.98 | $17.41 | $9.92 | $801.31 |
| 3955 | Continuous Home Care - Min 15 Hours | $829.27 | $18.66 | $9.92 | $857.85 |
| 3956 | Continuous Home Care - Min 16 Hours | $884.55 | $19.90 | $9.92 | $914.37 |
| 3957 | Continuous Home Care - Min 17 Hours | $939.84 | $21.15 | $9.92 | $970.91 |
| 3958 | Continuous Home Care - Min 18 Hours | $995.12 | $22.39 | $9.92 | $1,027.43 |
| 3959 | Continuous Home Care - Min 19 Hours | $1,050.41 | $23.63 | $9.92 | $1,083.96 |
| 3960 | Continuous Home Care - Min 20 Hours | $1,105.69 | $24.88 | $9.92 | $1,140.49 |
| 3961 | Continuous Home Care - Min 21 Hours | $1,160.98 | $26.12 | $9.92 | $1,197.02 |
| 3962 | Continuous Home Care - Min 22 Hours | $1,216.26 | $27.37 | $9.92 | $1,253.55 |
| 3963 | Continuous Home Care - Min 23 Hours | $1,271.55 | $28.61 | $9.92 | $1,310.08 |
| 3964 | Continuous Home Care - Min 24 Hours | $1,326.83 | $29.85 | $9.92 | $1,366.60 |
| 3965 | Hospice Inpatient Respite Care Coinsurance Rate - 5% of 3946 | $22.85 | $0.51 | $0.50 | $23.86 |
| 3966 | Drugs Coinsurance Rate | $1.00 | $0.00 | $0.00 | $1.00 |
| 3969 | Routine Home Care w/AIDS | $276.60 | $6.22 | $9.92 | $292.74 |
| 3970 | Routine Home Care w/Escort | $178.61 | $4.02 | $9.92 | $192.55 |
| 3971 | Continuous Home Care w/AIDS Min 8 Hours | $461.64 | $10.39 | $9.92 | $481.95 |
| 3972 | Continuous Home Care w/AIDS Min 9 Hours | $519.35 | $11.69 | $9.92 | $540.96 |
| 3973 | Continuous Home Care w/AIDS Min 10 Hours | $577.05 | $12.98 | $9.92 | $599.95 |
| 3974 | Continuous Home Care w/AIDS Min 11 Hours | $634.76 | $14.28 | $9.92 | $658.96 |
| 3975 | Continuous Home Care w/AIDS Min 12 Hours | $692.47 | $15.58 | $9.92 | $717.97 |
| 3976 | Continuous Home Care w/AIDS Min 13 Hours | $750.17 | $16.88 | $9.92 | $776.97 |
| 3977 | Continuous Home Care w/AIDS Min 14 Hours | $807.88 | $18.18 | $9.92 | $835.98 |
| 3978 | Continuous Home Care w/AIDS Min 15 Hours | $865.58 | $19.48 | $9.92 | $894.98 |
| 3979 | Continuous Home Care w/AIDS Min 16 Hours | $923.29 | $20.77 | $9.92 | $953.98 |
| 3980 | Continuous Home Care w/AIDS Min 17 Hours | $980.99 | $22.07 | $9.92 | $1,012.98 |
| 3981 | Continuous Home Care w/AIDS Min 18 Hours | $1,038.70 | $23.37 | $9.92 | $1,071.99 |
| 3982 | Continuous Home Care w/AIDS Min 19 Hours | $1,096.40 | $24.67 | $9.92 | $1,130.99 |
| 3983 | Continuous Home Care w/AIDS Min 20 Hours | $1,154.11 | $25.97 | $9.92 | $1,190.00 |
| 3984 | Continuous Home Care w/AIDS Min 21 Hours | $1,211.81 | $27.27 | $9.92 | $1,249.00 |
| 3985 | Continuous Home Care w/AIDS Min 22 Hours | $1,269.52 | $28.56 | $9.92 | $1,308.00 |
| 3986 | Continuous Home Care w/AIDS Min 23 Hours | $1,327.22 | $29.86 | $9.92 | $1,367.00 |
| 3987 | Continuous Home Care w/AIDS Min 24 Hours | $1,384.93 | $31.16 | $9.92 | $1,426.01 |
| 3988 | General Inpatient w/ AIDS | $1,081.96 | $24.34 | $9.92 | $1,116.22 |
| 3989 | Routine Home Care w/ AIDS Escort | $295.54 | $6.65 | $9.92 | $312.11 |
| 3991 | Service Intensity Add-on | $55.29 | $1.24 | $0.00 | $56.53 |
* 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 | $170.77 | $3.84 | $9.92 | $184.53 |
| 3946 | Inpatient Respite | $481.66 | $10.84 | $9.92 | $502.42 |
| 3947 | General Inpatient Care | $1,036.22 | $23.31 | $9.92 | $1,069.45 |
| 3948 | Continuous Home Care - Min 8 Hours | $473.03 | $10.64 | $9.92 | $493.59 |
| 3949 | Continuous Home Care - Min 9 Hours | $532.16 | $11.97 | $9.92 | $554.05 |
| 3950 | Continuous Home Care - Min 10 Hours | $591.29 | $13.30 | $9.92 | $614.51 |
| 3951 | Continuous Home Care - Min 11 Hours | $650.42 | $14.63 | $9.92 | $674.97 |
| 3952 | Continuous Home Care - Min 12 Hours | $709.55 | $15.96 | $9.92 | $735.43 |
| 3953 | Continuous Home Care - Min 13 Hours | $768.67 | $17.30 | $9.92 | $795.89 |
| 3954 | Continuous Home Care - Min 14 Hours | $827.80 | $18.63 | $9.92 | $856.35 |
| 3955 | Continuous Home Care - Min 15 Hours | $886.93 | $19.96 | $9.92 | $916.81 |
| 3956 | Continuous Home Care - Min 16 Hours | $946.06 | $21.29 | $9.92 | $977.27 |
| 3957 | Continuous Home Care - Min 17 Hours | $1,005.19 | $22.62 | $9.92 | $1,037.73 |
| 3958 | Continuous Home Care - Min 18 Hours | $1,064.32 | $23.95 | $9.92 | $1,098.19 |
| 3959 | Continuous Home Care - Min 19 Hours | $1,123.45 | $25.28 | $9.92 | $1,158.65 |
| 3960 | Continuous Home Care - Min 20 Hours | $1,182.58 | $26.61 | $9.92 | $1,219.11 |
| 3961 | Continuous Home Care - Min 21 Hours | $1,241.70 | $27.94 | $9.92 | $1,279.56 |
| 3962 | Continuous Home Care - Min 22 Hours | $1,300.83 | $29.27 | $9.92 | $1,340.02 |
| 3963 | Continuous Home Care - Min 23 Hours | $1,359.96 | $30.60 | $9.92 | $1,400.48 |
| 3964 | Continuous Home Care - Min 24 Hours | $1,419.09 | $31.93 | $9.92 | $1,460.94 |
| 3965 | Hospice Inpatient Respite Care Coinsurance Rate - 5% of 3946 | $24.08 | $0.54 | $0.50 | $25.12 |
| 3966 | Drugs Coinsurance Rate | $1.00 | $0.00 | $0.00 | $1.00 |
| 3969 | Routine Home Care w/AIDS | $295.84 | $6.66 | $9.92 | $312.42 |
| 3970 | Routine Home Care w/Escort | $189.71 | $4.27 | $9.92 | $203.90 |
| 3971 | Continuous Home Care w/AIDS Min 8 Hours | $505.95 | $11.38 | $9.92 | $527.25 |
| 3972 | Continuous Home Care w/AIDS Min 9 Hours | $569.19 | $12.81 | $9.92 | $591.92 |
| 3973 | Continuous Home Care w/AIDS Min 10 Hours | $632.43 | $14.23 | $9.92 | $656.58 |
| 3974 | Continuous Home Care w/AIDS Min 11 Hours | $695.68 | $15.65 | $9.92 | $721.25 |
| 3975 | Continuous Home Care w/AIDS Min 12 Hours | $758.92 | $17.08 | $9.92 | $785.92 |
| 3976 | Continuous Home Care w/AIDS Min 13 Hours | $822.16 | $18.50 | $9.92 | $850.58 |
| 3977 | Continuous Home Care w/AIDS Min 14 Hours | $885.41 | $19.92 | $9.92 | $915.25 |
| 3978 | Continuous Home Care w/AIDS Min 15 Hours | $948.65 | $21.34 | $9.92 | $979.91 |
| 3979 | Continuous Home Care w/AIDS Min 16 Hours | $1,011.89 | $22.77 | $9.92 | $1,044.58 |
| 3980 | Continuous Home Care w/AIDS Min 17 Hours | $1,075.14 | $24.19 | $9.92 | $1,109.25 |
| 3981 | Continuous Home Care w/AIDS Min 18 Hours | $1,138.38 | $25.61 | $9.92 | $1,173.91 |
| 3982 | Continuous Home Care w/AIDS Min 19 Hours | $1,201.62 | $27.04 | $9.92 | $1,238.58 |
| 3983 | Continuous Home Care w/AIDS Min 20 Hours | $1,264.87 | $28.46 | $9.92 | $1,303.25 |
| 3984 | Continuous Home Care w/AIDS Min 21 Hours | $1,328.11 | $29.88 | $9.92 | $1,367.91 |
| 3985 | Continuous Home Care w/AIDS Min 22 Hours | $1,391.35 | $31.31 | $9.92 | $1,432.58 |
| 3986 | Continuous Home Care w/AIDS Min 23 Hours | $1,454.60 | $32.73 | $9.92 | $1,497.25 |
| 3987 | Continuous Home Care w/AIDS Min 24 Hours | $1,517.84 | $34.15 | $9.92 | $1,561.91 |
| 3988 | General Inpatient w/ AIDS | $1,151.65 | $25.91 | $9.92 | $1,187.48 |
| 3989 | Routine Home Care w/ AIDS Escort | $314.78 | $7.08 | $9.92 | $331.78 |
| 3991 | Service Intensity Add-on | $59.13 | $1.33 | $0.00 | $60.46 |
* 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 | $160.90 | $3.62 | $9.92 | $174.44 |
| 3946 | Inpatient Respite | $459.77 | $10.34 | $9.92 | $480.03 |
| 3947 | General Inpatient Care | $980.47 | $22.06 | $9.92 | $1,012.45 |
| 3948 | Continuous Home Care - Min 8 Hours | $445.69 | $10.03 | $9.92 | $465.64 |
| 3949 | Continuous Home Care - Min 9 Hours | $501.40 | $11.28 | $9.92 | $522.60 |
| 3950 | Continuous Home Care - Min 10 Hours | $557.11 | $12.53 | $9.92 | $579.56 |
| 3951 | Continuous Home Care - Min 11 Hours | $612.82 | $13.79 | $9.92 | $636.53 |
| 3952 | Continuous Home Care - Min 12 Hours | $668.54 | $15.04 | $9.92 | $693.50 |
| 3953 | Continuous Home Care - Min 13 Hours | $724.25 | $16.30 | $9.92 | $750.47 |
| 3954 | Continuous Home Care - Min 14 Hours | $779.96 | $17.55 | $9.92 | $807.43 |
| 3955 | Continuous Home Care - Min 15 Hours | $835.67 | $18.80 | $9.92 | $864.39 |
| 3956 | Continuous Home Care - Min 16 Hours | $891.38 | $20.06 | $9.92 | $921.36 |
| 3957 | Continuous Home Care - Min 17 Hours | $947.09 | $21.31 | $9.92 | $978.32 |
| 3958 | Continuous Home Care - Min 18 Hours | $1,002.80 | $22.56 | $9.92 | $1,035.28 |
| 3959 | Continuous Home Care - Min 19 Hours | $1,058.51 | $23.82 | $9.92 | $1,092.25 |
| 3960 | Continuous Home Care - Min 20 Hours | $1,114.23 | $25.07 | $9.92 | $1,149.22 |
| 3961 | Continuous Home Care - Min 21 Hours | $1,169.94 | $26.32 | $9.92 | $1,206.18 |
| 3962 | Continuous Home Care - Min 22 Hours | $1,225.65 | $27.58 | $9.92 | $1,263.15 |
| 3963 | Continuous Home Care - Min 23 Hours | $1,281.36 | $28.83 | $9.92 | $1,320.11 |
| 3964 | Continuous Home Care - Min 24 Hours | $1,337.07 | $30.08 | $9.92 | $1,377.07 |
| 3965 | Hospice Inpatient Respite Care Coinsurance Rate - 5% of 3946 | $22.99 | $0.52 | $0.50 | $24.01 |
| 3966 | Drugs Coinsurance Rate | $1.00 | $0.00 | $0.00 | $1.00 |
| 3969 | Routine Home Care w/AIDS | $278.74 | $6.27 | $9.92 | $294.93 |
| 3970 | Routine Home Care w/Escort | $179.84 | $4.05 | $9.92 | $193.81 |
| 3971 | Continuous Home Care w/AIDS Min 8 Hours | $466.56 | $10.50 | $9.92 | $486.98 |
| 3972 | Continuous Home Care w/AIDS Min 9 Hours | $524.88 | $11.81 | $9.92 | $546.61 |
| 3973 | Continuous Home Care w/AIDS Min 10 Hours | $583.20 | $13.12 | $9.92 | $606.24 |
| 3974 | Continuous Home Care w/AIDS Min 11 Hours | $641.52 | $14.43 | $9.92 | $665.87 |
| 3975 | Continuous Home Care w/AIDS Min 12 Hours | $699.84 | $15.75 | $9.92 | $725.51 |
| 3976 | Continuous Home Care w/AIDS Min 13 Hours | $758.16 | $17.06 | $9.92 | $785.14 |
| 3977 | Continuous Home Care w/AIDS Min 14 Hours | $816.48 | $18.37 | $9.92 | $844.77 |
| 3978 | Continuous Home Care w/AIDS Min 15 Hours | $874.80 | $19.68 | $9.92 | $904.40 |
| 3979 | Continuous Home Care w/AIDS Min 16 Hours | $933.12 | $21.00 | $9.92 | $964.04 |
| 3980 | Continuous Home Care w/AIDS Min 17 Hours | $991.44 | $22.31 | $9.92 | $1,023.67 |
| 3981 | Continuous Home Care w/AIDS Min 18 Hours | $1,049.76 | $23.62 | $9.92 | $1,083.30 |
| 3982 | Continuous Home Care w/AIDS Min 19 Hours | $1,108.08 | $24.93 | $9.92 | $1,142.93 |
| 3983 | Continuous Home Care w/AIDS Min 20 Hours | $1,166.40 | $26.24 | $9.92 | $1,202.56 |
| 3984 | Continuous Home Care w/AIDS Min 21 Hours | $1,224.72 | $27.56 | $9.92 | $1,262.20 |
| 3985 | Continuous Home Care w/AIDS Min 22 Hours | $1,283.04 | $28.87 | $9.92 | $1,321.83 |
| 3986 | Continuous Home Care w/AIDS Min 23 Hours | $1,341.36 | $30.18 | $9.92 | $1,381.46 |
| 3987 | Continuous Home Care w/AIDS Min 24 Hours | $1,399.68 | $31.49 | $9.92 | $1,441.09 |
| 3988 | General Inpatient w/ AIDS | $1,089.69 | $24.52 | $9.92 | $1,124.13 |
| 3989 | Routine Home Care w/ AIDS Escort | $297.68 | $6.70 | $9.92 | $314.30 |
| 3991 | Service Intensity Add-on | $55.71 | $1.25 | $0.00 | $56.96 |
* 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 | $155.79 | $3.51 | $9.92 | $169.22 |
| 3946 | Inpatient Respite | $448.45 | $10.09 | $9.92 | $468.46 |
| 3947 | General Inpatient Care | $951.62 | $21.41 | $9.92 | $982.95 |
| 3948 | Continuous Home Care - Min 8 Hours | $431.55 | $9.71 | $9.92 | $451.18 |
| 3949 | Continuous Home Care - Min 9 Hours | $485.49 | $10.92 | $9.92 | $506.33 |
| 3950 | Continuous Home Care - Min 10 Hours | $539.43 | $12.14 | $9.92 | $561.49 |
| 3951 | Continuous Home Care - Min 11 Hours | $593.38 | $13.35 | $9.92 | $616.65 |
| 3952 | Continuous Home Care - Min 12 Hours | $647.32 | $14.56 | $9.92 | $671.80 |
| 3953 | Continuous Home Care - Min 13 Hours | $701.26 | $15.78 | $9.92 | $726.96 |
| 3954 | Continuous Home Care - Min 14 Hours | $755.21 | $16.99 | $9.92 | $782.12 |
| 3955 | Continuous Home Care - Min 15 Hours | $809.15 | $18.21 | $9.92 | $837.28 |
| 3956 | Continuous Home Care - Min 16 Hours | $863.09 | $19.42 | $9.92 | $892.43 |
| 3957 | Continuous Home Care - Min 17 Hours | $917.04 | $20.63 | $9.92 | $947.59 |
| 3958 | Continuous Home Care - Min 18 Hours | $970.98 | $21.85 | $9.92 | $1,002.75 |
| 3959 | Continuous Home Care - Min 19 Hours | $1,024.92 | $23.06 | $9.92 | $1,057.90 |
| 3960 | Continuous Home Care - Min 20 Hours | $1,078.87 | $24.27 | $9.92 | $1,113.06 |
| 3961 | Continuous Home Care - Min 21 Hours | $1,132.81 | $25.49 | $9.92 | $1,168.22 |
| 3962 | Continuous Home Care - Min 22 Hours | $1,186.75 | $26.70 | $9.92 | $1,223.37 |
| 3963 | Continuous Home Care - Min 23 Hours | $1,240.70 | $27.92 | $9.92 | $1,278.54 |
| 3964 | Continuous Home Care - Min 24 Hours | $1,294.64 | $29.13 | $9.92 | $1,333.69 |
| 3965 | Hospice Inpatient Respite Care Coinsurance Rate - 5% of 3946 | $22.42 | $0.50 | $0.50 | $23.42 |
| 3966 | Drugs Coinsurance Rate | $1.00 | $0.00 | $0.00 | $1.00 |
| 3969 | Routine Home Care w/AIDS | $269.89 | $6.07 | $9.92 | $285.88 |
| 3970 | Routine Home Care w/Escort | $174.73 | $3.93 | $9.92 | $188.58 |
| 3971 | Continuous Home Care w/AIDS Min 8 Hours | $446.18 | $10.04 | $9.92 | $466.14 |
| 3972 | Continuous Home Care w/AIDS Min 9 Hours | $501.95 | $11.29 | $9.92 | $523.16 |
| 3973 | Continuous Home Care w/AIDS Min 10 Hours | $557.73 | $12.55 | $9.92 | $580.20 |
| 3974 | Continuous Home Care w/AIDS Min 11 Hours | $613.50 | $13.80 | $9.92 | $637.22 |
| 3975 | Continuous Home Care w/AIDS Min 12 Hours | $669.27 | $15.06 | $9.92 | $694.25 |
| 3976 | Continuous Home Care w/AIDS Min 13 Hours | $725.04 | $16.31 | $9.92 | $751.27 |
| 3977 | Continuous Home Care w/AIDS Min 14 Hours | $780.82 | $17.57 | $9.92 | $808.31 |
| 3978 | Continuous Home Care w/AIDS Min 15 Hours | $836.59 | $18.82 | $9.92 | $865.33 |
| 3979 | Continuous Home Care w/AIDS Min 16 Hours | $892.36 | $20.08 | $9.92 | $922.36 |
| 3980 | Continuous Home Care w/AIDS Min 17 Hours | $948.13 | $21.33 | $9.92 | $979.38 |
| 3981 | Continuous Home Care w/AIDS Min 18 Hours | $1,003.91 | $22.59 | $9.92 | $1,036.42 |
| 3982 | Continuous Home Care w/AIDS Min 19 Hours | $1,059.68 | $23.84 | $9.92 | $1,093.44 |
| 3983 | Continuous Home Care w/AIDS Min 20 Hours | $1,115.45 | $25.10 | $9.92 | $1,150.47 |
| 3984 | Continuous Home Care w/AIDS Min 21 Hours | $1,171.22 | $26.35 | $9.92 | $1,207.49 |
| 3985 | Continuous Home Care w/AIDS Min 22 Hours | $1,227.00 | $27.61 | $9.92 | $1,264.53 |
| 3986 | Continuous Home Care w/AIDS Min 23 Hours | $1,282.77 | $28.86 | $9.92 | $1,321.55 |
| 3987 | Continuous Home Care w/AIDS Min 24 Hours | $1,338.54 | $30.12 | $9.92 | $1,378.58 |
| 3988 | General Inpatient w/ AIDS | $1,057.63 | $23.80 | $9.92 | $1,091.35 |
| 3989 | Routine Home Care w/ AIDS Escort | $288.83 | $6.50 | $9.92 | $305.25 |
| 3991 | Service Intensity Add-on | $53.95 | $1.21 | $0.00 | $55.16 |
* WRR =´Worker Recruitment and Retention addon´ if applicable
* RTR =´Recruitment, Training and Retention addon´ if applicable
