Certified Hospice Program
Medicaid Rate Sheet
Effective: 10/01/2022 - 09/30/2023
- 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 | 1% Add-on |
|---|---|---|---|---|---|---|
| 3945 | Routine Home Care | $184.19 | $4.14 | $9.92 | $198.25 | $200.23 |
| 3946 | Inpatient Respite | $455.97 | $10.26 | $9.92 | $476.15 | $480.91 |
| 3947 | General Inpatient Care | $972.30 | $21.88 | $9.92 | $1,004.10 | $1,014.14 |
| 3948 | Continuous Home Care - Min 8 Hours | $432.62 | $9.73 | $9.92 | $452.27 | $456.79 |
| 3949 | Continuous Home Care - Min 9 Hours | $486.70 | $10.95 | $9.92 | $507.57 | $512.65 |
| 3950 | Continuous Home Care - Min 10 Hours | $540.78 | $12.17 | $9.92 | $562.87 | $568.50 |
| 3951 | Continuous Home Care - Min 11 Hours | $594.85 | $13.38 | $9.92 | $618.15 | $624.33 |
| 3952 | Continuous Home Care - Min 12 Hours | $648.93 | $14.60 | $9.92 | $673.45 | $680.18 |
| 3953 | Continuous Home Care - Min 13 Hours | $703.01 | $15.82 | $9.92 | $728.75 | $736.04 |
| 3954 | Continuous Home Care - Min 14 Hours | $757.09 | $17.03 | $9.92 | $784.04 | $791.88 |
| 3955 | Continuous Home Care - Min 15 Hours | $811.16 | $18.25 | $9.92 | $839.33 | $847.72 |
| 3956 | Continuous Home Care - Min 16 Hours | $865.24 | $19.47 | $9.92 | $894.63 | $903.58 |
| 3957 | Continuous Home Care - Min 17 Hours | $919.32 | $20.68 | $9.92 | $949.92 | $959.42 |
| 3958 | Continuous Home Care - Min 18 Hours | $973.40 | $21.90 | $9.92 | $1,005.22 | $1,015.27 |
| 3959 | Continuous Home Care - Min 19 Hours | $1,027.47 | $23.12 | $9.92 | $1,060.51 | $1,071.12 |
| 3960 | Continuous Home Care - Min 20 Hours | $1,081.55 | $24.33 | $9.92 | $1,115.80 | $1,126.96 |
| 3961 | Continuous Home Care - Min 21 Hours | $1,135.63 | $25.55 | $9.92 | $1,171.10 | $1,182.81 |
| 3962 | Continuous Home Care - Min 22 Hours | $1,189.71 | $26.77 | $9.92 | $1,226.40 | $1,238.66 |
| 3963 | Continuous Home Care - Min 23 Hours | $1,243.78 | $27.99 | $9.92 | $1,281.69 | $1,294.51 |
| 3964 | Continuous Home Care - Min 24 Hours | $1,297.86 | $29.20 | $9.92 | $1,336.98 | $1,350.35 |
| 3965 | Hospice Inpatient Respite Care Coinsurance Rate - 5% of 3946 | $22.80 | $0.51 | $0.50 | $23.81 | $24.05 |
| 3966 | Drugs Coinsurance Rate | $1.00 | $0.00 | $0.00 | $1.00 | $1.01 |
| 3969 | Routine Home Care w/AIDS | $300.02 | $6.75 | $9.92 | $316.69 | $319.86 |
| 3970 | Routine Home Care w/Escort | $204.15 | $4.59 | $9.92 | $218.66 | $220.85 |
| 3971 | Continuous Home Care w/AIDS Min 8 Hours | $445.81 | $10.03 | $9.92 | $465.76 | $470.42 |
| 3972 | Continuous Home Care w/AIDS Min 9 Hours | $501.53 | $11.28 | $9.92 | $522.73 | $527.96 |
| 3973 | Continuous Home Care w/AIDS Min 10 Hours | $557.26 | $12.54 | $9.92 | $579.72 | $585.52 |
| 3974 | Continuous Home Care w/AIDS Min 11 Hours | $612.98 | $13.79 | $9.92 | $636.69 | $643.06 |
| 3975 | Continuous Home Care w/AIDS Min 12 Hours | $668.71 | $15.05 | $9.92 | $693.68 | $700.62 |
| 3976 | Continuous Home Care w/AIDS Min 13 Hours | $724.44 | $16.30 | $9.92 | $750.66 | $758.17 |
| 3977 | Continuous Home Care w/AIDS Min 14 Hours | $780.16 | $17.55 | $9.92 | $807.63 | $815.71 |
| 3978 | Continuous Home Care w/AIDS Min 15 Hours | $835.89 | $18.81 | $9.92 | $864.62 | $873.27 |
| 3979 | Continuous Home Care w/AIDS Min 16 Hours | $891.61 | $20.06 | $9.92 | $921.59 | $930.81 |
| 3980 | Continuous Home Care w/AIDS Min 17 Hours | $947.34 | $21.32 | $9.92 | $978.58 | $988.37 |
| 3981 | Continuous Home Care w/AIDS Min 18 Hours | $1,003.07 | $22.57 | $9.92 | $1,035.56 | $1,045.92 |
| 3982 | Continuous Home Care w/AIDS Min 19 Hours | $1,058.79 | $23.82 | $9.92 | $1,092.53 | $1,103.46 |
| 3983 | Continuous Home Care w/AIDS Min 20 Hours | $1,114.52 | $25.08 | $9.92 | $1,149.52 | $1,161.02 |
| 3984 | Continuous Home Care w/AIDS Min 21 Hours | $1,170.24 | $26.33 | $9.92 | $1,206.49 | $1,218.55 |
| 3985 | Continuous Home Care w/AIDS Min 22 Hours | $1,225.97 | $27.58 | $9.92 | $1,263.47 | $1,276.10 |
| 3986 | Continuous Home Care w/AIDS Min 23 Hours | $1,281.69 | $28.84 | $9.92 | $1,320.45 | $1,333.65 |
| 3987 | Continuous Home Care w/AIDS Min 24 Hours | $1,337.42 | $30.09 | $9.92 | $1,377.43 | $1,391.20 |
| 3988 | General Inpatient w/ AIDS | $1,080.61 | $24.31 | $9.92 | $1,114.84 | $1,125.99 |
| 3989 | Routine Home Care w/ AIDS Escort | $319.98 | $7.20 | $9.92 | $337.10 | $340.47 |
| 3991 | Service Intensity Add-on | $54.88 | $1.23 | $0.00 | $56.11 | $56.67 |
* 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 | 1% Add-on |
|---|---|---|---|---|---|---|
| 3945 | Routine Home Care | $186.71 | $4.20 | $9.92 | $200.83 | $202.84 |
| 3946 | Inpatient Respite | $461.66 | $10.39 | $9.92 | $481.97 | $486.79 |
| 3947 | General Inpatient Care | $985.00 | $22.16 | $9.92 | $1,017.08 | $1,027.25 |
| 3948 | Continuous Home Care - Min 8 Hours | $439.49 | $9.89 | $9.92 | $459.30 | $463.89 |
| 3949 | Continuous Home Care - Min 9 Hours | $494.43 | $11.12 | $9.92 | $515.47 | $520.62 |
| 3950 | Continuous Home Care - Min 10 Hours | $549.36 | $12.36 | $9.92 | $571.64 | $577.36 |
| 3951 | Continuous Home Care - Min 11 Hours | $604.30 | $13.60 | $9.92 | $627.82 | $634.10 |
| 3952 | Continuous Home Care - Min 12 Hours | $659.24 | $14.83 | $9.92 | $683.99 | $690.83 |
| 3953 | Continuous Home Care - Min 13 Hours | $714.17 | $16.07 | $9.92 | $740.16 | $747.56 |
| 3954 | Continuous Home Care - Min 14 Hours | $769.11 | $17.30 | $9.92 | $796.33 | $804.29 |
| 3955 | Continuous Home Care - Min 15 Hours | $824.04 | $18.54 | $9.92 | $852.50 | $861.03 |
| 3956 | Continuous Home Care - Min 16 Hours | $878.98 | $19.78 | $9.92 | $908.68 | $917.77 |
| 3957 | Continuous Home Care - Min 17 Hours | $933.92 | $21.01 | $9.92 | $964.85 | $974.50 |
| 3958 | Continuous Home Care - Min 18 Hours | $988.85 | $22.25 | $9.92 | $1,021.02 | $1,031.23 |
| 3959 | Continuous Home Care - Min 19 Hours | $1,043.79 | $23.49 | $9.92 | $1,077.20 | $1,087.97 |
| 3960 | Continuous Home Care - Min 20 Hours | $1,098.73 | $24.72 | $9.92 | $1,133.37 | $1,144.70 |
| 3961 | Continuous Home Care - Min 21 Hours | $1,153.66 | $25.96 | $9.92 | $1,189.54 | $1,201.44 |
| 3962 | Continuous Home Care - Min 22 Hours | $1,208.60 | $27.19 | $9.92 | $1,245.71 | $1,258.17 |
| 3963 | Continuous Home Care - Min 23 Hours | $1,263.53 | $28.43 | $9.92 | $1,301.88 | $1,314.90 |
| 3964 | Continuous Home Care - Min 24 Hours | $1,318.47 | $29.67 | $9.92 | $1,358.06 | $1,371.64 |
| 3965 | Hospice Inpatient Respite Care Coinsurance Rate - 5% of 3946 | $23.08 | $0.52 | $0.50 | $24.10 | $24.34 |
| 3966 | Drugs Coinsurance Rate | $1.00 | $0.00 | $0.00 | $1.00 | $1.01 |
| 3969 | Routine Home Care w/AIDS | $304.12 | $6.84 | $9.92 | $320.88 | $324.09 |
| 3970 | Routine Home Care w/Escort | $206.67 | $4.65 | $9.92 | $221.24 | $223.45 |
| 3971 | Continuous Home Care w/AIDS Min 8 Hours | $454.85 | $10.23 | $9.92 | $475.00 | $479.75 |
| 3972 | Continuous Home Care w/AIDS Min 9 Hours | $511.70 | $11.51 | $9.92 | $533.13 | $538.46 |
| 3973 | Continuous Home Care w/AIDS Min 10 Hours | $568.56 | $12.79 | $9.92 | $591.27 | $597.18 |
| 3974 | Continuous Home Care w/AIDS Min 11 Hours | $625.41 | $14.07 | $9.92 | $649.40 | $655.89 |
| 3975 | Continuous Home Care w/AIDS Min 12 Hours | $682.27 | $15.35 | $9.92 | $707.54 | $714.62 |
| 3976 | Continuous Home Care w/AIDS Min 13 Hours | $739.13 | $16.63 | $9.92 | $765.68 | $773.34 |
| 3977 | Continuous Home Care w/AIDS Min 14 Hours | $795.98 | $17.91 | $9.92 | $823.81 | $832.05 |
| 3978 | Continuous Home Care w/AIDS Min 15 Hours | $852.84 | $19.19 | $9.92 | $881.95 | $890.77 |
| 3979 | Continuous Home Care w/AIDS Min 16 Hours | $909.69 | $20.47 | $9.92 | $940.08 | $949.48 |
| 3980 | Continuous Home Care w/AIDS Min 17 Hours | $966.55 | $21.75 | $9.92 | $998.22 | $1,008.20 |
| 3981 | Continuous Home Care w/AIDS Min 18 Hours | $1,023.41 | $23.03 | $9.92 | $1,056.36 | $1,066.92 |
| 3982 | Continuous Home Care w/AIDS Min 19 Hours | $1,080.26 | $24.31 | $9.92 | $1,114.49 | $1,125.63 |
| 3983 | Continuous Home Care w/AIDS Min 20 Hours | $1,137.12 | $25.59 | $9.92 | $1,172.63 | $1,184.36 |
| 3984 | Continuous Home Care w/AIDS Min 21 Hours | $1,193.97 | $26.86 | $9.92 | $1,230.75 | $1,243.06 |
| 3985 | Continuous Home Care w/AIDS Min 22 Hours | $1,250.83 | $28.14 | $9.92 | $1,288.89 | $1,301.78 |
| 3986 | Continuous Home Care w/AIDS Min 23 Hours | $1,307.68 | $29.42 | $9.92 | $1,347.02 | $1,360.49 |
| 3987 | Continuous Home Care w/AIDS Min 24 Hours | $1,364.54 | $30.70 | $9.92 | $1,405.16 | $1,419.21 |
| 3988 | General Inpatient w/ AIDS | $1,094.73 | $24.63 | $9.92 | $1,129.28 | $1,140.57 |
| 3989 | Routine Home Care w/ AIDS Escort | $324.08 | $7.29 | $9.92 | $341.29 | $344.70 |
| 3991 | Service Intensity Add-on | $55.67 | $1.25 | $0.00 | $56.92 | $57.49 |
* 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 | 1% Add-on |
|---|---|---|---|---|---|---|
| 3945 | Routine Home Care | $217.66 | $4.90 | $9.92 | $232.48 | $234.80 |
| 3946 | Inpatient Respite | $531.68 | $11.96 | $9.92 | $553.56 | $559.10 |
| 3947 | General Inpatient Care | $1,141.30 | $25.68 | $9.92 | $1,176.90 | $1,188.67 |
| 3948 | Continuous Home Care - Min 8 Hours | $524.07 | $11.79 | $9.92 | $545.78 | $551.24 |
| 3949 | Continuous Home Care - Min 9 Hours | $589.58 | $13.27 | $9.92 | $612.77 | $618.90 |
| 3950 | Continuous Home Care - Min 10 Hours | $655.09 | $14.74 | $9.92 | $679.75 | $686.55 |
| 3951 | Continuous Home Care - Min 11 Hours | $720.60 | $16.21 | $9.92 | $746.73 | $754.20 |
| 3952 | Continuous Home Care - Min 12 Hours | $786.11 | $17.69 | $9.92 | $813.72 | $821.86 |
| 3953 | Continuous Home Care - Min 13 Hours | $851.61 | $19.16 | $9.92 | $880.69 | $889.50 |
| 3954 | Continuous Home Care - Min 14 Hours | $917.12 | $20.64 | $9.92 | $947.68 | $957.16 |
| 3955 | Continuous Home Care - Min 15 Hours | $982.63 | $22.11 | $9.92 | $1,014.66 | $1,024.81 |
| 3956 | Continuous Home Care - Min 16 Hours | $1,048.14 | $23.58 | $9.92 | $1,081.64 | $1,092.46 |
| 3957 | Continuous Home Care - Min 17 Hours | $1,113.65 | $25.06 | $9.92 | $1,148.63 | $1,160.12 |
| 3958 | Continuous Home Care - Min 18 Hours | $1,179.16 | $26.53 | $9.92 | $1,215.61 | $1,227.77 |
| 3959 | Continuous Home Care - Min 19 Hours | $1,244.67 | $28.01 | $9.92 | $1,282.60 | $1,295.43 |
| 3960 | Continuous Home Care - Min 20 Hours | $1,310.18 | $29.48 | $9.92 | $1,349.58 | $1,363.08 |
| 3961 | Continuous Home Care - Min 21 Hours | $1,375.68 | $30.95 | $9.92 | $1,416.55 | $1,430.72 |
| 3962 | Continuous Home Care - Min 22 Hours | $1,441.19 | $32.43 | $9.92 | $1,483.54 | $1,498.38 |
| 3963 | Continuous Home Care - Min 23 Hours | $1,506.70 | $33.90 | $9.92 | $1,550.52 | $1,566.03 |
| 3964 | Continuous Home Care - Min 24 Hours | $1,572.21 | $35.37 | $9.92 | $1,617.50 | $1,633.68 |
| 3965 | Hospice Inpatient Respite Care Coinsurance Rate - 5% of 3946 | $26.58 | $0.60 | $0.50 | $27.68 | $27.96 |
| 3966 | Drugs Coinsurance Rate | $1.00 | $0.00 | $0.00 | $1.00 | $1.01 |
| 3969 | Routine Home Care w/AIDS | $354.53 | $7.98 | $9.92 | $372.43 | $376.15 |
| 3970 | Routine Home Care w/Escort | $237.62 | $5.35 | $9.92 | $252.89 | $255.42 |
| 3971 | Continuous Home Care w/AIDS Min 8 Hours | $566.12 | $12.74 | $9.92 | $588.78 | $594.67 |
| 3972 | Continuous Home Care w/AIDS Min 9 Hours | $636.89 | $14.33 | $9.92 | $661.14 | $667.75 |
| 3973 | Continuous Home Care w/AIDS Min 10 Hours | $707.65 | $15.92 | $9.92 | $733.49 | $740.82 |
| 3974 | Continuous Home Care w/AIDS Min 11 Hours | $778.42 | $17.51 | $9.92 | $805.85 | $813.91 |
| 3975 | Continuous Home Care w/AIDS Min 12 Hours | $849.18 | $19.11 | $9.92 | $878.21 | $886.99 |
| 3976 | Continuous Home Care w/AIDS Min 13 Hours | $919.95 | $20.70 | $9.92 | $950.57 | $960.08 |
| 3977 | Continuous Home Care w/AIDS Min 14 Hours | $990.71 | $22.29 | $9.92 | $1,022.92 | $1,033.15 |
| 3978 | Continuous Home Care w/AIDS Min 15 Hours | $1,061.48 | $23.88 | $9.92 | $1,095.28 | $1,106.23 |
| 3979 | Continuous Home Care w/AIDS Min 16 Hours | $1,132.24 | $25.48 | $9.92 | $1,167.64 | $1,179.32 |
| 3980 | Continuous Home Care w/AIDS Min 17 Hours | $1,203.01 | $27.07 | $9.92 | $1,240.00 | $1,252.40 |
| 3981 | Continuous Home Care w/AIDS Min 18 Hours | $1,273.77 | $28.66 | $9.92 | $1,312.35 | $1,325.47 |
| 3982 | Continuous Home Care w/AIDS Min 19 Hours | $1,344.54 | $30.25 | $9.92 | $1,384.71 | $1,398.56 |
| 3983 | Continuous Home Care w/AIDS Min 20 Hours | $1,415.30 | $31.84 | $9.92 | $1,457.06 | $1,471.63 |
| 3984 | Continuous Home Care w/AIDS Min 21 Hours | $1,486.07 | $33.44 | $9.92 | $1,529.43 | $1,544.72 |
| 3985 | Continuous Home Care w/AIDS Min 22 Hours | $1,556.83 | $35.03 | $9.92 | $1,601.78 | $1,617.80 |
| 3986 | Continuous Home Care w/AIDS Min 23 Hours | $1,627.60 | $36.62 | $9.92 | $1,674.14 | $1,690.88 |
| 3987 | Continuous Home Care w/AIDS Min 24 Hours | $1,698.36 | $38.21 | $9.92 | $1,746.49 | $1,763.95 |
| 3988 | General Inpatient w/ AIDS | $1,268.44 | $28.54 | $9.92 | $1,306.90 | $1,319.97 |
| 3989 | Routine Home Care w/ AIDS Escort | $374.49 | $8.43 | $9.92 | $392.84 | $396.77 |
| 3991 | Service Intensity Add-on | $65.33 | $1.47 | $0.00 | $66.80 | $67.47 |
* 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 | 1% Add-on |
|---|---|---|---|---|---|---|
| 3945 | Routine Home Care | $200.59 | $4.51 | $9.92 | $215.02 | $217.17 |
| 3946 | Inpatient Respite | $493.07 | $11.09 | $9.92 | $514.08 | $519.22 |
| 3947 | General Inpatient Care | $1,055.11 | $23.74 | $9.92 | $1,088.77 | $1,099.66 |
| 3948 | Continuous Home Care - Min 8 Hours | $477.43 | $10.74 | $9.92 | $498.09 | $503.07 |
| 3949 | Continuous Home Care - Min 9 Hours | $537.11 | $12.08 | $9.92 | $559.11 | $564.70 |
| 3950 | Continuous Home Care - Min 10 Hours | $596.79 | $13.43 | $9.92 | $620.14 | $626.34 |
| 3951 | Continuous Home Care - Min 11 Hours | $656.47 | $14.77 | $9.92 | $681.16 | $687.97 |
| 3952 | Continuous Home Care - Min 12 Hours | $716.15 | $16.11 | $9.92 | $742.18 | $749.60 |
| 3953 | Continuous Home Care - Min 13 Hours | $775.82 | $17.46 | $9.92 | $803.20 | $811.23 |
| 3954 | Continuous Home Care - Min 14 Hours | $835.50 | $18.80 | $9.92 | $864.22 | $872.86 |
| 3955 | Continuous Home Care - Min 15 Hours | $895.18 | $20.14 | $9.92 | $925.24 | $934.49 |
| 3956 | Continuous Home Care - Min 16 Hours | $954.86 | $21.48 | $9.92 | $986.26 | $996.12 |
| 3957 | Continuous Home Care - Min 17 Hours | $1,014.54 | $22.83 | $9.92 | $1,047.29 | $1,057.76 |
| 3958 | Continuous Home Care - Min 18 Hours | $1,074.22 | $24.17 | $9.92 | $1,108.31 | $1,119.39 |
| 3959 | Continuous Home Care - Min 19 Hours | $1,133.90 | $25.51 | $9.92 | $1,169.33 | $1,181.02 |
| 3960 | Continuous Home Care - Min 20 Hours | $1,193.58 | $26.86 | $9.92 | $1,230.36 | $1,242.66 |
| 3961 | Continuous Home Care - Min 21 Hours | $1,253.25 | $28.20 | $9.92 | $1,291.37 | $1,304.28 |
| 3962 | Continuous Home Care - Min 22 Hours | $1,312.93 | $29.54 | $9.92 | $1,352.39 | $1,365.91 |
| 3963 | Continuous Home Care - Min 23 Hours | $1,372.61 | $30.88 | $9.92 | $1,413.41 | $1,427.54 |
| 3964 | Continuous Home Care - Min 24 Hours | $1,432.29 | $32.23 | $9.92 | $1,474.44 | $1,489.18 |
| 3965 | Hospice Inpatient Respite Care Coinsurance Rate - 5% of 3946 | $24.65 | $0.55 | $0.50 | $25.70 | $25.96 |
| 3966 | Drugs Coinsurance Rate | $1.00 | $0.00 | $0.00 | $1.00 | $1.01 |
| 3969 | Routine Home Care w/AIDS | $326.73 | $7.35 | $9.92 | $344.00 | $347.44 |
| 3970 | Routine Home Care w/Escort | $220.55 | $4.96 | $9.92 | $235.43 | $237.78 |
| 3971 | Continuous Home Care w/AIDS Min 8 Hours | $504.76 | $11.36 | $9.92 | $526.04 | $531.30 |
| 3972 | Continuous Home Care w/AIDS Min 9 Hours | $567.86 | $12.78 | $9.92 | $590.56 | $596.47 |
| 3973 | Continuous Home Care w/AIDS Min 10 Hours | $630.95 | $14.20 | $9.92 | $655.07 | $661.62 |
| 3974 | Continuous Home Care w/AIDS Min 11 Hours | $694.05 | $15.62 | $9.92 | $719.59 | $726.79 |
| 3975 | Continuous Home Care w/AIDS Min 12 Hours | $757.14 | $17.04 | $9.92 | $784.10 | $791.94 |
| 3976 | Continuous Home Care w/AIDS Min 13 Hours | $820.24 | $18.46 | $9.92 | $848.62 | $857.11 |
| 3977 | Continuous Home Care w/AIDS Min 14 Hours | $883.33 | $19.87 | $9.92 | $913.12 | $922.25 |
| 3978 | Continuous Home Care w/AIDS Min 15 Hours | $946.43 | $21.29 | $9.92 | $977.64 | $987.42 |
| 3979 | Continuous Home Care w/AIDS Min 16 Hours | $1,009.52 | $22.71 | $9.92 | $1,042.15 | $1,052.57 |
| 3980 | Continuous Home Care w/AIDS Min 17 Hours | $1,072.62 | $24.13 | $9.92 | $1,106.67 | $1,117.74 |
| 3981 | Continuous Home Care w/AIDS Min 18 Hours | $1,135.71 | $25.55 | $9.92 | $1,171.18 | $1,182.89 |
| 3982 | Continuous Home Care w/AIDS Min 19 Hours | $1,198.81 | $26.97 | $9.92 | $1,235.70 | $1,248.06 |
| 3983 | Continuous Home Care w/AIDS Min 20 Hours | $1,261.90 | $28.39 | $9.92 | $1,300.21 | $1,313.21 |
| 3984 | Continuous Home Care w/AIDS Min 21 Hours | $1,325.00 | $29.81 | $9.92 | $1,364.73 | $1,378.38 |
| 3985 | Continuous Home Care w/AIDS Min 22 Hours | $1,388.09 | $31.23 | $9.92 | $1,429.24 | $1,443.53 |
| 3986 | Continuous Home Care w/AIDS Min 23 Hours | $1,451.19 | $32.65 | $9.92 | $1,493.76 | $1,508.70 |
| 3987 | Continuous Home Care w/AIDS Min 24 Hours | $1,514.28 | $34.07 | $9.92 | $1,558.27 | $1,573.85 |
| 3988 | General Inpatient w/ AIDS | $1,172.65 | $26.38 | $9.92 | $1,208.95 | $1,221.04 |
| 3989 | Routine Home Care w/ AIDS Escort | $346.69 | $7.80 | $9.92 | $364.41 | $368.05 |
| 3991 | Service Intensity Add-on | $60.00 | $1.35 | $0.00 | $61.35 | $61.96 |
* 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 | 1% Add-on |
|---|---|---|---|---|---|---|
| 3945 | Routine Home Care | $185.83 | $4.18 | $9.92 | $199.93 | $201.93 |
| 3946 | Inpatient Respite | $459.67 | $10.34 | $9.92 | $479.93 | $484.73 |
| 3947 | General Inpatient Care | $980.56 | $22.06 | $9.92 | $1,012.54 | $1,022.67 |
| 3948 | Continuous Home Care - Min 8 Hours | $437.09 | $9.83 | $9.92 | $456.84 | $461.41 |
| 3949 | Continuous Home Care - Min 9 Hours | $491.72 | $11.06 | $9.92 | $512.70 | $517.83 |
| 3950 | Continuous Home Care - Min 10 Hours | $546.36 | $12.29 | $9.92 | $568.57 | $574.26 |
| 3951 | Continuous Home Care - Min 11 Hours | $600.99 | $13.52 | $9.92 | $624.43 | $630.67 |
| 3952 | Continuous Home Care - Min 12 Hours | $655.63 | $14.75 | $9.92 | $680.30 | $687.10 |
| 3953 | Continuous Home Care - Min 13 Hours | $710.27 | $15.98 | $9.92 | $736.17 | $743.53 |
| 3954 | Continuous Home Care - Min 14 Hours | $764.90 | $17.21 | $9.92 | $792.03 | $799.95 |
| 3955 | Continuous Home Care - Min 15 Hours | $819.54 | $18.44 | $9.92 | $847.90 | $856.38 |
| 3956 | Continuous Home Care - Min 16 Hours | $874.17 | $19.67 | $9.92 | $903.76 | $912.80 |
| 3957 | Continuous Home Care - Min 17 Hours | $928.81 | $20.90 | $9.92 | $959.63 | $969.23 |
| 3958 | Continuous Home Care - Min 18 Hours | $983.45 | $22.13 | $9.92 | $1,015.50 | $1,025.66 |
| 3959 | Continuous Home Care - Min 19 Hours | $1,038.08 | $23.36 | $9.92 | $1,071.36 | $1,082.07 |
| 3960 | Continuous Home Care - Min 20 Hours | $1,092.72 | $24.59 | $9.92 | $1,127.23 | $1,138.50 |
| 3961 | Continuous Home Care - Min 21 Hours | $1,147.35 | $25.82 | $9.92 | $1,183.09 | $1,194.92 |
| 3962 | Continuous Home Care - Min 22 Hours | $1,201.99 | $27.04 | $9.92 | $1,238.95 | $1,251.34 |
| 3963 | Continuous Home Care - Min 23 Hours | $1,256.62 | $28.27 | $9.92 | $1,294.81 | $1,307.76 |
| 3964 | Continuous Home Care - Min 24 Hours | $1,311.26 | $29.50 | $9.92 | $1,350.68 | $1,364.19 |
| 3965 | Hospice Inpatient Respite Care Coinsurance Rate - 5% of 3946 | $22.98 | $0.52 | $0.50 | $24.00 | $24.24 |
| 3966 | Drugs Coinsurance Rate | $1.00 | $0.00 | $0.00 | $1.00 | $1.01 |
| 3969 | Routine Home Care w/AIDS | $302.69 | $6.81 | $9.92 | $319.42 | $322.61 |
| 3970 | Routine Home Care w/Escort | $205.79 | $4.63 | $9.92 | $220.34 | $222.54 |
| 3971 | Continuous Home Care w/AIDS Min 8 Hours | $451.68 | $10.16 | $9.92 | $471.76 | $476.48 |
| 3972 | Continuous Home Care w/AIDS Min 9 Hours | $508.14 | $11.43 | $9.92 | $529.49 | $534.78 |
| 3973 | Continuous Home Care w/AIDS Min 10 Hours | $564.60 | $12.70 | $9.92 | $587.22 | $593.09 |
| 3974 | Continuous Home Care w/AIDS Min 11 Hours | $621.06 | $13.97 | $9.92 | $644.95 | $651.40 |
| 3975 | Continuous Home Care w/AIDS Min 12 Hours | $677.53 | $15.24 | $9.92 | $702.69 | $709.72 |
| 3976 | Continuous Home Care w/AIDS Min 13 Hours | $733.99 | $16.51 | $9.92 | $760.42 | $768.02 |
| 3977 | Continuous Home Care w/AIDS Min 14 Hours | $790.45 | $17.79 | $9.92 | $818.16 | $826.34 |
| 3978 | Continuous Home Care w/AIDS Min 15 Hours | $846.91 | $19.06 | $9.92 | $875.89 | $884.65 |
| 3979 | Continuous Home Care w/AIDS Min 16 Hours | $903.37 | $20.33 | $9.92 | $933.62 | $942.96 |
| 3980 | Continuous Home Care w/AIDS Min 17 Hours | $959.83 | $21.60 | $9.92 | $991.35 | $1,001.26 |
| 3981 | Continuous Home Care w/AIDS Min 18 Hours | $1,016.29 | $22.87 | $9.92 | $1,049.08 | $1,059.57 |
| 3982 | Continuous Home Care w/AIDS Min 19 Hours | $1,072.75 | $24.14 | $9.92 | $1,106.81 | $1,117.88 |
| 3983 | Continuous Home Care w/AIDS Min 20 Hours | $1,129.21 | $25.41 | $9.92 | $1,164.54 | $1,176.19 |
| 3984 | Continuous Home Care w/AIDS Min 21 Hours | $1,185.67 | $26.68 | $9.92 | $1,222.27 | $1,234.49 |
| 3985 | Continuous Home Care w/AIDS Min 22 Hours | $1,242.13 | $27.95 | $9.92 | $1,280.00 | $1,292.80 |
| 3986 | Continuous Home Care w/AIDS Min 23 Hours | $1,298.59 | $29.22 | $9.92 | $1,337.73 | $1,351.11 |
| 3987 | Continuous Home Care w/AIDS Min 24 Hours | $1,355.05 | $30.49 | $9.92 | $1,395.46 | $1,409.41 |
| 3988 | General Inpatient w/ AIDS | $1,089.79 | $24.52 | $9.92 | $1,124.23 | $1,135.47 |
| 3989 | Routine Home Care w/ AIDS Escort | $322.65 | $7.26 | $9.92 | $339.83 | $343.23 |
| 3991 | Service Intensity Add-on | $55.39 | $1.25 | $0.00 | $56.64 | $57.21 |
* 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 | 1% Add-on |
|---|---|---|---|---|---|---|
| 3945 | Routine Home Care | $254.30 | $5.72 | $9.92 | $269.94 | $272.64 |
| 3946 | Inpatient Respite | $614.60 | $13.83 | $9.92 | $638.35 | $644.73 |
| 3947 | General Inpatient Care | $1,326.38 | $29.84 | $9.92 | $1,366.14 | $1,379.80 |
| 3948 | Continuous Home Care - Min 8 Hours | $624.22 | $14.04 | $9.92 | $648.18 | $654.66 |
| 3949 | Continuous Home Care - Min 9 Hours | $702.25 | $15.80 | $9.92 | $727.97 | $735.25 |
| 3950 | Continuous Home Care - Min 10 Hours | $780.28 | $17.56 | $9.92 | $807.76 | $815.84 |
| 3951 | Continuous Home Care - Min 11 Hours | $858.30 | $19.31 | $9.92 | $887.53 | $896.41 |
| 3952 | Continuous Home Care - Min 12 Hours | $936.33 | $21.07 | $9.92 | $967.32 | $976.99 |
| 3953 | Continuous Home Care - Min 13 Hours | $1,014.36 | $22.82 | $9.92 | $1,047.10 | $1,057.57 |
| 3954 | Continuous Home Care - Min 14 Hours | $1,092.39 | $24.58 | $9.92 | $1,126.89 | $1,138.16 |
| 3955 | Continuous Home Care - Min 15 Hours | $1,170.41 | $26.33 | $9.92 | $1,206.66 | $1,218.73 |
| 3956 | Continuous Home Care - Min 16 Hours | $1,248.44 | $28.09 | $9.92 | $1,286.45 | $1,299.31 |
| 3957 | Continuous Home Care - Min 17 Hours | $1,326.47 | $29.85 | $9.92 | $1,366.24 | $1,379.90 |
| 3958 | Continuous Home Care - Min 18 Hours | $1,404.50 | $31.60 | $9.92 | $1,446.02 | $1,460.48 |
| 3959 | Continuous Home Care - Min 19 Hours | $1,482.52 | $33.36 | $9.92 | $1,525.80 | $1,541.06 |
| 3960 | Continuous Home Care - Min 20 Hours | $1,560.55 | $35.11 | $9.92 | $1,605.58 | $1,621.64 |
| 3961 | Continuous Home Care - Min 21 Hours | $1,638.58 | $36.87 | $9.92 | $1,685.37 | $1,702.22 |
| 3962 | Continuous Home Care - Min 22 Hours | $1,716.61 | $38.62 | $9.92 | $1,765.15 | $1,782.80 |
| 3963 | Continuous Home Care - Min 23 Hours | $1,794.63 | $40.38 | $9.92 | $1,844.93 | $1,863.38 |
| 3964 | Continuous Home Care - Min 24 Hours | $1,872.66 | $42.13 | $9.92 | $1,924.71 | $1,943.96 |
| 3965 | Hospice Inpatient Respite Care Coinsurance Rate - 5% of 3946 | $30.73 | $0.69 | $0.50 | $31.92 | $32.24 |
| 3966 | Drugs Coinsurance Rate | $1.00 | $0.00 | $0.00 | $1.00 | $1.01 |
| 3969 | Routine Home Care w/AIDS | $414.22 | $9.32 | $9.92 | $433.46 | $437.79 |
| 3970 | Routine Home Care w/Escort | $274.26 | $6.17 | $9.92 | $290.35 | $293.25 |
| 3971 | Continuous Home Care w/AIDS Min 8 Hours | $697.88 | $15.70 | $9.92 | $723.50 | $730.74 |
| 3972 | Continuous Home Care w/AIDS Min 9 Hours | $785.12 | $17.67 | $9.92 | $812.71 | $820.84 |
| 3973 | Continuous Home Care w/AIDS Min 10 Hours | $872.35 | $19.63 | $9.92 | $901.90 | $910.92 |
| 3974 | Continuous Home Care w/AIDS Min 11 Hours | $959.59 | $21.59 | $9.92 | $991.10 | $1,001.01 |
| 3975 | Continuous Home Care w/AIDS Min 12 Hours | $1,046.82 | $23.55 | $9.92 | $1,080.29 | $1,091.09 |
| 3976 | Continuous Home Care w/AIDS Min 13 Hours | $1,134.06 | $25.52 | $9.92 | $1,169.50 | $1,181.20 |
| 3977 | Continuous Home Care w/AIDS Min 14 Hours | $1,221.29 | $27.48 | $9.92 | $1,258.69 | $1,271.28 |
| 3978 | Continuous Home Care w/AIDS Min 15 Hours | $1,308.53 | $29.44 | $9.92 | $1,347.89 | $1,361.37 |
| 3979 | Continuous Home Care w/AIDS Min 16 Hours | $1,395.76 | $31.40 | $9.92 | $1,437.08 | $1,451.45 |
| 3980 | Continuous Home Care w/AIDS Min 17 Hours | $1,483.00 | $33.37 | $9.92 | $1,526.29 | $1,541.55 |
| 3981 | Continuous Home Care w/AIDS Min 18 Hours | $1,570.23 | $35.33 | $9.92 | $1,615.48 | $1,631.63 |
| 3982 | Continuous Home Care w/AIDS Min 19 Hours | $1,657.47 | $37.29 | $9.92 | $1,704.68 | $1,721.73 |
| 3983 | Continuous Home Care w/AIDS Min 20 Hours | $1,744.70 | $39.26 | $9.92 | $1,793.88 | $1,811.82 |
| 3984 | Continuous Home Care w/AIDS Min 21 Hours | $1,831.94 | $41.22 | $9.92 | $1,883.08 | $1,901.91 |
| 3985 | Continuous Home Care w/AIDS Min 22 Hours | $1,919.17 | $43.18 | $9.92 | $1,972.27 | $1,991.99 |
| 3986 | Continuous Home Care w/AIDS Min 23 Hours | $2,006.41 | $45.14 | $9.92 | $2,061.47 | $2,082.08 |
| 3987 | Continuous Home Care w/AIDS Min 24 Hours | $2,093.64 | $47.11 | $9.92 | $2,150.67 | $2,172.18 |
| 3988 | General Inpatient w/ AIDS | $1,474.14 | $33.17 | $9.92 | $1,517.23 | $1,532.40 |
| 3989 | Routine Home Care w/ AIDS Escort | $434.18 | $9.77 | $9.92 | $453.87 | $458.41 |
| 3991 | Service Intensity Add-on | $76.77 | $1.73 | $0.00 | $78.50 | $79.29 |
* 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 | 1% Add-on |
|---|---|---|---|---|---|---|
| 3945 | Routine Home Care | $257.84 | $5.80 | $9.92 | $273.56 | $276.30 |
| 3946 | Inpatient Respite | $622.59 | $14.01 | $9.92 | $646.52 | $652.99 |
| 3947 | General Inpatient Care | $1,344.22 | $30.24 | $9.92 | $1,384.38 | $1,398.22 |
| 3948 | Continuous Home Care - Min 8 Hours | $633.88 | $14.26 | $9.92 | $658.06 | $664.64 |
| 3949 | Continuous Home Care - Min 9 Hours | $713.11 | $16.04 | $9.92 | $739.07 | $746.46 |
| 3950 | Continuous Home Care - Min 10 Hours | $792.35 | $17.83 | $9.92 | $820.10 | $828.30 |
| 3951 | Continuous Home Care - Min 11 Hours | $871.58 | $19.61 | $9.92 | $901.11 | $910.12 |
| 3952 | Continuous Home Care - Min 12 Hours | $950.82 | $21.39 | $9.92 | $982.13 | $991.95 |
| 3953 | Continuous Home Care - Min 13 Hours | $1,030.05 | $23.18 | $9.92 | $1,063.15 | $1,073.78 |
| 3954 | Continuous Home Care - Min 14 Hours | $1,109.28 | $24.96 | $9.92 | $1,144.16 | $1,155.60 |
| 3955 | Continuous Home Care - Min 15 Hours | $1,188.52 | $26.74 | $9.92 | $1,225.18 | $1,237.43 |
| 3956 | Continuous Home Care - Min 16 Hours | $1,267.75 | $28.52 | $9.92 | $1,306.19 | $1,319.25 |
| 3957 | Continuous Home Care - Min 17 Hours | $1,346.99 | $30.31 | $9.92 | $1,387.22 | $1,401.09 |
| 3958 | Continuous Home Care - Min 18 Hours | $1,426.22 | $32.09 | $9.92 | $1,468.23 | $1,482.91 |
| 3959 | Continuous Home Care - Min 19 Hours | $1,505.46 | $33.87 | $9.92 | $1,549.25 | $1,564.74 |
| 3960 | Continuous Home Care - Min 20 Hours | $1,584.69 | $35.66 | $9.92 | $1,630.27 | $1,646.57 |
| 3961 | Continuous Home Care - Min 21 Hours | $1,663.93 | $37.44 | $9.92 | $1,711.29 | $1,728.40 |
| 3962 | Continuous Home Care - Min 22 Hours | $1,743.16 | $39.22 | $9.92 | $1,792.30 | $1,810.22 |
| 3963 | Continuous Home Care - Min 23 Hours | $1,822.40 | $41.00 | $9.92 | $1,873.32 | $1,892.05 |
| 3964 | Continuous Home Care - Min 24 Hours | $1,901.63 | $42.79 | $9.92 | $1,954.34 | $1,973.88 |
| 3965 | Hospice Inpatient Respite Care Coinsurance Rate - 5% of 3946 | $31.13 | $0.70 | $0.50 | $32.33 | $32.65 |
| 3966 | Drugs Coinsurance Rate | $1.00 | $0.00 | $0.00 | $1.00 | $1.01 |
| 3969 | Routine Home Care w/AIDS | $419.98 | $9.45 | $9.92 | $439.35 | $443.74 |
| 3970 | Routine Home Care w/Escort | $277.80 | $6.25 | $9.92 | $293.97 | $296.91 |
| 3971 | Continuous Home Care w/AIDS Min 8 Hours | $710.58 | $15.99 | $9.92 | $736.49 | $743.85 |
| 3972 | Continuous Home Care w/AIDS Min 9 Hours | $799.41 | $17.99 | $9.92 | $827.32 | $835.59 |
| 3973 | Continuous Home Care w/AIDS Min 10 Hours | $888.23 | $19.99 | $9.92 | $918.14 | $927.32 |
| 3974 | Continuous Home Care w/AIDS Min 11 Hours | $977.05 | $21.98 | $9.92 | $1,008.95 | $1,019.04 |
| 3975 | Continuous Home Care w/AIDS Min 12 Hours | $1,065.88 | $23.98 | $9.92 | $1,099.78 | $1,110.78 |
| 3976 | Continuous Home Care w/AIDS Min 13 Hours | $1,154.70 | $25.98 | $9.92 | $1,190.60 | $1,202.51 |
| 3977 | Continuous Home Care w/AIDS Min 14 Hours | $1,243.52 | $27.98 | $9.92 | $1,281.42 | $1,294.23 |
| 3978 | Continuous Home Care w/AIDS Min 15 Hours | $1,332.34 | $29.98 | $9.92 | $1,372.24 | $1,385.96 |
| 3979 | Continuous Home Care w/AIDS Min 16 Hours | $1,421.17 | $31.98 | $9.92 | $1,463.07 | $1,477.70 |
| 3980 | Continuous Home Care w/AIDS Min 17 Hours | $1,509.99 | $33.97 | $9.92 | $1,553.88 | $1,569.42 |
| 3981 | Continuous Home Care w/AIDS Min 18 Hours | $1,598.81 | $35.97 | $9.92 | $1,644.70 | $1,661.15 |
| 3982 | Continuous Home Care w/AIDS Min 19 Hours | $1,687.64 | $37.97 | $9.92 | $1,735.53 | $1,752.89 |
| 3983 | Continuous Home Care w/AIDS Min 20 Hours | $1,776.46 | $39.97 | $9.92 | $1,826.35 | $1,844.61 |
| 3984 | Continuous Home Care w/AIDS Min 21 Hours | $1,865.28 | $41.97 | $9.92 | $1,917.17 | $1,936.34 |
| 3985 | Continuous Home Care w/AIDS Min 22 Hours | $1,954.10 | $43.97 | $9.92 | $2,007.99 | $2,028.07 |
| 3986 | Continuous Home Care w/AIDS Min 23 Hours | $2,042.93 | $45.97 | $9.92 | $2,098.82 | $2,119.81 |
| 3987 | Continuous Home Care w/AIDS Min 24 Hours | $2,131.75 | $47.96 | $9.92 | $2,189.63 | $2,211.53 |
| 3988 | General Inpatient w/ AIDS | $1,493.97 | $33.61 | $9.92 | $1,537.50 | $1,552.88 |
| 3989 | Routine Home Care w/ AIDS Escort | $439.94 | $9.90 | $9.92 | $459.76 | $464.36 |
| 3991 | Service Intensity Add-on | $77.87 | $1.75 | $0.00 | $79.62 | $80.42 |
* 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 | 1% Add-on |
|---|---|---|---|---|---|---|
| 3945 | Routine Home Care | $217.66 | $4.90 | $9.92 | $232.48 | $234.80 |
| 3946 | Inpatient Respite | $531.68 | $11.96 | $9.92 | $553.56 | $559.10 |
| 3947 | General Inpatient Care | $1,141.30 | $25.68 | $9.92 | $1,176.90 | $1,188.67 |
| 3948 | Continuous Home Care - Min 8 Hours | $524.07 | $11.79 | $9.92 | $545.78 | $551.24 |
| 3949 | Continuous Home Care - Min 9 Hours | $589.58 | $13.27 | $9.92 | $612.77 | $618.90 |
| 3950 | Continuous Home Care - Min 10 Hours | $655.09 | $14.74 | $9.92 | $679.75 | $686.55 |
| 3951 | Continuous Home Care - Min 11 Hours | $720.60 | $16.21 | $9.92 | $746.73 | $754.20 |
| 3952 | Continuous Home Care - Min 12 Hours | $786.11 | $17.69 | $9.92 | $813.72 | $821.86 |
| 3953 | Continuous Home Care - Min 13 Hours | $851.61 | $19.16 | $9.92 | $880.69 | $889.50 |
| 3954 | Continuous Home Care - Min 14 Hours | $917.12 | $20.64 | $9.92 | $947.68 | $957.16 |
| 3955 | Continuous Home Care - Min 15 Hours | $982.63 | $22.11 | $9.92 | $1,014.66 | $1,024.81 |
| 3956 | Continuous Home Care - Min 16 Hours | $1,048.14 | $23.58 | $9.92 | $1,081.64 | $1,092.46 |
| 3957 | Continuous Home Care - Min 17 Hours | $1,113.65 | $25.06 | $9.92 | $1,148.63 | $1,160.12 |
| 3958 | Continuous Home Care - Min 18 Hours | $1,179.16 | $26.53 | $9.92 | $1,215.61 | $1,227.77 |
| 3959 | Continuous Home Care - Min 19 Hours | $1,244.67 | $28.01 | $9.92 | $1,282.60 | $1,295.43 |
| 3960 | Continuous Home Care - Min 20 Hours | $1,310.18 | $29.48 | $9.92 | $1,349.58 | $1,363.08 |
| 3961 | Continuous Home Care - Min 21 Hours | $1,375.68 | $30.95 | $9.92 | $1,416.55 | $1,430.72 |
| 3962 | Continuous Home Care - Min 22 Hours | $1,441.19 | $32.43 | $9.92 | $1,483.54 | $1,498.38 |
| 3963 | Continuous Home Care - Min 23 Hours | $1,506.70 | $33.90 | $9.92 | $1,550.52 | $1,566.03 |
| 3964 | Continuous Home Care - Min 24 Hours | $1,572.21 | $35.37 | $9.92 | $1,617.50 | $1,633.68 |
| 3965 | Hospice Inpatient Respite Care Coinsurance Rate - 5% of 3946 | $26.58 | $0.60 | $0.50 | $27.68 | $27.96 |
| 3966 | Drugs Coinsurance Rate | $1.00 | $0.00 | $0.00 | $1.00 | $1.01 |
| 3969 | Routine Home Care w/AIDS | $354.53 | $7.98 | $9.92 | $372.43 | $376.15 |
| 3970 | Routine Home Care w/Escort | $237.62 | $5.35 | $9.92 | $252.89 | $255.42 |
| 3971 | Continuous Home Care w/AIDS Min 8 Hours | $566.12 | $12.74 | $9.92 | $588.78 | $594.67 |
| 3972 | Continuous Home Care w/AIDS Min 9 Hours | $636.89 | $14.33 | $9.92 | $661.14 | $667.75 |
| 3973 | Continuous Home Care w/AIDS Min 10 Hours | $707.65 | $15.92 | $9.92 | $733.49 | $740.82 |
| 3974 | Continuous Home Care w/AIDS Min 11 Hours | $778.42 | $17.51 | $9.92 | $805.85 | $813.91 |
| 3975 | Continuous Home Care w/AIDS Min 12 Hours | $849.18 | $19.11 | $9.92 | $878.21 | $886.99 |
| 3976 | Continuous Home Care w/AIDS Min 13 Hours | $919.95 | $20.70 | $9.92 | $950.57 | $960.08 |
| 3977 | Continuous Home Care w/AIDS Min 14 Hours | $990.71 | $22.29 | $9.92 | $1,022.92 | $1,033.15 |
| 3978 | Continuous Home Care w/AIDS Min 15 Hours | $1,061.48 | $23.88 | $9.92 | $1,095.28 | $1,106.23 |
| 3979 | Continuous Home Care w/AIDS Min 16 Hours | $1,132.24 | $25.48 | $9.92 | $1,167.64 | $1,179.32 |
| 3980 | Continuous Home Care w/AIDS Min 17 Hours | $1,203.01 | $27.07 | $9.92 | $1,240.00 | $1,252.40 |
| 3981 | Continuous Home Care w/AIDS Min 18 Hours | $1,273.77 | $28.66 | $9.92 | $1,312.35 | $1,325.47 |
| 3982 | Continuous Home Care w/AIDS Min 19 Hours | $1,344.54 | $30.25 | $9.92 | $1,384.71 | $1,398.56 |
| 3983 | Continuous Home Care w/AIDS Min 20 Hours | $1,415.30 | $31.84 | $9.92 | $1,457.06 | $1,471.63 |
| 3984 | Continuous Home Care w/AIDS Min 21 Hours | $1,486.07 | $33.44 | $9.92 | $1,529.43 | $1,544.72 |
| 3985 | Continuous Home Care w/AIDS Min 22 Hours | $1,556.83 | $35.03 | $9.92 | $1,601.78 | $1,617.80 |
| 3986 | Continuous Home Care w/AIDS Min 23 Hours | $1,627.60 | $36.62 | $9.92 | $1,674.14 | $1,690.88 |
| 3987 | Continuous Home Care w/AIDS Min 24 Hours | $1,698.36 | $38.21 | $9.92 | $1,746.49 | $1,763.95 |
| 3988 | General Inpatient w/ AIDS | $1,268.44 | $28.54 | $9.92 | $1,306.90 | $1,319.97 |
| 3989 | Routine Home Care w/ AIDS Escort | $374.49 | $8.43 | $9.92 | $392.84 | $396.77 |
| 3991 | Service Intensity Add-on | $65.33 | $1.47 | $0.00 | $66.80 | $67.47 |
* 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 | 1% Add-on |
|---|---|---|---|---|---|---|
| 3945 | Routine Home Care | $257.84 | $5.80 | $9.92 | $273.56 | $276.30 |
| 3946 | Inpatient Respite | $622.59 | $14.01 | $9.92 | $646.52 | $652.99 |
| 3947 | General Inpatient Care | $1,344.22 | $30.24 | $9.92 | $1,384.38 | $1,398.22 |
| 3948 | Continuous Home Care - Min 8 Hours | $633.88 | $14.26 | $9.92 | $658.06 | $664.64 |
| 3949 | Continuous Home Care - Min 9 Hours | $713.11 | $16.04 | $9.92 | $739.07 | $746.46 |
| 3950 | Continuous Home Care - Min 10 Hours | $792.35 | $17.83 | $9.92 | $820.10 | $828.30 |
| 3951 | Continuous Home Care - Min 11 Hours | $871.58 | $19.61 | $9.92 | $901.11 | $910.12 |
| 3952 | Continuous Home Care - Min 12 Hours | $950.82 | $21.39 | $9.92 | $982.13 | $991.95 |
| 3953 | Continuous Home Care - Min 13 Hours | $1,030.05 | $23.18 | $9.92 | $1,063.15 | $1,073.78 |
| 3954 | Continuous Home Care - Min 14 Hours | $1,109.28 | $24.96 | $9.92 | $1,144.16 | $1,155.60 |
| 3955 | Continuous Home Care - Min 15 Hours | $1,188.52 | $26.74 | $9.92 | $1,225.18 | $1,237.43 |
| 3956 | Continuous Home Care - Min 16 Hours | $1,267.75 | $28.52 | $9.92 | $1,306.19 | $1,319.25 |
| 3957 | Continuous Home Care - Min 17 Hours | $1,346.99 | $30.31 | $9.92 | $1,387.22 | $1,401.09 |
| 3958 | Continuous Home Care - Min 18 Hours | $1,426.22 | $32.09 | $9.92 | $1,468.23 | $1,482.91 |
| 3959 | Continuous Home Care - Min 19 Hours | $1,505.46 | $33.87 | $9.92 | $1,549.25 | $1,564.74 |
| 3960 | Continuous Home Care - Min 20 Hours | $1,584.69 | $35.66 | $9.92 | $1,630.27 | $1,646.57 |
| 3961 | Continuous Home Care - Min 21 Hours | $1,663.93 | $37.44 | $9.92 | $1,711.29 | $1,728.40 |
| 3962 | Continuous Home Care - Min 22 Hours | $1,743.16 | $39.22 | $9.92 | $1,792.30 | $1,810.22 |
| 3963 | Continuous Home Care - Min 23 Hours | $1,822.40 | $41.00 | $9.92 | $1,873.32 | $1,892.05 |
| 3964 | Continuous Home Care - Min 24 Hours | $1,901.63 | $42.79 | $9.92 | $1,954.34 | $1,973.88 |
| 3965 | Hospice Inpatient Respite Care Coinsurance Rate - 5% of 3946 | $31.13 | $0.70 | $0.50 | $32.33 | $32.65 |
| 3966 | Drugs Coinsurance Rate | $1.00 | $0.00 | $0.00 | $1.00 | $1.01 |
| 3969 | Routine Home Care w/AIDS | $419.98 | $9.45 | $9.92 | $439.35 | $443.74 |
| 3970 | Routine Home Care w/Escort | $277.80 | $6.25 | $9.92 | $293.97 | $296.91 |
| 3971 | Continuous Home Care w/AIDS Min 8 Hours | $710.58 | $15.99 | $9.92 | $736.49 | $743.85 |
| 3972 | Continuous Home Care w/AIDS Min 9 Hours | $799.41 | $17.99 | $9.92 | $827.32 | $835.59 |
| 3973 | Continuous Home Care w/AIDS Min 10 Hours | $888.23 | $19.99 | $9.92 | $918.14 | $927.32 |
| 3974 | Continuous Home Care w/AIDS Min 11 Hours | $977.05 | $21.98 | $9.92 | $1,008.95 | $1,019.04 |
| 3975 | Continuous Home Care w/AIDS Min 12 Hours | $1,065.88 | $23.98 | $9.92 | $1,099.78 | $1,110.78 |
| 3976 | Continuous Home Care w/AIDS Min 13 Hours | $1,154.70 | $25.98 | $9.92 | $1,190.60 | $1,202.51 |
| 3977 | Continuous Home Care w/AIDS Min 14 Hours | $1,243.52 | $27.98 | $9.92 | $1,281.42 | $1,294.23 |
| 3978 | Continuous Home Care w/AIDS Min 15 Hours | $1,332.34 | $29.98 | $9.92 | $1,372.24 | $1,385.96 |
| 3979 | Continuous Home Care w/AIDS Min 16 Hours | $1,421.17 | $31.98 | $9.92 | $1,463.07 | $1,477.70 |
| 3980 | Continuous Home Care w/AIDS Min 17 Hours | $1,509.99 | $33.97 | $9.92 | $1,553.88 | $1,569.42 |
| 3981 | Continuous Home Care w/AIDS Min 18 Hours | $1,598.81 | $35.97 | $9.92 | $1,644.70 | $1,661.15 |
| 3982 | Continuous Home Care w/AIDS Min 19 Hours | $1,687.64 | $37.97 | $9.92 | $1,735.53 | $1,752.89 |
| 3983 | Continuous Home Care w/AIDS Min 20 Hours | $1,776.46 | $39.97 | $9.92 | $1,826.35 | $1,844.61 |
| 3984 | Continuous Home Care w/AIDS Min 21 Hours | $1,865.28 | $41.97 | $9.92 | $1,917.17 | $1,936.34 |
| 3985 | Continuous Home Care w/AIDS Min 22 Hours | $1,954.10 | $43.97 | $9.92 | $2,007.99 | $2,028.07 |
| 3986 | Continuous Home Care w/AIDS Min 23 Hours | $2,042.93 | $45.97 | $9.92 | $2,098.82 | $2,119.81 |
| 3987 | Continuous Home Care w/AIDS Min 24 Hours | $2,131.75 | $47.96 | $9.92 | $2,189.63 | $2,211.53 |
| 3988 | General Inpatient w/ AIDS | $1,493.97 | $33.61 | $9.92 | $1,537.50 | $1,552.88 |
| 3989 | Routine Home Care w/ AIDS Escort | $439.94 | $9.90 | $9.92 | $459.76 | $464.36 |
| 3991 | Service Intensity Add-on | $77.87 | $1.75 | $0.00 | $79.62 | $80.42 |
* 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 | 1% Add-on |
|---|---|---|---|---|---|---|
| 3945 | Routine Home Care | $242.77 | $5.46 | $9.92 | $258.15 | $260.73 |
| 3946 | Inpatient Respite | $588.50 | $13.24 | $9.92 | $611.66 | $617.78 |
| 3947 | General Inpatient Care | $1,268.12 | $28.53 | $9.92 | $1,306.57 | $1,319.64 |
| 3948 | Continuous Home Care - Min 8 Hours | $592.69 | $13.34 | $9.92 | $615.95 | $622.11 |
| 3949 | Continuous Home Care - Min 9 Hours | $666.78 | $15.00 | $9.92 | $691.70 | $698.62 |
| 3950 | Continuous Home Care - Min 10 Hours | $740.87 | $16.67 | $9.92 | $767.46 | $775.13 |
| 3951 | Continuous Home Care - Min 11 Hours | $814.95 | $18.34 | $9.92 | $843.21 | $851.64 |
| 3952 | Continuous Home Care - Min 12 Hours | $889.04 | $20.00 | $9.92 | $918.96 | $928.15 |
| 3953 | Continuous Home Care - Min 13 Hours | $963.13 | $21.67 | $9.92 | $994.72 | $1,004.67 |
| 3954 | Continuous Home Care - Min 14 Hours | $1,037.21 | $23.34 | $9.92 | $1,070.47 | $1,081.17 |
| 3955 | Continuous Home Care - Min 15 Hours | $1,111.30 | $25.00 | $9.92 | $1,146.22 | $1,157.68 |
| 3956 | Continuous Home Care - Min 16 Hours | $1,185.39 | $26.67 | $9.92 | $1,221.98 | $1,234.20 |
| 3957 | Continuous Home Care - Min 17 Hours | $1,259.47 | $28.34 | $9.92 | $1,297.73 | $1,310.71 |
| 3958 | Continuous Home Care - Min 18 Hours | $1,333.56 | $30.01 | $9.92 | $1,373.49 | $1,387.22 |
| 3959 | Continuous Home Care - Min 19 Hours | $1,407.65 | $31.67 | $9.92 | $1,449.24 | $1,463.73 |
| 3960 | Continuous Home Care - Min 20 Hours | $1,481.73 | $33.34 | $9.92 | $1,524.99 | $1,540.24 |
| 3961 | Continuous Home Care - Min 21 Hours | $1,555.82 | $35.01 | $9.92 | $1,600.75 | $1,616.76 |
| 3962 | Continuous Home Care - Min 22 Hours | $1,629.91 | $36.67 | $9.92 | $1,676.50 | $1,693.27 |
| 3963 | Continuous Home Care - Min 23 Hours | $1,703.99 | $38.34 | $9.92 | $1,752.25 | $1,769.77 |
| 3964 | Continuous Home Care - Min 24 Hours | $1,778.08 | $40.01 | $9.92 | $1,828.01 | $1,846.29 |
| 3965 | Hospice Inpatient Respite Care Coinsurance Rate - 5% of 3946 | $29.43 | $0.66 | $0.50 | $30.59 | $30.90 |
| 3966 | Drugs Coinsurance Rate | $1.00 | $0.00 | $0.00 | $1.00 | $1.01 |
| 3969 | Routine Home Care w/AIDS | $395.43 | $8.90 | $9.92 | $414.25 | $418.39 |
| 3970 | Routine Home Care w/Escort | $262.73 | $5.91 | $9.92 | $278.56 | $281.35 |
| 3971 | Continuous Home Care w/AIDS Min 8 Hours | $656.40 | $14.77 | $9.92 | $681.09 | $687.90 |
| 3972 | Continuous Home Care w/AIDS Min 9 Hours | $738.45 | $16.62 | $9.92 | $764.99 | $772.64 |
| 3973 | Continuous Home Care w/AIDS Min 10 Hours | $820.50 | $18.46 | $9.92 | $848.88 | $857.37 |
| 3974 | Continuous Home Care w/AIDS Min 11 Hours | $902.55 | $20.31 | $9.92 | $932.78 | $942.11 |
| 3975 | Continuous Home Care w/AIDS Min 12 Hours | $984.61 | $22.15 | $9.92 | $1,016.68 | $1,026.85 |
| 3976 | Continuous Home Care w/AIDS Min 13 Hours | $1,066.66 | $24.00 | $9.92 | $1,100.58 | $1,111.59 |
| 3977 | Continuous Home Care w/AIDS Min 14 Hours | $1,148.71 | $25.85 | $9.92 | $1,184.48 | $1,196.32 |
| 3978 | Continuous Home Care w/AIDS Min 15 Hours | $1,230.76 | $27.69 | $9.92 | $1,268.37 | $1,281.05 |
| 3979 | Continuous Home Care w/AIDS Min 16 Hours | $1,312.81 | $29.54 | $9.92 | $1,352.27 | $1,365.79 |
| 3980 | Continuous Home Care w/AIDS Min 17 Hours | $1,394.86 | $31.38 | $9.92 | $1,436.16 | $1,450.52 |
| 3981 | Continuous Home Care w/AIDS Min 18 Hours | $1,476.91 | $33.23 | $9.92 | $1,520.06 | $1,535.26 |
| 3982 | Continuous Home Care w/AIDS Min 19 Hours | $1,558.96 | $35.08 | $9.92 | $1,603.96 | $1,620.00 |
| 3983 | Continuous Home Care w/AIDS Min 20 Hours | $1,641.01 | $36.92 | $9.92 | $1,687.85 | $1,704.73 |
| 3984 | Continuous Home Care w/AIDS Min 21 Hours | $1,723.06 | $38.77 | $9.92 | $1,771.75 | $1,789.47 |
| 3985 | Continuous Home Care w/AIDS Min 22 Hours | $1,805.11 | $40.61 | $9.92 | $1,855.64 | $1,874.20 |
| 3986 | Continuous Home Care w/AIDS Min 23 Hours | $1,887.16 | $42.46 | $9.92 | $1,939.54 | $1,958.94 |
| 3987 | Continuous Home Care w/AIDS Min 24 Hours | $1,969.21 | $44.31 | $9.92 | $2,023.44 | $2,043.67 |
| 3988 | General Inpatient w/ AIDS | $1,409.39 | $31.71 | $9.92 | $1,451.02 | $1,465.53 |
| 3989 | Routine Home Care w/ AIDS Escort | $415.39 | $9.35 | $9.92 | $434.66 | $439.01 |
| 3991 | Service Intensity Add-on | $73.16 | $1.65 | $0.00 | $74.81 | $75.56 |
* 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 | 1% Add-on |
|---|---|---|---|---|---|---|
| 3945 | Routine Home Care | $200.27 | $4.51 | $9.92 | $214.70 | $216.85 |
| 3946 | Inpatient Respite | $492.34 | $11.08 | $9.92 | $513.34 | $518.47 |
| 3947 | General Inpatient Care | $1,053.49 | $23.70 | $9.92 | $1,087.11 | $1,097.98 |
| 3948 | Continuous Home Care - Min 8 Hours | $476.55 | $10.72 | $9.92 | $497.19 | $502.16 |
| 3949 | Continuous Home Care - Min 9 Hours | $536.12 | $12.06 | $9.92 | $558.10 | $563.68 |
| 3950 | Continuous Home Care - Min 10 Hours | $595.69 | $13.40 | $9.92 | $619.01 | $625.20 |
| 3951 | Continuous Home Care - Min 11 Hours | $655.26 | $14.74 | $9.92 | $679.92 | $686.72 |
| 3952 | Continuous Home Care - Min 12 Hours | $714.83 | $16.08 | $9.92 | $740.83 | $748.24 |
| 3953 | Continuous Home Care - Min 13 Hours | $774.39 | $17.42 | $9.92 | $801.73 | $809.75 |
| 3954 | Continuous Home Care - Min 14 Hours | $833.96 | $18.76 | $9.92 | $862.64 | $871.27 |
| 3955 | Continuous Home Care - Min 15 Hours | $893.53 | $20.10 | $9.92 | $923.55 | $932.79 |
| 3956 | Continuous Home Care - Min 16 Hours | $953.10 | $21.44 | $9.92 | $984.46 | $994.30 |
| 3957 | Continuous Home Care - Min 17 Hours | $1,012.67 | $22.79 | $9.92 | $1,045.38 | $1,055.83 |
| 3958 | Continuous Home Care - Min 18 Hours | $1,072.24 | $24.13 | $9.92 | $1,106.29 | $1,117.35 |
| 3959 | Continuous Home Care - Min 19 Hours | $1,131.81 | $25.47 | $9.92 | $1,167.20 | $1,178.87 |
| 3960 | Continuous Home Care - Min 20 Hours | $1,191.38 | $26.81 | $9.92 | $1,228.11 | $1,240.39 |
| 3961 | Continuous Home Care - Min 21 Hours | $1,250.94 | $28.15 | $9.92 | $1,289.01 | $1,301.90 |
| 3962 | Continuous Home Care - Min 22 Hours | $1,310.51 | $29.49 | $9.92 | $1,349.92 | $1,363.42 |
| 3963 | Continuous Home Care - Min 23 Hours | $1,370.08 | $30.83 | $9.92 | $1,410.83 | $1,424.94 |
| 3964 | Continuous Home Care - Min 24 Hours | $1,429.65 | $32.17 | $9.92 | $1,471.74 | $1,486.46 |
| 3965 | Hospice Inpatient Respite Care Coinsurance Rate - 5% of 3946 | $24.62 | $0.55 | $0.50 | $25.67 | $25.93 |
| 3966 | Drugs Coinsurance Rate | $1.00 | $0.00 | $0.00 | $1.00 | $1.01 |
| 3969 | Routine Home Care w/AIDS | $326.21 | $7.34 | $9.92 | $343.47 | $346.90 |
| 3970 | Routine Home Care w/Escort | $220.23 | $4.96 | $9.92 | $235.11 | $237.46 |
| 3971 | Continuous Home Care w/AIDS Min 8 Hours | $503.60 | $11.33 | $9.92 | $524.85 | $530.10 |
| 3972 | Continuous Home Care w/AIDS Min 9 Hours | $566.55 | $12.75 | $9.92 | $589.22 | $595.11 |
| 3973 | Continuous Home Care w/AIDS Min 10 Hours | $629.50 | $14.16 | $9.92 | $653.58 | $660.12 |
| 3974 | Continuous Home Care w/AIDS Min 11 Hours | $692.45 | $15.58 | $9.92 | $717.95 | $725.13 |
| 3975 | Continuous Home Care w/AIDS Min 12 Hours | $755.41 | $17.00 | $9.92 | $782.33 | $790.15 |
| 3976 | Continuous Home Care w/AIDS Min 13 Hours | $818.36 | $18.41 | $9.92 | $846.69 | $855.16 |
| 3977 | Continuous Home Care w/AIDS Min 14 Hours | $881.31 | $19.83 | $9.92 | $911.06 | $920.17 |
| 3978 | Continuous Home Care w/AIDS Min 15 Hours | $944.26 | $21.25 | $9.92 | $975.43 | $985.18 |
| 3979 | Continuous Home Care w/AIDS Min 16 Hours | $1,007.21 | $22.66 | $9.92 | $1,039.79 | $1,050.19 |
| 3980 | Continuous Home Care w/AIDS Min 17 Hours | $1,070.16 | $24.08 | $9.92 | $1,104.16 | $1,115.20 |
| 3981 | Continuous Home Care w/AIDS Min 18 Hours | $1,133.11 | $25.49 | $9.92 | $1,168.52 | $1,180.21 |
| 3982 | Continuous Home Care w/AIDS Min 19 Hours | $1,196.06 | $26.91 | $9.92 | $1,232.89 | $1,245.22 |
| 3983 | Continuous Home Care w/AIDS Min 20 Hours | $1,259.01 | $28.33 | $9.92 | $1,297.26 | $1,310.23 |
| 3984 | Continuous Home Care w/AIDS Min 21 Hours | $1,321.96 | $29.74 | $9.92 | $1,361.62 | $1,375.24 |
| 3985 | Continuous Home Care w/AIDS Min 22 Hours | $1,384.91 | $31.16 | $9.92 | $1,425.99 | $1,440.25 |
| 3986 | Continuous Home Care w/AIDS Min 23 Hours | $1,447.86 | $32.58 | $9.92 | $1,490.36 | $1,505.26 |
| 3987 | Continuous Home Care w/AIDS Min 24 Hours | $1,510.81 | $33.99 | $9.92 | $1,554.72 | $1,570.27 |
| 3988 | General Inpatient w/ AIDS | $1,170.85 | $26.34 | $9.92 | $1,207.11 | $1,219.18 |
| 3989 | Routine Home Care w/ AIDS Escort | $346.17 | $7.79 | $9.92 | $363.88 | $367.52 |
| 3991 | Service Intensity Add-on | $59.90 | $1.35 | $0.00 | $61.25 | $61.86 |
* 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 | 1% Add-on |
|---|---|---|---|---|---|---|
| 3945 | Routine Home Care | $209.98 | $4.72 | $9.92 | $224.62 | $226.87 |
| 3946 | Inpatient Respite | $514.30 | $11.57 | $9.92 | $535.79 | $541.15 |
| 3947 | General Inpatient Care | $1,102.51 | $24.81 | $9.92 | $1,137.24 | $1,148.61 |
| 3948 | Continuous Home Care - Min 8 Hours | $503.08 | $11.32 | $9.92 | $524.32 | $529.56 |
| 3949 | Continuous Home Care - Min 9 Hours | $565.96 | $12.73 | $9.92 | $588.61 | $594.50 |
| 3950 | Continuous Home Care - Min 10 Hours | $628.85 | $14.15 | $9.92 | $652.92 | $659.45 |
| 3951 | Continuous Home Care - Min 11 Hours | $691.73 | $15.56 | $9.92 | $717.21 | $724.38 |
| 3952 | Continuous Home Care - Min 12 Hours | $754.62 | $16.98 | $9.92 | $781.52 | $789.34 |
| 3953 | Continuous Home Care - Min 13 Hours | $817.50 | $18.39 | $9.92 | $845.81 | $854.27 |
| 3954 | Continuous Home Care - Min 14 Hours | $880.38 | $19.81 | $9.92 | $910.11 | $919.21 |
| 3955 | Continuous Home Care - Min 15 Hours | $943.27 | $21.22 | $9.92 | $974.41 | $984.15 |
| 3956 | Continuous Home Care - Min 16 Hours | $1,006.15 | $22.64 | $9.92 | $1,038.71 | $1,049.10 |
| 3957 | Continuous Home Care - Min 17 Hours | $1,069.04 | $24.05 | $9.92 | $1,103.01 | $1,114.04 |
| 3958 | Continuous Home Care - Min 18 Hours | $1,131.92 | $25.47 | $9.92 | $1,167.31 | $1,178.98 |
| 3959 | Continuous Home Care - Min 19 Hours | $1,194.81 | $26.88 | $9.92 | $1,231.61 | $1,243.93 |
| 3960 | Continuous Home Care - Min 20 Hours | $1,257.69 | $28.30 | $9.92 | $1,295.91 | $1,308.87 |
| 3961 | Continuous Home Care - Min 21 Hours | $1,320.58 | $29.71 | $9.92 | $1,360.21 | $1,373.81 |
| 3962 | Continuous Home Care - Min 22 Hours | $1,383.46 | $31.13 | $9.92 | $1,424.51 | $1,438.76 |
| 3963 | Continuous Home Care - Min 23 Hours | $1,446.35 | $32.54 | $9.92 | $1,488.81 | $1,503.70 |
| 3964 | Continuous Home Care - Min 24 Hours | $1,509.23 | $33.96 | $9.92 | $1,553.11 | $1,568.64 |
| 3965 | Hospice Inpatient Respite Care Coinsurance Rate - 5% of 3946 | $25.72 | $0.58 | $0.50 | $26.80 | $27.07 |
| 3966 | Drugs Coinsurance Rate | $1.00 | $0.00 | $0.00 | $1.00 | $1.01 |
| 3969 | Routine Home Care w/AIDS | $342.02 | $7.70 | $9.92 | $359.64 | $363.24 |
| 3970 | Routine Home Care w/Escort | $229.94 | $5.17 | $9.92 | $245.03 | $247.48 |
| 3971 | Continuous Home Care w/AIDS Min 8 Hours | $538.50 | $12.12 | $9.92 | $560.54 | $566.15 |
| 3972 | Continuous Home Care w/AIDS Min 9 Hours | $605.82 | $13.63 | $9.92 | $629.37 | $635.66 |
| 3973 | Continuous Home Care w/AIDS Min 10 Hours | $673.13 | $15.15 | $9.92 | $698.20 | $705.18 |
| 3974 | Continuous Home Care w/AIDS Min 11 Hours | $740.44 | $16.66 | $9.92 | $767.02 | $774.69 |
| 3975 | Continuous Home Care w/AIDS Min 12 Hours | $807.76 | $18.17 | $9.92 | $835.85 | $844.21 |
| 3976 | Continuous Home Care w/AIDS Min 13 Hours | $875.07 | $19.69 | $9.92 | $904.68 | $913.73 |
| 3977 | Continuous Home Care w/AIDS Min 14 Hours | $942.38 | $21.20 | $9.92 | $973.50 | $983.24 |
| 3978 | Continuous Home Care w/AIDS Min 15 Hours | $1,009.69 | $22.72 | $9.92 | $1,042.33 | $1,052.75 |
| 3979 | Continuous Home Care w/AIDS Min 16 Hours | $1,077.01 | $24.23 | $9.92 | $1,111.16 | $1,122.27 |
| 3980 | Continuous Home Care w/AIDS Min 17 Hours | $1,144.32 | $25.75 | $9.92 | $1,179.99 | $1,191.79 |
| 3981 | Continuous Home Care w/AIDS Min 18 Hours | $1,211.63 | $27.26 | $9.92 | $1,248.81 | $1,261.30 |
| 3982 | Continuous Home Care w/AIDS Min 19 Hours | $1,278.95 | $28.78 | $9.92 | $1,317.65 | $1,330.83 |
| 3983 | Continuous Home Care w/AIDS Min 20 Hours | $1,346.26 | $30.29 | $9.92 | $1,386.47 | $1,400.33 |
| 3984 | Continuous Home Care w/AIDS Min 21 Hours | $1,413.57 | $31.81 | $9.92 | $1,455.30 | $1,469.85 |
| 3985 | Continuous Home Care w/AIDS Min 22 Hours | $1,480.88 | $33.32 | $9.92 | $1,524.12 | $1,539.36 |
| 3986 | Continuous Home Care w/AIDS Min 23 Hours | $1,548.20 | $34.83 | $9.92 | $1,592.95 | $1,608.88 |
| 3987 | Continuous Home Care w/AIDS Min 24 Hours | $1,615.51 | $36.35 | $9.92 | $1,661.78 | $1,678.40 |
| 3988 | General Inpatient w/ AIDS | $1,225.33 | $27.57 | $9.92 | $1,262.82 | $1,275.45 |
| 3989 | Routine Home Care w/ AIDS Escort | $361.98 | $8.14 | $9.92 | $380.04 | $383.84 |
| 3991 | Service Intensity Add-on | $62.93 | $1.42 | $0.00 | $64.35 | $64.99 |
* 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 | 1% Add-on |
|---|---|---|---|---|---|---|
| 3945 | Routine Home Care | $197.03 | $4.43 | $9.92 | $211.38 | $213.49 |
| 3946 | Inpatient Respite | $485.01 | $10.91 | $9.92 | $505.84 | $510.90 |
| 3947 | General Inpatient Care | $1,037.12 | $23.34 | $9.92 | $1,070.38 | $1,081.08 |
| 3948 | Continuous Home Care - Min 8 Hours | $467.70 | $10.52 | $9.92 | $488.14 | $493.02 |
| 3949 | Continuous Home Care - Min 9 Hours | $526.16 | $11.84 | $9.92 | $547.92 | $553.40 |
| 3950 | Continuous Home Care - Min 10 Hours | $584.62 | $13.15 | $9.92 | $607.69 | $613.77 |
| 3951 | Continuous Home Care - Min 11 Hours | $643.08 | $14.47 | $9.92 | $667.47 | $674.14 |
| 3952 | Continuous Home Care - Min 12 Hours | $701.55 | $15.78 | $9.92 | $727.25 | $734.52 |
| 3953 | Continuous Home Care - Min 13 Hours | $760.01 | $17.10 | $9.92 | $787.03 | $794.90 |
| 3954 | Continuous Home Care - Min 14 Hours | $818.47 | $18.42 | $9.92 | $846.81 | $855.28 |
| 3955 | Continuous Home Care - Min 15 Hours | $876.93 | $19.73 | $9.92 | $906.58 | $915.65 |
| 3956 | Continuous Home Care - Min 16 Hours | $935.39 | $21.05 | $9.92 | $966.36 | $976.02 |
| 3957 | Continuous Home Care - Min 17 Hours | $993.86 | $22.36 | $9.92 | $1,026.14 | $1,036.40 |
| 3958 | Continuous Home Care - Min 18 Hours | $1,052.32 | $23.68 | $9.92 | $1,085.92 | $1,096.78 |
| 3959 | Continuous Home Care - Min 19 Hours | $1,110.78 | $24.99 | $9.92 | $1,145.69 | $1,157.15 |
| 3960 | Continuous Home Care - Min 20 Hours | $1,169.24 | $26.31 | $9.92 | $1,205.47 | $1,217.52 |
| 3961 | Continuous Home Care - Min 21 Hours | $1,227.70 | $27.62 | $9.92 | $1,265.24 | $1,277.89 |
| 3962 | Continuous Home Care - Min 22 Hours | $1,286.17 | $28.94 | $9.92 | $1,325.03 | $1,338.28 |
| 3963 | Continuous Home Care - Min 23 Hours | $1,344.63 | $30.25 | $9.92 | $1,384.80 | $1,398.65 |
| 3964 | Continuous Home Care - Min 24 Hours | $1,403.09 | $31.57 | $9.92 | $1,444.58 | $1,459.03 |
| 3965 | Hospice Inpatient Respite Care Coinsurance Rate - 5% of 3946 | $24.25 | $0.55 | $0.50 | $25.30 | $25.55 |
| 3966 | Drugs Coinsurance Rate | $1.00 | $0.00 | $0.00 | $1.00 | $1.01 |
| 3969 | Routine Home Care w/AIDS | $320.93 | $7.22 | $9.92 | $338.07 | $341.45 |
| 3970 | Routine Home Care w/Escort | $216.99 | $4.88 | $9.92 | $231.79 | $234.11 |
| 3971 | Continuous Home Care w/AIDS Min 8 Hours | $491.95 | $11.07 | $9.92 | $512.94 | $518.07 |
| 3972 | Continuous Home Care w/AIDS Min 9 Hours | $553.45 | $12.45 | $9.92 | $575.82 | $581.58 |
| 3973 | Continuous Home Care w/AIDS Min 10 Hours | $614.94 | $13.84 | $9.92 | $638.70 | $645.09 |
| 3974 | Continuous Home Care w/AIDS Min 11 Hours | $676.44 | $15.22 | $9.92 | $701.58 | $708.60 |
| 3975 | Continuous Home Care w/AIDS Min 12 Hours | $737.93 | $16.60 | $9.92 | $764.45 | $772.09 |
| 3976 | Continuous Home Care w/AIDS Min 13 Hours | $799.42 | $17.99 | $9.92 | $827.33 | $835.60 |
| 3977 | Continuous Home Care w/AIDS Min 14 Hours | $860.92 | $19.37 | $9.92 | $890.21 | $899.11 |
| 3978 | Continuous Home Care w/AIDS Min 15 Hours | $922.41 | $20.75 | $9.92 | $953.08 | $962.61 |
| 3979 | Continuous Home Care w/AIDS Min 16 Hours | $983.91 | $22.14 | $9.92 | $1,015.97 | $1,026.13 |
| 3980 | Continuous Home Care w/AIDS Min 17 Hours | $1,045.40 | $23.52 | $9.92 | $1,078.84 | $1,089.63 |
| 3981 | Continuous Home Care w/AIDS Min 18 Hours | $1,106.90 | $24.91 | $9.92 | $1,141.73 | $1,153.15 |
| 3982 | Continuous Home Care w/AIDS Min 19 Hours | $1,168.39 | $26.29 | $9.92 | $1,204.60 | $1,216.65 |
| 3983 | Continuous Home Care w/AIDS Min 20 Hours | $1,229.88 | $27.67 | $9.92 | $1,267.47 | $1,280.14 |
| 3984 | Continuous Home Care w/AIDS Min 21 Hours | $1,291.38 | $29.06 | $9.92 | $1,330.36 | $1,343.66 |
| 3985 | Continuous Home Care w/AIDS Min 22 Hours | $1,352.87 | $30.44 | $9.92 | $1,393.23 | $1,407.16 |
| 3986 | Continuous Home Care w/AIDS Min 23 Hours | $1,414.37 | $31.82 | $9.92 | $1,456.11 | $1,470.67 |
| 3987 | Continuous Home Care w/AIDS Min 24 Hours | $1,475.86 | $33.21 | $9.92 | $1,518.99 | $1,534.18 |
| 3988 | General Inpatient w/ AIDS | $1,152.66 | $25.93 | $9.92 | $1,188.51 | $1,200.40 |
| 3989 | Routine Home Care w/ AIDS Escort | $340.89 | $7.67 | $9.92 | $358.48 | $362.06 |
| 3991 | Service Intensity Add-on | $58.89 | $1.33 | $0.00 | $60.22 | $60.82 |
* 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 |
1% Add-on |
|---|---|---|---|---|---|---|
| 3945 | Routine Home Care | $189.89 | $4.27 | $9.92 | $204.08 | $206.12 |
| 3946 | Inpatient Respite | $468.87 | $10.55 | $9.92 | $489.34 | $494.23 |
| 3947 | General Inpatient Care | $1,001.08 | $22.52 | $9.92 | $1,033.52 | $1,043.86 |
| 3948 | Continuous Home Care - Min 8 Hours | $448.19 | $10.08 | $9.92 | $468.19 | $472.87 |
| 3949 | Continuous Home Care - Min 9 Hours | $504.22 | $11.34 | $9.92 | $525.48 | $530.73 |
| 3950 | Continuous Home Care - Min 10 Hours | $560.24 | $12.61 | $9.92 | $582.77 | $588.60 |
| 3951 | Continuous Home Care - Min 11 Hours | $616.27 | $13.87 | $9.92 | $640.06 | $646.46 |
| 3952 | Continuous Home Care - Min 12 Hours | $672.29 | $15.13 | $9.92 | $697.34 | $704.31 |
| 3953 | Continuous Home Care - Min 13 Hours | $728.31 | $16.39 | $9.92 | $754.62 | $762.17 |
| 3954 | Continuous Home Care - Min 14 Hours | $784.34 | $17.65 | $9.92 | $811.91 | $820.03 |
| 3955 | Continuous Home Care - Min 15 Hours | $840.36 | $18.91 | $9.92 | $869.19 | $877.88 |
| 3956 | Continuous Home Care - Min 16 Hours | $896.39 | $20.17 | $9.92 | $926.48 | $935.74 |
| 3957 | Continuous Home Care - Min 17 Hours | $952.41 | $21.43 | $9.92 | $983.76 | $993.60 |
| 3958 | Continuous Home Care - Min 18 Hours | $1,008.44 | $22.69 | $9.92 | $1,041.05 | $1,051.46 |
| 3959 | Continuous Home Care - Min 19 Hours | $1,064.46 | $23.95 | $9.92 | $1,098.33 | $1,109.31 |
| 3960 | Continuous Home Care - Min 20 Hours | $1,120.48 | $25.21 | $9.92 | $1,155.61 | $1,167.17 |
| 3961 | Continuous Home Care - Min 21 Hours | $1,176.51 | $26.47 | $9.92 | $1,212.90 | $1,225.03 |
| 3962 | Continuous Home Care - Min 22 Hours | $1,232.53 | $27.73 | $9.92 | $1,270.18 | $1,282.88 |
| 3963 | Continuous Home Care - Min 23 Hours | $1,288.56 | $28.99 | $9.92 | $1,327.47 | $1,340.74 |
| 3964 | Continuous Home Care - Min 24 Hours | $1,344.58 | $30.25 | $9.92 | $1,384.75 | $1,398.60 |
| 3965 | Hospice Inpatient Respite Care Coinsurance Rate - 5% of 3946 | $23.44 | $0.53 | $0.50 | $24.47 | $24.71 |
| 3966 | Drugs Coinsurance Rate | $1.00 | $0.00 | $0.00 | $1.00 | $1.01 |
| 3969 | Routine Home Care w/AIDS | $309.31 | $6.96 | $9.92 | $326.19 | $329.45 |
| 3970 | Routine Home Care w/Escort | $209.85 | $4.72 | $9.92 | $224.49 | $226.73 |
| 3971 | Continuous Home Care w/AIDS Min 8 Hours | $466.29 | $10.49 | $9.92 | $486.70 | $491.57 |
| 3972 | Continuous Home Care w/AIDS Min 9 Hours | $524.58 | $11.80 | $9.92 | $546.30 | $551.76 |
| 3973 | Continuous Home Care w/AIDS Min 10 Hours | $582.87 | $13.11 | $9.92 | $605.90 | $611.96 |
| 3974 | Continuous Home Care w/AIDS Min 11 Hours | $641.15 | $14.43 | $9.92 | $665.50 | $672.16 |
| 3975 | Continuous Home Care w/AIDS Min 12 Hours | $699.44 | $15.74 | $9.92 | $725.10 | $732.35 |
| 3976 | Continuous Home Care w/AIDS Min 13 Hours | $757.73 | $17.05 | $9.92 | $784.70 | $792.55 |
| 3977 | Continuous Home Care w/AIDS Min 14 Hours | $816.01 | $18.36 | $9.92 | $844.29 | $852.73 |
| 3978 | Continuous Home Care w/AIDS Min 15 Hours | $874.30 | $19.67 | $9.92 | $903.89 | $912.93 |
| 3979 | Continuous Home Care w/AIDS Min 16 Hours | $932.59 | $20.98 | $9.92 | $963.49 | $973.12 |
| 3980 | Continuous Home Care w/AIDS Min 17 Hours | $990.87 | $22.29 | $9.92 | $1,023.08 | $1,033.31 |
| 3981 | Continuous Home Care w/AIDS Min 18 Hours | $1,049.16 | $23.61 | $9.92 | $1,082.69 | $1,093.52 |
| 3982 | Continuous Home Care w/AIDS Min 19 Hours | $1,107.45 | $24.92 | $9.92 | $1,142.29 | $1,153.71 |
| 3983 | Continuous Home Care w/AIDS Min 20 Hours | $1,165.73 | $26.23 | $9.92 | $1,201.88 | $1,213.90 |
| 3984 | Continuous Home Care w/AIDS Min 21 Hours | $1,224.02 | $27.54 | $9.92 | $1,261.48 | $1,274.09 |
| 3985 | Continuous Home Care w/AIDS Min 22 Hours | $1,282.31 | $28.85 | $9.92 | $1,321.08 | $1,334.29 |
| 3986 | Continuous Home Care w/AIDS Min 23 Hours | $1,340.59 | $30.16 | $9.92 | $1,380.67 | $1,394.48 |
| 3987 | Continuous Home Care w/AIDS Min 24 Hours | $1,398.88 | $31.47 | $9.92 | $1,440.27 | $1,454.67 |
| 3988 | General Inpatient w/ AIDS | $1,112.60 | $25.03 | $9.92 | $1,147.55 | $1,159.03 |
| 3989 | Routine Home Care w/ AIDS Escort | $329.27 | $7.41 | $9.92 | $346.60 | $350.07 |
| 3991 | Service Intensity Add-on | $56.66 | $1.27 | $0.00 | $57.93 | $58.51 |
* WRR ='Worker Recruitment and Retention addon' if applicable
* RTR ='Recruitment, Training and Retention addon' if applicable
