Mental Hygiene Services Rates

OPWDD RATE CODES AS OF 9/1/19

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Rate Code Definition OPWDD Purpose State/Voluntary
1546 OPWDD APG - Free-Standing Article 16 Clinic On-Site - Effective 7/1/11  
1549 OPWDD APG - Free-Standing Article 16 Clinic Off-Site - Effective 7/1/11  
 
1900 OPWDD CARE COORD ORG/HH LVL 1; VOL; MTHLY Effective 7/1/18 Voluntary
1901 OPWDD CARE COORD ORG/HH LVL 2; VOL; MTHLY Effective 7/1/18 Voluntary
1902 OPWDD CARE COORD ORG/HH LVL 3; VOL; MTHLY Effective 7/1/18 Voluntary
1903 OPWDD CARE COORD ORG/HH LVL 4; VOL; MTHLY Effective 7/1/18 Voluntary
1904 OPWDD CARE COORD ORG/HH OPT OUT; VOL; MTHLY Effective 7/1/18 Voluntary
1905 OPWDD CARE COORD ORG/HH TRANS; MTHLY Effective 7/1/18 Voluntary
1906 OPWDD CARE COORD ORG/HH OPT OUT TRNS; MTHLY Effective 7/1/18 Voluntary
 
2438 OPWDD FIDA - Age 21-49 Medicare Dual Effective 4/1/16 Voluntary
2439 OPWDD FIDA - Age 50+ Medicare Dual Effective 4/1/16 Voluntary
 
1605 OPWDD Specialty Hospital; Vol Operated; Per Diem Terrance Cardinal Cooke Specialty Hospital - Effective 1/1/13 Voluntary
 
3822 HRF/MR VOICF Voluntary
 
4100 State Operated OPWDD Development Center   State
4101 OPWDD State Operated ICF/DD   State
4102 OPWDD St. Op ICFDD Small Residential Unit   State
 
4104 ICF; Vol; Day Service; Full Unit VOICF Day Service - Effective 1/1/15 Voluntary
4105 ICF; Vol; Day Service; Half Unit VOICF Day Service - Effective 1/1/15 Voluntary
4106 ICF; Vol; Vocational Service; Full Unit VOICF Prevoc Service - Effective 1/1/15 Voluntary
4107 ICF; Vol; Vocational Service; Half Unit VOICF Prevoc Service - Effective 1/1/15 Voluntary
4108 ICF; Vol; INHS Day Service; Full Unit VOICF In House Day Service effective 1/1/16 Voluntary
4109 ICF; Vol;Comm Voc; Group 3 + Ind Effective 7/1/15 Voluntary
4110 ICF; State; Day Service; Full Unit SOICF Day Service - Effective 4/1/16 State
4111 ICF; State; Day Service; Half Unit SOICF Day Service - Effective 4/1/16 State
4112 ICF; State; Vocational Service; Full Unit SOICF Prevoc Service - Effective date TBD State
4113 ICF; State; Vocational Service; Half Unit SOICF Prevoc Service - Effective date TBD State
4114 ICF; State; INHS Day Service; Full Unit SOICF In House Day Service - effective date TBD State
4115 ICF; State; Comm Voc; Group 3 + Ind Effective TBD State
4116 ICF; Vol; Comm Vocational 1:1 Effective 7/1/15 Voluntary
4117 ICF; Vol;Comm Voc; Group of 2 Effective 7/1/15 Voluntary
4118 ICF; State; Comm; Vocational 1:1 Effective TBD State
4119 ICF; State; Comm Voc; Group of 2 Effective TBD State
 
4120 ICF TEMPLATE SPECIALIZED; VOL; PER DIEM Effective 9/1/18 Voluntary
4121 ICF TEMPLATE HIGHLY COMPLEX; VOL;PER DIEM Effective 9/1/18 Voluntary
4122 ICF AUSPICE CHANGE; VOL; PER DIEM Effective 9/1/18 Voluntary
 
4160 OPWDD State Operated Full Day Day Treatment State
4161 OPWDD State Operated Half Day Day Treatment State
4162 OPWDD State Operated Collocated Day Treatment State
4163 OPWDD State Operated Intake Day Treatment State
4164 OPWDD State Operated Diagnosis & Evaluation Day Treatment State
 
4170 OPWDD Day Treatment Full Day   Voluntary
4171 OPWDD Day Treatment Half Day   Voluntary
4172 OPWDD Day Treatment Collocated Model   Voluntary
4173 OPWDD Day Treatment Intake   Voluntary
4174 OPWDD Day Treatment Diagnosis & Evaluation   Voluntary
       
4428 Res Hab; State-IRA Supvd; Per Diem Effective 7/1/14 State
4429 Res Hab; State-IRA Supvd; Med Leave; Per Diem Effective 7/1/14 State
4430 Res Hab; State-IRA Supvd; Non-Med Leave; Per Diem Effective 7/1/14 State
       
4431 Res Hab; State-FC; Per Diem Effective 7/1/15 State
       
4433 Path to Employment; State; Indiv; 1/4 Hr Effective 7/1/14 State
4434 Path to Employment; State; Group; 1/4 Hr Effective 7/1/14 State
       
4436 Prevoc; Community; State; 1/4 Hr Effective 7/1/15 State
       
4437 Res Hab; Vol-IRA Supvd; Per Diem Effective 7/1/14 Voluntary
4438 Res Hab; Vol-IRA Supvd; Med Leave; Per Diem Effective 7/1/14 Voluntary
4439 Res Hab; Vol-IRA Supvd; Non-Med Leave; Per Diem Effective 7/1/14 Voluntary
       
4440 Res Hab; Voluntary-FC; Per Diem   Voluntary
       
4444 Path to Employment; Vol; Indiv; 1/4 Hr Effective 7/1/14 Voluntary
4445 Path to Employment; Vol; Group; 1/4 Hr Effective 7/1/14 Voluntary
       
4446 Grp Day Hab-State;Full Unit/OPWDD   State
4447 Grp Day Hab-State;Half Unit/OPWDD   State
       
4450 SEMP; Intensive; State; Ind; 1/4 Hr Effective 7/1/15 State
4451 SEMP; Intensive; State; Grp; 1/4 Hr Effective 7/1/15 State
       
4453 Grp Day Hab-Vol;Full Unit/OPWDD   Voluntary
4454 Grp Day Hab-Vol;Half Unit/OPWDD   Voluntary
4455 Supplemental Grp Day Hab-Vol Full Unit/OPWDD   Voluntary
4456 Supplemental Grp Day Hab-Vol Half Unit/OPWDD   Voluntary
       
4458 Prevoc-State;Full Unit/OPWDD   State
4459 Prevoc-State;Half Unit/OPWDD   State
       
4460 SEMP; Extended; State; Ind; 1/4 Hr Effective 7/1/15 State
4461 SEMP; Extended; State; Grp; 1/4 Hr Effective 7/1/15 State
       
4464 Prevoc;Voluntary;Full Unit/OPWDD   Voluntary
4465 Prevoc;Voluntary;Half Unit/OPWDD   Voluntary
       
4476 Environ Mods; $1.00 Per Unit Fee; State   State
4477 Environ Mods; $10.00 Per Unit Fee; State   State
4478 Environ Mods; $100.00 Per Unit Fee; State   State
4479 Environ Mods; $1000.00 Per Unit Fee; State   State
       
4482 Adaptive Technology; $1.00 Per Unit Fee; State   State
4483 Adaptive Technology; $10.00 Per Unit Fee; State   State
4484 Adaptive Technology; $100.00 Per Unit Fee; State   State
4485 Adaptive Technology; $1000.00 Per Unit Fee; State   State
       
4496 Individual Family Education &Training Serv-State;Unit   State
4497 Individual Family Education &Training Serv-Voluntary;Unit   Voluntary
4498 Group Family Education &Training Serv-State;Unit   State
4499 Group Family Education &Training Serv-Voluntary;Unit   Voluntary
       
4703 Res Hab;State;IRA-Suprt Monthly   State
4704 Res Hab;State;IRA-Suprt Semi-Monthly 1st half   State
4705 Res Hab;State;IRA-Suprt Semi-Monthly 2nd half   State
       
4709 Res Hab;Vol;IRA/CR-Suprt Monthly   Voluntary
4710 Res Hab;Vol;IRA/CR-Suprt Semi-Monthly 1st half   Voluntary
4711 Res Hab;Vol;IRA/CR-Suprt Semi-Monthly 2nd half   Voluntary
       
4720 IBS; Vol; IBP/FBA Plan Development; Flat Fee Effective 10/1/13 Voluntary
4721 IBS; Vol; Plan Implementation; ¼ Hr Effective 10/1/13 Voluntary
       
4722 Comm/Res Hab; Vol; Indiv; ¼ Hr Effective 11/1/10 Voluntary
4723 Comm/Res Hab; Vol; Group – 2 Individuals; ¼ Hr Effective 11/1/10 Voluntary
4724 Comm/Res Hab; Vol; Group – 3 Individuals; ¼ Hr Effective 11/1/10 Voluntary
       
4741 Comm/Res Hab; State; Group-1 Individual; 1/4 Hr Effective 10/1/13 State
4742 Comm/Res Hab; State; Group-2 Individuals; 1/4 Hr Effective 10/1/13 State
4743 Comm/Res Hab; State; Group-3 Individuals; 1/4 Hr Effective 10/1/13 State
       
4749 Respite-Hourly;1/4 Hour Unit; State VO OPTS and SO Effective 2/1/10 State
       
4755 Com Hab; Agy Sup; Vol; Ind; 1/4 Hr Effective 10/1/14 Voluntary
4756 Com Hab; Agy Sup; Vol; Grp; 1/4 Hr Effective 10/1/14 Voluntary
4757 Com Hab; Cert Fac Resid; Agy Sup; Vol; Ind; 1/4 Hr Effective 10/1/14 Voluntary
4758 Com Hab; Cert Fac Resid; Agy Sup; Vol; Grp; 1/4 Hr Effective 10/1/14 Voluntary
       
4759 SEMP; Agy Sup; Phase 1; Vol; Ind; 1/4 Hr Effective 7/1/15 Voluntary
4760 SEMP; Agy Sup; Phase 1; Vol; Grp; 1/4 Hr Effective 7/1/15 Voluntary
4761 SEMP; Agy Sup; Phase 2; Vol; Ind; 1/4 Hr Effective 7/1/15 Voluntary
4762 SEMP; Agy Sup; Phase 2; Vol; Grp; 1/4 Hr Effective 7/1/15 Voluntary
       
4764 Respite; Via FI Fee; Vol; 1/4 Hr Effective 7/1/15 Voluntary
4765 Com Hab; Via FI; Vol; Ind; 1/4 Hr Effective 10/1/14 Voluntary
4766 Com Hab; Via FI; Vol; Grp; 1/4 Hr Effective 10/1/14 Voluntary
4767 Com Hab; Cert Fac Resid; Via FI; Vol; Ind; 1/4 Hr Effective 10/1/14 Voluntary
4768 Com Hab; Cert Fac Resid; Via FI; Vol; Grp; 1/4 Hr Effective 10/1/14 Voluntary
       
4769 SEMP; Via FI; Phase 1; Vol; Ind; 1/4 Hr Effective 10/1/14 Voluntary
4770 SEMP; Via FI; Phase 1; Vol; Grp; 1/4 Hr Effective 10/1/14 Voluntary
4771 SEMP; Via FI; Phase 2; Vol; Ind; 1/4 Hr Effective 10/1/14 Voluntary
4772 SEMP; Via FI; Phase 2; Vol; Grp; 1/4 Hr Effective 10/1/14 Voluntary
       
4777 Live-In Caregiver; Via FI; Vol; Month Effective 10/1/14 Voluntary
4778 Support Broker; Via FI; Vol; 1/4 Hr Effective 10/1/14 Voluntary
       
4781 Prevoc; Comm; Ind; Vol; 1/4 Hr Effective 7/1/15 Voluntary
4782 Prevoc; Comm; Group of 2; Vol; 1/4 Hr Effective 7/1/15 Voluntary
4783 Prevoc; Comm; Group of 3+; Vol; 1/4 Hr Effective 7/1/15 Voluntary
       
4785 Ind Goods & Svcs; Via FI; Vol; $10 Unit Effective 10/1/14 Voluntary
       
4786 Com Trans Svcs; Via FI; Vol; $10 Unit Effective 12/1/14 Voluntary
       
4787 Fiscal Intermediary; Vol; Level 1; Mth Effective 10/1/14 Voluntary
4788 Fiscal Intermediary; Vol; Level 2; Mth Effective 10/1/14 Voluntary
4789 Fiscal Intermediary; Vol; Level 3; Mth Effective 10/1/14 Voluntary
       
4790 SEMP; Intensive; Vol; Ind; 1/4 Hr Effective 7/1/15 Voluntary
4791 SEMP; Intensive; Vol; Grp; 1/4 Hr Effective 7/1/15 Voluntary
4792 SEMP; Extended; Vol; Ind; 1/4 Hr Effective 7/1/15 Voluntary
4793 SEMP; Extended; Vol; Grp; 1/4 Hr Effective 7/1/15 Voluntary
       
4796 Com Hab; Cert Fac Resid; Vol; Ind; 1/4 Hr Effective 10/1/14 Voluntary
4797 Com Hab; Cert Fac Resid; Vol; Grp; 1/4 Hr Effective 10/1/14 Voluntary
4798 Com Hab; Cert Fac Resid; State; Ind; 1/4 Hr Effective 11/1/17 State
4799 Com Hab; Cert Fac Resid; State; Grp; 1/4 Hr Effective 11/1/17 State
       
7400 RES HAB;VOL;IRA SPVD;HIGH NEEDS TIER 1 Effective 7/1/17 Voluntary
7401 RES HAB;VOL;IRA SPVD;HIGH NEEDS TIER 1;MED LEAVE Effective 7/1/17 Voluntary
7402 RES HAB;VOL;IRA SPVD;HIGH NEEDS TIER 1;NONMED LEAVE Effective 7/1/17 Voluntary
7403 RES HAB;VOL;IRA SPVD;HIGH NEEDS TIER 2 Effective 7/1/17 Voluntary
7404 RES HAB;VOL;IRA SPVD;HIGH NEEDS TIER 2;MED LEAVE Effective 7/1/17 Voluntary
7405 RES HAB;VOL;IRA SPVD;HIGH NEEDS TIER 2;NONMED LEAVE Effective 7/1/17 Voluntary
7406 RES HAB;VOL;IRA SPVD;HIGH NEEDS TIER 3 Effective 7/1/17 Voluntary
7407 RES HAB;VOL;IRA SPVD;HIGH NEEDS TIER 3;MED LEAVE Effective 7/1/17 Voluntary
7408 RES HAB;VOL;IRA SPVD;HIGH NEEDS TIER 3;NONMED LEAVE Effective 7/1/17 Voluntary
       
7409 RES HAB; VOL; IRA SPT MTH; HIGH NEEDS TIER 1 Effective 7/1/17 Voluntary
7410 RES HAB; VOL; IRA SPT 1ST; HIGH NEEDS TIER 1 Effective 7/1/17 Voluntary
7411 RES HAB; VOL; IRA SPT 2ND; HIGH NEEDS TIER 1 Effective 7/1/17 Voluntary
7412 RES HAB; VOL; IRA SPT MTH; HIGH NEEDS TIER 2 Effective 7/1/17 Voluntary
7413 RES HAB; VOL; IRA SPT 1ST; HIGH NEEDS TIER 2 Effective 7/1/17 Voluntary
7414 RES HAB; VOL; IRA SPT 2ND; HIGH NEEDS TIER 2 Effective 7/1/17 Voluntary
       
7421 Respite; In Home; Vol; 1/4 Hr Effective 7/1/17 Voluntary
7422 Respite; Site Based; Vol; 1/4 Hr Effective 7/1/17 Voluntary
7423 Respite; Recreation; Vol; 1/4 Hr Effective 7/1/17 Voluntary
7424 Respite; Camp; Vol; 1/4 Hr Effective 7/1/17 Voluntary
7425 Respite; Intensive; Vol; 1/4 Hr Effective 7/1/17 Voluntary
7426 Respite; Agy Sup; In Home; Vol; 1/4 Hr Effective 7/1/17 Voluntary
7427 Respite; Agy Sup Intensive; In Home; Vol; 1/4 Hr Effective 7/1/17 Voluntary
7428 Respite; In Home; Vol; Per Diem Effective 7/1/17 Voluntary
7429 Respite; Site Based; Vol; Per Diem Effective 7/1/17 Voluntary
7430 Respite; In Home; State; 1/4 Hr Effective 7/1/17 State
       
7435 Group Day Hab; Vol; Full Unit; High Needs Tier 1 Effective 7/1/17 Voluntary
7436 Group Day Hab; Vol; Half Unit; High Needs Tier 1 Effective 7/1/17 Voluntary
7437 Group Day Hab; Vol; Full Unit; High Needs Tier 2 Effective 7/1/17 Voluntary
7438 Group Day Hab; Vol; Half Unit; High Needs Tier 2 Effective 7/1/17 Voluntary
7439 Group Day Hab; Vol; Full Unit; High Needs Tier 3 Effective 7/1/17 Voluntary
7440 Group Day Hab; Vol; Half Unit; High Needs Tier 3 Effective 7/1/17 Voluntary
       
7441 Supplemental Grp Day Hab;Vol;Full Unit;High Needs Tier 1 Effective 7/1/17 Voluntary
7442 Supplemental Grp Day Hab;Vol;Half Unit;High Needs Tier 1 Effective 7/1/17 Voluntary
7443 Supplemental Grp Day Hab;Vol;Full Unit;High Needs Tier 2 Effective 7/1/17 Voluntary
7444 Supplemental Grp Day Hab;Vol;Half Unit;High Needs Tier 2 Effective 7/1/17 Voluntary
7445 Supplemental Grp Day Hab;Vol;Full Unit;High Needs Tier 3 Effective 7/1/17 Voluntary
7446 Supplemental Grp Day Hab;Vol;Half Unit;High Needs Tier 3 Effective 7/1/17 Voluntary
       
8032 ENVIR MODS - $1.00 UNIT (CHILDREN´S WAIVER) Effective 4/1/19 State
8034 ENVIR MODS - $10.00 UNIT (CHILDREN´S WAIVER) Effective 4/1/19 State
8035 ENVIR MODS - $100.00 UNIT (CHILDREN´S WAIVER) Effective 4/1/19 State
8036 ENVIR MODS - $1000.00 UNIT (CHILDREN´S WAIVER) Effective 4/1/19 State
8037 ADAP & ASSIST EQUIP - $1.00 UNIT (CHILDREN´S WAIVER) Effective 4/1/19 State
8038 ADAP & ASSIST EQUIP - $10.00 UNIT (CHILDREN´S WAIVER) Effective 4/1/19 State
8039 ADAP & ASSIST EQUIP - $100.00 UNIT (CHILDREN´S WAIVER) Effective 4/1/19 State
8040 ADAPT & ASSIST EQUIP - $1000.00 UNIT (CHILDREN´S WAIVER) Effective 4/1/19 State
8041 VEHICLE MODS - $1.00 UNIT (CHILDREN´S WAIVER) Effective 4/1/19 State
8042 VEHICLE MODS - $10.00 UNIT (CHILDREN´S WAIVER) Effective 4/1/19 State
8043 VEHICLE MODS - $100.00 UNIT (CHILDREN´S WAIVER) Effective 4/1/19 State
8044 VEHICLE MODS - $1000.00 UNIT (CHILDREN´S WAIVER) Effective 4/1/19 State