rate-schedule_medicaid_c_04-01-2022

Page 1

Standard Rate Schedule: Medicaid 1915(c) Inv Invoice‐based ‐ Provider submits actual costs to Finance department E

EVV adjustment included

D

DCW adjustment included Rev. 04/01/2022

Rate as of 1/1/2022

Service

B4100BO ‐ Food thickener B4103BO ‐ Enteral Formulae ‐ Pediatric B4149BO ‐ Enteral Formulae ‐ Mfg Blend Natural Foods B4150BO ‐ Enteral Formulae B4152BO ‐ Ent Form Caloric Dense B4153BO ‐ Ent Form Hydrolyzed Proteins B4154BO ‐ Ent Form Special Met Needs, Excl Inherit Dis B4155BO ‐ Ent Form Incomplete/Modular B4157BO ‐ Ent Form Special Met Needs, Incl Inherit Dis B4158BO ‐ Ent Form Complete ‐ Pediatric B4159BO ‐ Ent Form Complete Soy‐based ‐ Pediatric B4160BO ‐ Ent Form Caloric Dense ‐ Pediatric B4161BO ‐ Ent Form Hydrolyzed Protiens ‐ Pediatric B4162BO ‐ Ent Form Special Metabolic ‐ Pediatric H2011HI ‐ Crisis Intervention and Stabilization Supports with Technical Amendment H2015 ‐ Community Networking Service ‐ Ind H2015 ‐ EOR Community Networking Service ‐ Ind H2015HQ ‐ Community Networking Group H2015HQ ‐ EOR Community Networking Group

Rate as of 2/1/2022

Rate as of 3/1/2022

Rate as of 4/1/2022

Inv Inv Inv Inv Inv Inv Inv Inv Inv Inv Inv Inv Inv Inv

$ $ $ $ $ $ $ $ $ $ $ $ $ $

0.58 3.45 1.70 0.72 0.60 2.07 1.49 2.68 3.92 0.67 0.67 0.58 1.95 4.05

$ $ $ $ $ $ $ $ $ $ $ $ $ $

0.58 3.45 1.70 0.72 0.60 2.07 1.49 2.68 3.92 0.67 0.67 0.58 1.95 4.05

$ $ $ $ $ $ $ $ $ $ $ $ $ $

0.58 3.45 1.70 0.72 0.60 2.07 1.49 2.68 3.92 0.67 0.67 0.58 1.95 4.05

$ $ $ $ $ $ $ $ $ $ $ $ $ $

0.58 3.45 1.70 0.72 0.60 2.07 1.49 2.68 3.92 0.67 0.67 0.58 1.95 4.05

D D D D

$ $ $ $ $

9.00 6.60 6.27 3.60 3.42

$ $ $ $ $

9.00 $ 6.60 $ 6.27 $ 3.60 $ 3.42 $

9.00 6.60 6.27 3.60 3.42

$ $ $ $ $

9.00 6.28 5.96 3.31 3.14

3.13 $

3.13 $

3.31

$

3.31

2.97 $ 1.00 $ 1.00 $

2.97 $ 1.00 $ 1.00 $

3.14 $ 1.00 $ 1.00 $

3.14 1.00 1.00

5.74 $

5.74 $

6.28

6.28

H2015HQXUCR ‐ Community Networking Group, retainer pymt, disaster related D $ H2015HQXUCR ‐ EOR Community Networking Group, retainer pymt, disaster related D $ H2015U1 ‐ Community Networking ‐ Class & Conf Inv $ H2015U2 ‐ Community Networking ‐ Transportation Inv $ H2015XUCR ‐ Community Networking Service ‐ Ind, retainer pymt, disaster related D $

$


Standard Rate Schedule: Medicaid 1915(c) Inv Invoice‐based ‐ Provider submits actual costs to Finance department E

EVV adjustment included

D

DCW adjustment included Rev. 04/01/2022

Rate as of 1/1/2022

Service

H2015XUCR ‐ EOR Community Networking Service ‐ Ind, retainer pymt, disaster related H2016 ‐ Level 1‐Residential Supports H2016HI ‐ Level 4‐Residential Supports H2016HIU2 ‐ Level 4 AFL‐Residential Supports H2016HIXUCR ‐ Level 4‐Residential Supports, retainer pymt, disaster related H2016HIXUCRU2 ‐ Level 4 AFL‐Residential Supports, retainer pymt, disaster related H2016U2 ‐ Level 1 AFL Residential Supports H2016XUCR ‐ Level 1‐Residential Supports, retainer pymt, disaster related H2016XUCRU2 ‐ Level 1 AFL Residential Supports, retainer pymt, disaster related H2025 ‐ EOR Supported Employment ‐ Ind H2025 ‐ Supported Employment ‐ Ind H2025HQ ‐ EOR Supported Employment Group H2025HQ ‐ Supported Employment Group H2025HQXUCR ‐ EOR Supported Employment Group, retainer pymt, disaster related H2025HQXUCR ‐ Supported Employment Group, retainer pymt, disaster related H2025TS ‐ EOR Supported Employment – Long Term Follow‐up H2025TS ‐ Supported Employment – Long Term Follow‐up H2025TSHQ ‐ EOR Supported Employment – Long Term Follow‐up ‐ Group H2025TSHQ ‐ Supported Employment – Long Term Follow‐up ‐ Group H2025TSXUCR ‐ EOR Supported Employment – Long Term Follow‐up, retainer pymt, disaster related

Rate as of 2/1/2022

Rate as of 3/1/2022

Rate as of 4/1/2022

D D D D

$ $ $ $

5.45 121.04 189.92 196.12

$ $ $ $

5.45 $ 121.04 $ 189.92 $ 196.12 $

5.97 121.04 189.92 196.12

$ $ $ $

5.97 119.07 178.97 183.97

D

$

170.30 $

170.30 $

184.12

$

178.97

D D D

$ $ $

170.30 $ 126.79 $ 110.25 $

170.30 $ 126.79 $ 110.25 $

189.12 126.79 124.07

$ $ $

183.97 124.07 119.07

D D D D D

$ $ $ $ $

110.25 8.85 9.31 3.69 3.88

110.25 $ 8.85 $ 9.31 $ 3.69 $ 3.88 $

129.07 8.85 9.31 3.69 3.88

$ $ $ $ $

124.07 7.89 8.30 3.33 3.50

D

$

3.07 $

3.07

$

3.33

$

3.33

D D D D D

$ $ $ $ $

3.23 8.85 9.31 2.89 3.04

3.23 $ 8.85 $ 9.31 $ 2.89 $ 3.04 $

3.50 8.85 9.31 2.89 3.04

$ $ $ $ $

3.50 7.89 8.30 2.66 2.80

D

$

7.37 $

7.37

7.89

$

7.89

$ $ $ $ $

$ $ $ $ $

$


Standard Rate Schedule: Medicaid 1915(c) Inv Invoice‐based ‐ Provider submits actual costs to Finance department E

EVV adjustment included

D

DCW adjustment included Rev. 04/01/2022

Rate as of 1/1/2022

Service

Rate as of 2/1/2022

Rate as of 3/1/2022

Rate as of 4/1/2022

H2025TSXUCR ‐ Supported Employment – Long Term Follow‐up, retainer pymt, disaster related

D

$

7.76 $

7.76 $

8.30

$

8.30

H2025XUCR ‐ EOR Supported Employment ‐ Ind, retainer pymt, disaster related

D

$

7.37 $

7.37

$

7.89

$

7.89

H2025XUCR ‐ Supported Employment ‐ Ind, retainer pymt, disaster related S5110 ‐ Natural Supports Education: Individual S5111 ‐ Natural Supports Education: Conference S5150 ‐ EOR Respite ‐ Non‐inst Individual S5150 ‐ Respite ‐ Non‐inst Individual S5150HQ ‐ EOR Respite ‐ Group S5150HQ ‐ Respite ‐ Group S5150US ‐ Respite: Facility S5165 ‐ Home Modifications T1005TD ‐ AWC ‐ Nursing Respite, RN T1005TD ‐ EOR ‐ Nursing Respite, RN T1005TD ‐ Nursing Respite, RN T1005TE ‐ AWC ‐ Nursing Respite, LPN T1005TE ‐ EOR ‐ Nursing Respite, LPN T1005TE ‐ Nursing Respite, LPN T1999 ‐ Individual Goods and Services T2012 ‐ Community Living and Supports, only in the community

D

7.76 10.30 1.00 5.70 6.00 4.13 4.35 149.44 1.00 15.60 14.82 15.60 15.60 14.82 15.60 1.00 6.19

$ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $

8.30 10.30 1.00 5.70 6.00 4.13 4.35 149.44 1.00 15.60 14.82 15.60 15.60 14.82 15.60 1.00 6.19

$ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $

8.30 8.96 1.00 4.31 4.54 3.02 3.17 147.37 1.00 10.40 9.88 10.40 10.40 9.88 10.40 1.00 5.92

T2012GC ‐ Community Living and Supports, relative as provider lives in home T2012GCHQ ‐ Community Living and Supports ‐ Group, relative as provider lives in home T2012HQ ‐ Community Living and Supports ‐ Group, only in the community T2013TF ‐ Community Living and Supports

$ $ Inv $ D $ D $ D $ D $ D $ Inv $ $ $ $ $ $ $ Inv $ D $

7.76 10.30 1.00 5.70 6.00 4.13 4.35 149.44 1.00 15.60 14.82 15.60 15.60 14.82 15.60 1.00 6.19

$ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $

D

$

6.19 $

6.19 $

6.19

$

5.92

D

$

4.07 $

4.07 $

4.07

$

3.90

D $ E, D $

4.07 $ 6.19 $

4.07 $ 6.81 $

4.07 6.81

$ $

3.90 6.46


Standard Rate Schedule: Medicaid 1915(c) Inv Invoice‐based ‐ Provider submits actual costs to Finance department E

EVV adjustment included

D

DCW adjustment included Rev. 04/01/2022

Rate as of 1/1/2022

Service

Rate as of 2/1/2022

Rate as of 3/1/2022

Rate as of 4/1/2022

T2013TF ‐ EOR Community Living and Supports E, D $ T2013TFHQ ‐ Community Living and Supports‐ Group E, D $ T2013TFHQ ‐ EOR Community Living and Supports‐Group E, D $ T2013TFHQXUCR ‐ Community Living and Supports‐ Group, retainer pymt, disaster related D $ T2013TFHQXUCR ‐ EOR Community Living and Supports‐ Group, retainer pymt, disaster related D $

5.88 $ 4.07 $ 3.87 $

6.47 $ 4.48 $ 4.26 $

6.47 4.48 4.26

$ $ $

6.14 4.25 4.04

3.54 $

3.54 $

3.90

$

3.90

3.36 $

3.36

$

3.70

$

3.70

T2013TFXUCR ‐ Community Living and Supports, retainer pymt, disaster related T2013TFXUCR ‐ EOR Community Living and Supports, retainer pymt, disaster related T2014 ‐ Level 2 ‐ Residential Supports T2014U2 ‐ Level 2 AFL ‐ Residential Supports

D

$

5.38 $

5.38 $

5.92

$

5.92

D D D

$ $ $

5.11 $ 152.79 $ 152.79 $

5.11 $ 152.79 $ 152.79 $

5.62 152.79 157.79

$ $ $

5.62 146.68 151.68

T2014XUCR ‐ Level 2 ‐ Residential Supports, retainer pymt, disaster related T2020 ‐ Level 3 ‐ Residential Supports T2020U2 ‐ Level 3 AFL ‐ Residential Supports

D D D

$ $ $

132.86 $ 179.37 $ 179.37 $

132.86 $ 179.37 $ 179.37 $

146.68 179.37 184.37

$ $ $

146.68 169.79 174.79

T2020XUCR ‐ Level 3 ‐ Residential Supports, retainer pymt, disaster related T2020XUCRU2 ‐ Level 3 AFL ‐ Residential Supports, retainer pymt, disaster related T2021 ‐ Day Support ‐ Individual T2021HQ ‐ Day Support Group T2021HQXUCR ‐ Day Support Group, retainer pymt, disaster related T2021XUCR ‐ Day Support ‐ Individual, retainer pymt, disaster related T2025 ‐ Specialized Consultative Service T2025HO ‐ Specialized Consultative Services: BCBA T2025U1 ‐ Financial Support Services

D

$

155.97 $

155.97 $

169.79

$

169.79

D D D D D

$ $ $ $ $ $ $ $

155.97 25.88 15.84 15.84 25.88 39.90 39.90 175.00

155.97 25.88 15.84 15.84 25.88 39.90 39.90 175.00

174.79 28.04 16.56 16.56 28.04 39.90 39.90 175.00

$ $ $ $ $ $ $ $

174.79 28.04 16.56 16.56 28.04 39.90 39.90 175.00

$ $ $ $ $ $ $ $

$ $ $ $ $ $ $ $


Standard Rate Schedule: Medicaid 1915(c) Inv Invoice‐based ‐ Provider submits actual costs to Finance department E

EVV adjustment included

D

DCW adjustment included Rev. 04/01/2022

Rate as of 1/1/2022

Service

T2025U2U1 ‐ Employer Supplies ‐ start‐up costs T2025U2U1 ‐ Employer Supplies ‐ start‐up costs T2025U3 ‐ Crisis Services: Crisis Consultation T2027 ‐ Day Supports: Developmental Day

Rate as of 3/1/2022

Rate as of 4/1/2022

150.00 $ 1.00 $ 19.92 $ 24.75 $

150.00 1.00 19.92 24.75

$ $ $ $

150.00 $ 1.00 $ 19.92 $ 25.29 $

150.00 1.00 19.92 25.29

T2027XUCR ‐ Day Supports: Developmental Day, retainer pymt, disaster related D $ T2029 ‐ Assistive Technology ‐ Equip & Supplies Inv $ T2033 ‐ EOR Supported Living – Level 1 D $ T2033 ‐ Supported Living – Level 1 D $ T2033HI ‐ EOR Supported Living – Level 2 D $ T2033HI ‐ Supported Living – Level 2 D $

24.75 1.00 228.13 240.14 275.44 289.94

$ $ $ $ $ $

24.75 1.00 228.13 240.14 275.44 289.94

$ $ $ $ $ $

25.29 $ 1.00 $ 228.13 $ 240.14 $ 275.44 $ 289.94 $

25.29 1.00 168.51 177.37 216.46 227.85

T2033HIXUCR ‐ EOR Supported Living – Level 2, retainer pymt, disaster related T2033HIXUCR ‐ Supported Living – Level 2, retainer pymt, disaster related T2033TF ‐ EOR Supported Living – Level 3 T2033TF ‐ Supported Living – Level 3

D D D D

$ $ $ $

183.63 193.29 321.96 338.90

$ $ $ $

183.63 $ 193.29 $ 321.96 $ 338.90 $

216.46 227.85 321.96 338.90

$ $ $ $

216.46 227.85 263.88 277.77

T2033TFXUCR ‐ EOR Supported Living – Level 3, retainer pymt, disaster related T2033TFXUCR ‐ Supported Living – Level 3, retainer pymt, disaster related T2033U1 ‐ EOR Supported Living ‐ Periodic T2033U1 ‐ Supported Living ‐ Periodic T2033U1XUCR ‐ EOR Supported Living ‐ Periodic, retainer pymt, disaster related T2033U2 ‐ Supported Living ‐ Transition

D D E, D E, D

$ $ $ $

214.63 225.93 7.87 8.28

$ $ $ $

214.63 $ 225.93 $ 8.65 $ 9.11 $

263.88 277.77 8.39 9.11

$ $ $ $

263.88 277.77 6.28 6.61

D D

$ $

5.24 $ 8.28 $

5.24 $ 8.28 $

5.75 8.28

$ $

5.75 6.06

D D

$ $ $

152.09 $ 160.09 $ 249.69 $

152.09 $ 160.09 $ 249.69 $

168.51 177.37 249.69

$ $ $

168.51 177.37 249.69

T2033XUCR ‐ EOR Supported Living – Level 1, retainer pymt, disaster related T2033XUCR ‐ Supported Living – Level 1, retainer pymt, disaster related T2034 ‐ Crisis Services: Out of Home

$ Inv $ $ D $

Rate as of 2/1/2022


Standard Rate Schedule: Medicaid 1915(c) Inv Invoice‐based ‐ Provider submits actual costs to Finance department E

EVV adjustment included

D

DCW adjustment included Rev. 04/01/2022

Rate as of 1/1/2022

Service

T2038 ‐ Community Transition T2039 ‐ Vehicle Modifications T2041 ‐ Community Navigator: Monthly T2041U1 ‐ Community Navigator: Periodic and Start Up Training T2041U1U6 ‐ Community Navigator: IFDS Orientation

Inv $ Inv $ $ $ $

1.00 $ 1.00 $ 150.00 $ 620.00 $ 35.00 $

Rate as of 2/1/2022

1.00 1.00 150.00 620.00 35.00

Rate as of 3/1/2022

$ $ $ $ $

1.00 $ 1.00 $ 150.00 $ 620.00 $ 35.00 $

Rate as of 4/1/2022

1.00 1.00 150.00 620.00 35.00


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