Waiver Rates
Division of Aging Service Rates for Medical Waivers
| Aged & Disabled | Assisted Living | Traumatic Brain Injury | Other Information |
|---|---|---|---|
| X | X | Service: Adult DAY Service - Level 1 UNIT: 0.5 Size: DAY 6/30/06 Waiver Rate: $20.90 7/1/06 Waiver Rates w/all Applicable Rate Adjustments: $21.95 Waiver Nat'l Code: S5101 mod_1: U7 mod_2: U1 INsite Sub_Code: ADS1 | |
| X | X | Service: Adult DAY Service - Level 1 - 1/4 HR UNIT: 0.25 Size: HOUR 6/30/06 Waiver Rate: $1.31 7/1/06 Waiver Rates w/all Applicable Rate Adjustments: $1.38 Waiver Nat'l Code: S5100 mod_1: U7 mod_2: U1 INsite Sub_Code: AS14 | |
| X | X | Service: Adult DAY Service - Level 2 UNIT: 0.5 Size: DAY 6/30/06 Waiver Rate: $27.43 7/1/06 Waiver Rates w/all Applicable Rate Adjustments: $28.80 Waiver Nat'l Code: S5101 mod_1: U7 mod_2: U2 INsite Sub_Code: ADS2 | |
| X | X | Service: Adult DAY Service - Level 2 - 1/4 HR UNIT: 0.25 Size: HOUR 6/30/06 Waiver Rate: $1.71 7/1/06 Waiver Rates w/all Applicable Rate Adjustments: $1.80 Waiver Nat'l Code: S5100 mod_1: U7 mod_2: U2 INsite Sub_Code: AS24 | |
| X | X | Service: Adult DAY Service - Level 3 UNIT: 0.5 Size: DAY 6/30/06 Waiver Rate: $32.66 7/1/06 Waiver Rates w/all Applicable Rate Adjustments: $34.29 Waiver Nat'l Code: S5101 mod_1: U7 mod_2: U3 INsite Sub_Code: ADS3 | |
| X | X | Service: Adult DAY Service - Level 3 - 1/4 HR UNIT: 0.25 Size: HOUR 6/30/06 Waiver Rate: $2.04 7/1/06 Waiver Rates w/all Applicable Rate Adjustments: $2.14 Waiver Nat'l Code: S5100 mod_1: U7 mod_2: U3 INsite Sub_Code: AS34 | |
| X | X | Service: Adult DAY Service - Transportation UNIT: 1 Size: Trip 6/30/06 Waiver Rate: $16.25 7/1/06 Waiver Rates w/all Applicable Rate Adjustments: $17.06 Waiver Nat'l Code: T2003 mod_1: U7 INsite Sub_Code: ADST | |
| X | Service: Adult Foster Care - Level 1 - DAY UNIT: 1 Size: DAY 6/30/06 Waiver Rate: N/A 7/1/06 Waiver Rates w/all Applicable Rate Adjustments: $40.00 Waiver Nat'l Code: Pending INsite Sub_Code: AF1 | ||
| X | Service: Adult Foster Care - Level 2 - DAY UNIT: 1 Size: DAY 6/30/06 Waiver Rate: N/A 7/1/06 Waiver Rates w/all Applicable Rate Adjustments: $50.00 Waiver Nat'l Code: Pending INsite Sub_Code: AF2 | ||
| X | Service: Adult Foster Care - Level 3 - DAY UNIT: 1 Size: DAY 6/30/06 Waiver Rate: N/A 7/1/06 Waiver Rates w/all Applicable Rate Adjustments: $60.00 Waiver Nat'l Code: Pending INsite Sub_Code: AF3 | ||
| X | X | Service: Assisted Living - Level 1 UNIT: 1 Size: DAY 6/30/06 Waiver Rate: $45.86 7/1/06 Waiver Rates w/all Applicable Rate Adjustments: $52.74 Waiver Nat'l Code: T2031 mod_1: U7 mod_2: U1 INsite Sub_Code: AL1 | |
| X | X | Service: Assisted Living - Level 2 UNIT: 1 Size: DAY 6/30/06 Waiver Rate: $53.78 7/1/06 Waiver Rates w/all Applicable Rate Adjustments: $61.85 Waiver Nat'l Code: T2031 mod_1: U7 mod_2: U2 INsite Sub_Code: AL2 | |
| X | X | Service: Assisted Living - Level 3 UNIT: 1 Size: DAY 6/30/06 Waiver Rate: $61.68 7/1/06 Waiver Rates w/all Applicable Rate Adjustments: $70.93 Waiver Nat'l Code: T2031 mod_1: U7 mod_2: U3 INsite Sub_Code: AL3 | |
| X | Service: Attendant Care (Agency) 15% increase UNIT: 0.25 Size: HOUR 6/30/06 Waiver Rate: $4.00 7/1/06 Waiver Rates w/all Applicable Rate Adjustments: $4.60 Waiver Nat'l Code: S5125 mod_1: U7 mod_2: UA INsite Sub_Code: ATTC | ||
| X | Service: Attendant Care (Agency) 5% increase UNIT: 0.25 Size: HOUR 6/30/06 Waiver Rate: $4.20 7/1/06 Waiver Rates w/all Applicable Rate Adjustments: $4.60 Waiver Nat'l Code: S5125 mod_1: U7 mod_2: UA INsite Sub_Code: ATTC | ||
| X | X | Service: Attendant Care (Non-Agency) UNIT: 0.25 Size: HOUR 6/30/06 Waiver Rate: $2.45 7/1/06 Waiver Rates w/all Applicable Rate Adjustments: $2.57 Waiver Nat'l Code: S5125 mod_1: U7 INsite Sub_Code: ATTC | |
| X | Service: Attendant Care - Consumer-Directed UNIT: 0.25 Size: HOUR 6/30/06 Waiver Rate: N/A 7/1/06 Waiver Rates w/all Applicable Rate Adjustments: $2.70 Waiver Nat'l Code: S5125 mod_1: U7 mod_2: U1 INsite Sub_Code: ATTC | ||
| X | Service: Behavior Management UNIT: 0.25 Size: HOUR 6/30/06 Waiver Rate: $17.38 7/1/06 Waiver Rates w/all Applicable Rate Adjustments: $17.38 Waiver Nat'l Code: H0004 mod_1: U7 mod_2: U2 INsite Sub_Code: BMAN | ||
| X | Service: Behavior Management - Level 1 UNIT: 0.25 Size: HOUR 6/30/06 Waiver Rate: $17.38 7/1/06 Waiver Rates w/all Applicable Rate Adjustments: $17.38 Waiver Nat'l Code: H0004 | ||
| X | X | X | Service: Case Management UNIT: 0.25 Size: HOUR 6/30/06 Waiver Rate: $9.21 7/1/06 Waiver Rates w/all Applicable Rate Adjustments: $9.67 Waiver Nat'l Code: T1016 mod_1: U7 INsite Sub_Code: CMGT |
| X | Service: CommUNITy Transition UNIT: 1 Size: UNIT 6/30/06 Waiver Rate: Individual 7/1/06 Waiver Rates w/all Applicable Rate Adjustments: Individual Waiver Nat'l Code: T2038 mod_1: U7 INsite Sub_Code: CT | ||
| X | Service: Congregate Care - Level 1 UNIT: 1 Size: DAY 6/30/06 Waiver Rate: $24.49 7/1/06 Waiver Rates w/all Applicable Rate Adjustments: $25.71 Waiver Nat'l Code: T2033 mod_1: U7 mod_2: U1 INsite Sub_Code: CC_1 | ||
| X | Service: Congregate Care - Level 2 UNIT: 1 Size: DAY 6/30/06 Waiver Rate: $29.23 7/1/06 Waiver Rates w/all Applicable Rate Adjustments: $30.69 Waiver Nat'l Code: T2033 mod_1: U7 mod_2: U2 INsite Sub_Code: CC_2 | ||
| X | Service: Congregate Care - Level 3 UNIT: 1 Size: DAY 6/30/06 Waiver Rate: $33.98 7/1/06 Waiver Rates w/all Applicable Rate Adjustments: $35.68 Waiver Nat'l Code: T2033 mod_1: U7 mod_2: U3 INsite Sub_Code: CC_3 | ||
| X | X | Service: Environmental Mod - Install UNIT: 1 Size: UNIT 6/30/06 Waiver Rate: Individual 7/1/06 Waiver Rates w/all Applicable Rate Adjustments: Individual Waiver Nat'l Code: S5165 mod_1: U7 mod_2: NU INsite Sub_Code: EMOI/HOMI | |
| X | X | Service: Environmental Mod - Maintain UNIT: 1 Size: UNIT 6/30/06 Waiver Rate: Individual 7/1/06 Waiver Rates w/all Applicable Rate Adjustments: Individual Waiver Nat'l Code: S5165 mod_1: U7 mod_2: RP INsite Sub_Code: EMOI/HOMM | |
| X | Service: Health Care Coordination - Level 1 UNIT: 1 Size: UNIT 6/30/06 Waiver Rate: $48.06 7/1/06 Waiver Rates w/all Applicable Rate Adjustments: $48.06 Waiver Nat'l Code: T2022 mod_1: U7 mod_2: U1 INsite Sub_Code: HCC1 | ||
| X | Service: Health Care Coordination - Level 2 UNIT: 1 Size: UNIT 6/30/06 Waiver Rate: $96.12 7/1/06 Waiver Rates w/all Applicable Rate Adjustments: $96.12 Waiver Nat'l Code: T2022 mod_1: U7 mod_2: U2 INsite Sub_Code: HCC1 | ||
| X | Service: Health Care Coordination - Level 3 UNIT: 1 Size: UNIT 6/30/06 Waiver Rate: $144.18 7/1/06 Waiver Rates w/all Applicable Rate Adjustments: $144.18 Waiver Nat'l Code: T2022 mod_1: U7 mod_2: U3 INsite Sub_Code: HCC1 | ||
| X | Service: Health Care Coordination - Level 4 UNIT: 1 Size: UNIT 6/30/06 Waiver Rate: $192.24 7/1/06 Waiver Rates w/all Applicable Rate Adjustments: $192.24 Waiver Nat'l Code: T2022 mod_1: U7 mod_2: U4 INsite Sub_Code: HCC1 | ||
| X | Service: Home Delivered Meals UNIT: 1 Size: MEAL 6/30/06 Waiver Rate: $4.69 7/1/06 Waiver Rates w/all Applicable Rate Adjustments: $4.92 Waiver Nat'l Code: S5170 mod_1: U7 INsite Sub_Code: HDM | ||
| X | Service: Homemaker (Agency) 15% increase UNIT: 0.25 Size: HOUR 6/30/06 Waiver Rate: $3.00 7/1/06 Waiver Rates w/all Applicable Rate Adjustments: $3.45 Waiver Nat'l Code: S5130 mod_1: U7 mod_2: UA INsite Sub_Code: HMK | ||
| X | Service: Homemaker (Agency) 5% increase UNIT: 0.25 Size: HOUR 6/30/06 Waiver Rate: $3.00 7/1/06 Waiver Rates w/all Applicable Rate Adjustments: $3.15 Waiver Nat'l Code: S5130 mod_1: U7 mod_2: UA INsite Sub_Code: HMK | ||
| X | X | Service: Homemaker (Non-Agency) UNIT: 0.25 Size: HOUR 6/30/06 Waiver Rate: $2.18 7/1/06 Waiver Rates w/all Applicable Rate Adjustments: $2.29 Waiver Nat'l Code: S5130 mod_1: U7 INsite Sub_Code: HMK | |
| X | Service: Nutritional Supplement-Boost/Ensure UNIT: 1 Size: UNIT 6/30/06 Waiver Rate: Individual 7/1/06 Waiver Rates w/all Applicable Rate Adjustments: Individual Waiver Nat'l Code: B4150 mod_1: U7 INsite Sub_Code: NUTS | ||
| X | Service: Occupational Therapy UNIT: 0.25 Size: HOUR 6/30/06 Waiver Rate: $17.99 7/1/06 Waiver Rates w/all Applicable Rate Adjustments: $13.01 Waiver Nat'l Code: G0152 mod_1: U7 mod_2: UA INsite Sub_Code: OCTH | ||
| X | X | Service: Personal Emerg Response System - Insta UNIT: 1 Size: UNIT 6/30/06 Waiver Rate: $52.07 7/1/06 Waiver Rates w/all Applicable Rate Adjustments: $52.07 Waiver Nat'l Code: S5160 mod_1: U7 INsite Sub_Code: PRSI | |
| X | X | Service: Personal Emerg Response System - Mont UNIT: 1 Size: MNTH 6/30/06 Waiver Rate: $52.07 7/1/06 Waiver Rates w/all Applicable Rate Adjustments: $52.07 Waiver Nat'l Code: S5161 mod_1: U7 INsite Sub_Code: PRSM | |
| X | Service: Pest Control UNIT: 1 Size: UNIT 6/30/06 Waiver Rate: Individual 7/1/06 Waiver Rates w/all Applicable Rate Adjustments: Individual Waiver Nat'l Code: T2025 mod_1: U7 mod_2: U1 INsite Sub_Code: PEST | ||
| X | Service: Physical Therapy UNIT: 0.25 Size: HOUR 6/30/06 Waiver Rate: $18.12 7/1/06 Waiver Rates w/all Applicable Rate Adjustments: $13.92 Waiver Nat'l Code: G0151 mod_1: U7 mod_2: UA INsite Sub_Code: PHTH | ||
| X | Service: Residential Based Habilitation UNIT: 0.25 Size: HOUR 6/30/06 Waiver Rate: $6.99 7/1/06 Waiver Rates w/all Applicable Rate Adjustments: $6.99 Waiver Nat'l Code: 97535 mod_1: U7 INsite Sub_Code: RBHA | ||
| X | X | Service: Respite Attendant Care (Agency) UNIT: 0.25 Size: HOUR 6/30/06 Waiver Rate: $4.00 7/1/06 Waiver Rates w/all Applicable Rate Adjustments: $4.00 Waiver Nat'l Code: S5150 mod_1: U7 mod_2: UA mod_3: UC INsite Sub_Code: RATT | |
| X | X | Service: Respite Attendant Care (Non-Agency) UNIT: 0.25 Size: HOUR 6/30/06 Waiver Rate: $2.45 7/1/06 Waiver Rates w/all Applicable Rate Adjustments: $2.45 Waiver Nat'l Code: S5150 mod_1: U7 mod_2: UC INsite Sub_Code: RATT | |
| X | X | Service: Respite Home Health Aide UNIT: 0.25 Size: HOUR 6/30/06 Waiver Rate: $4.00 7/1/06 Waiver Rates w/all Applicable Rate Adjustments: $4.00 Waiver Nat'l Code: S5150 mod_1: U7 mod_2: UA mod_3: U9 INsite Sub_Code: RHHA | |
| X | X | Service: Respite Homemaker (Agency) UNIT: 0.25 Size: HOUR 6/30/06 Waiver Rate: $3.00 7/1/06 Waiver Rates w/all Applicable Rate Adjustments: $3.00 Waiver Nat'l Code: S5150 mod_1: U7 mod_2: UA mod_3: UB INsite Sub_Code: RHMK | |
| X | X | Service: Respite Homemaker (Non-Agency) UNIT: 0.25 Size: HOUR 6/30/06 Waiver Rate: $2.18 7/1/06 Waiver Rates w/all Applicable Rate Adjustments: $2.18 Waiver Nat'l Code: S5150 mod_1: U7 mod_2: UB INsite Sub_Code: RHMK | |
| X | X | Service: Respite Nursing (RN) UNIT: 0.25 Size: HOUR 6/30/06 Waiver Rate: $7.79 7/1/06 Waiver Rates w/all Applicable Rate Adjustments: $7.79 Waiver Nat'l Code: T1005 mod_1: U7 mod_2: UA mod_3: TD/TE INsite Sub_Code: RNUR | |
| X | X | Service: Respite Nursing (LPN) UNIT: 0.25 Size: HOUR 6/30/06 Waiver Rate: $5.91 7/1/06 Waiver Rates w/all Applicable Rate Adjustments: $5.91 Waiver Nat'l Code: T1005 mod_1: U7 mod_2: UA mod_3: TD/TE INsite Sub_Code: RNUR | |
| X | X | Service: Specialized Med Equip/Supplies - Install UNIT: 1 Size: UNIT 6/30/06 Waiver Rate: Individual 7/1/06 Waiver Rates w/all Applicable Rate Adjustments: Individual Waiver Nat'l Code: T2029 mod_1: U7 mod_2: NU INsite Sub_Code: ATCH | |
| X | X | Service: Specialized Med Equip/Supplies - Maintain UNIT: 1 Size: UNIT 6/30/06 Waiver Rate: Individual 7/1/06 Waiver Rates w/all Applicable Rate Adjustments: Individual Waiver Nat'l Code: T2029 mod_1: U7 mod_2: RP INsite Sub_Code: ATCM | |
| X | Service: Speech Therapy UNIT: 0.25 Size: HOUR 6/30/06 Waiver Rate: $18.12 7/1/06 Waiver Rates w/all Applicable Rate Adjustments: $15.15 Waiver Nat'l Code: 92507 mod_1: U7 mod_2: UA INsite Sub_Code: SPTH | ||
| X | Service: Structured DAY Program - Group UNIT: 0.25 Size: HOUR 6/30/06 Waiver Rate: $1.67 7/1/06 Waiver Rates w/all Applicable Rate Adjustments: $1.67 Waiver Nat'l Code: T2021 mod_1: U7 mod_2: HQ INsite Sub_Code: HDG | ||
| X | Service: Structured DAY Program - Individual UNIT: 0.25 Size: HOUR 6/30/06 Waiver Rate: $8.38 7/1/06 Waiver Rates w/all Applicable Rate Adjustments: $8.38 Waiver Nat'l Code: T2021 mod_1: U7 INsite Sub_Code: HDI | ||
| X | Service: Supported Employment UNIT: 0.25 Size: HOUR 6/30/06 Waiver Rate: $9.17 7/1/06 Waiver Rates w/all Applicable Rate Adjustments: $9.17 Waiver Nat'l Code: H2023 mod_1: U7 INsite Sub_Code: HSE | ||
| X | Service: Transportation - Assisted UNIT: 1 Size: MILE 6/30/06 Waiver Rate: $0.56 7/1/06 Waiver Rates w/all Applicable Rate Adjustments: $0.59 Waiver Nat'l Code: T2004 mod_1: U7 mod_2: U2 INsite Sub_Code: TLV2 | ||
| X | X | Service: Transportation - Not Assisted UNIT: 1 Size: MILE 6/30/06 Waiver Rate: $0.28 7/1/06 Waiver Rates w/all Applicable Rate Adjustments: $0.29 Waiver Nat'l Code: T2004 mod_1: U7 mod_2: U1 INsite Sub_Code: TLV1 | |
| X | X | Service: Vehicle Modification - Install UNIT: 1 Size: UNIT 6/30/06 Waiver Rate: Individual 7/1/06 Waiver Rates w/all Applicable Rate Adjustments: Individual Waiver Nat'l Code: T2039 mod_1: U7 INsite Sub_Code: VMOD |
