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Health Care Services Review
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Fee Schedule
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Fee Schedule D Part I
Begin Main Content Area
Page Content
Content Editor
2024 Workers' Compensation Fee Schedule
Table D: Home Health Agency
NPI or Provider #
Provider #
MSA #
Skilled Nursing Rate
Physical Therapy Rate
Speech Therapy Rate
Occupational Therapy Rate
Social Services Rate
Home Aid Allowance
Implied Decimal 2 (in dollars)
1619953775
397001
6680
28429
27331
28396
27185
39418
15299
1386645323
397002
280
28811
27696
28785
27545
39944
15507
1437172301
397004
9280
28449
27342
28414
27195
39438
15312
1871548560
397006
9140
27643
26567
27613
26424
38328
14876
1912983974
397008
6160
33246
31954
33211
31770
46065
17892
1386631513
397009
6160
33246
31954
33211
31770
46065
17892
1215967468
397012
6160
33246
31954
33211
31770
46065
17892
1891755393
397013
4000
29152
28022
29123
27868
40416
15694
1225218761
397014
240
30327
29152
30291
28992
42041
16327
1467412296
397015
6160
33246
31954
33211
31770
46065
17892
1710129762
397021
7560
28180
27092
28147
26942
39069
15166
1821061979
397023
240
30327
29152
30291
28992
42041
16327
1831193598
397025
6160
33246
31954
33211
31770
46065
17892
1598725210
397028
39
27812
29637
30999
29898
46487
12927
1255328191
397029
39
27812
29637
30999
29898
46487
12927
1851394571
397031
7560
28180
27092
28147
26942
39069
15166
1184682528
397032
6160
33246
31954
33211
31770
46065
17892
1932196136
397034
2360
28785
27663
28756
27518
39910
15500
1396797163
397047
3240
29948
28788
29915
28624
41508
16123
1508946948
397050
7560
28180
27092
28147
26942
39069
15166
1043278500
397051
6160
33246
31954
33211
31770
46065
17892
1386631216
397053
39
27812
29637
30999
29898
46487
12927
1891817458
397061
9280
28449
27342
28414
27195
39438
15312
1891741138
397061
9280
28449
27342
28414
27195
39438
15312
1023098985
397071
6280
30954
29761
30925
29589
42907
16665
1811997315
397076
6280
30954
29761
30925
29589
42907
16665
1073579900
397083
6160
33246
31954
33211
31770
46065
17892
1366448268
397086
7560
28180
27092
28147
26942
39069
15166
1730250689
397087
280
28811
27696
28785
27545
39944
15507
1780687913
397089
2360
28785
27663
28756
27518
39910
15500
1063583797
397090
6280
30954
29761
30925
29589
42907
16665
1538143268
397091
39
27812
29637
30999
29898
46487
12927
1760471551
397092
39
27812
29637
30999
29898
46487
12927
1104889567
397094
39
27812
29637
30999
29898
46487
12927
1992705438
397095
39
27812
29637
30999
29898
46487
12927
1437259611
397096
39
27812
29637
30999
29898
46487
12927
1588693410
397097
39
27812
29637
30999
29898
46487
12927
1710941471
397101
39
27812
29637
30999
29898
46487
12927
1265857130
397102
7610
28425
27330
28395
27178
39415
15296
1972577617
397104
6160
33246
31954
33211
31770
46065
17892
1902825896
397105
240
30327
29152
30291
28992
42041
16327
1578503090
397107
6160
33246
31954
33211
31770
46065
17892
1790758928
397116
39
27812
29637
30999
29898
46487
12927
1265438733
397120
39
27812
29637
30999
29898
46487
12927
1992746366
397125
6160
33246
31954
33211
31770
46065
17892
1093702938
397126
8050
30666
29473
30626
29307
42494
16502
1265487029
397128
3240
29948
28788
29915
28624
41508
16123
1508139817
397129
39
27812
29637
30999
29898
46487
12927
1689673022
397130
39
27812
29637
30999
29898
46487
12927
1144203811
397133
39
27812
29637
30999
29898
46487
12927
1336485655
397134
6280
30954
29761
30925
29589
42907
16665
1598719379
397139
6280
30954
29761
30925
29589
42907
16665
1205839156
397141
6280
30954
29761
30925
29589
42907
16665
1164403358
397145
6160
33246
31954
33211
31770
46065
17892
1881004026
397157
2360
28785
27663
28756
27518
39910
15500
1801893219
397167
7560
28180
27092
28147
26942
39069
15166
1366431520
397173
39
27812
29637
30999
29898
46487
12927
1033213186
397183
6280
30954
29761
30925
29589
42907
16665
1659376887
397184
6160
33246
31954
33211
31770
46065
17892
1821027939
397188
6280
30954
29761
30925
29589
42907
16665
1982601852
397196
3680
28253
27158
28219
27013
39173
15214
1598810848
397197
6160
33246
31954
33211
31770
46065
17892
1245282714
397202
280
28811
27696
28785
27545
39944
15507
1306882709
397203
6160
33246
31954
33211
31770
46065
17892
1619956117
397212
6160
33246
31954
33211
31770
46065
17892
1457350548
397214
6680
28429
27331
28396
27185
39418
15299
1881108272
397221
6280
30954
29761
30925
29589
42907
16665
1598711038
397231
6160
33246
31954
33211
31770
46065
17892
1508823923
397232
39
27812
29637
30999
29898
46487
12927
1871590992
397234
6160
33246
31954
33211
31770
46065
17892
1780614412
397237
4000
29152
28022
29123
27868
40416
15694
1174519979
397250
3240
29948
28788
29915
28624
41508
16123
1134171309
397255
6280
30954
29761
30925
29589
42907
16665
1053362012
397259
6280
30954
29761
30925
29589
42907
16665
1366496556
397265
6160
33246
31954
33211
31770
46065
17892
1639103534
397272
7560
28180
27092
28147
26942
39069
15166
1407809114
397278
6280
30954
29761
30925
29589
42907
16665
1942255237
397282
6160
33246
31954
33211
31770
46065
17892
1053304345
397286
7560
28180
27092
28147
26942
39069
15166
1972642551
397294
6280
30954
29761
30925
29589
42907
16665
1518952456
397302
6160
33246
31954
33211
31770
46065
17892