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Fee Schedule
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Fee Schedule D Part I
Begin Main Content Area
Page Content
2022 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
25862
24863
25832
24729
35858
13918
1386645323
397002
280
26209
25195
26185
25058
36337
14107
1437172301
397004
9280
25880
24872
25848
24739
35876
13929
1871548560
397006
9140
25147
24167
25119
24038
34867
13533
1912983974
397008
6160
30243
29068
30212
28901
41904
16276
1386631513
397009
6160
30243
29068
30212
28901
41904
16276
1215967468
397012
6160
30243
29068
30212
28901
41904
16276
1891755393
397013
4000
26519
25491
26493
25351
36766
14276
1225218761
397014
240
27588
26519
27555
26374
38244
14852
1467412296
397015
6160
30243
29068
30212
28901
41904
16276
1710129762
397021
7560
25635
24645
25605
24509
35540
13797
1821061979
397023
240
27588
26519
27555
26374
38244
14852
1831193598
397025
6160
30243
29068
30212
28901
41904
16276
1598725210
397028
39
25300
26960
28200
27198
42289
11760
1255328191
397029
39
25300
26960
28200
27198
42289
11760
1851394571
397031
7560
25635
24645
25605
24509
35540
13797
1184682528
397032
6160
30243
29068
30212
28901
41904
16276
1932196136
397034
2360
26185
25165
26159
25033
36306
14100
1396797163
397047
3240
27243
26188
27213
26039
37760
14667
1508946948
397050
7560
25635
24645
25605
24509
35540
13797
1043278500
397051
6160
30243
29068
30212
28901
41904
16276
1386631216
397053
39
25300
26960
28200
27198
42289
11760
1891817458
397061
9280
25880
24872
25848
24739
35876
13929
1891741138
397061
9280
25880
24872
25848
24739
35876
13929
1023098985
397071
6280
28158
27073
28132
26917
39032
15160
1811997315
397076
6280
28158
27073
28132
26917
39032
15160
1073579900
397083
6160
30243
29068
30212
28901
41904
16276
1366448268
397086
7560
25635
24645
25605
24509
35540
13797
1730250689
397087
280
26209
25195
26185
25058
36337
14107
1780687913
397089
2360
26185
25165
26159
25033
36306
14100
1063583797
397090
6280
28158
27073
28132
26917
39032
15160
1538143268
397091
39
25300
26960
28200
27198
42289
11760
1760471551
397092
39
25300
26960
28200
27198
42289
11760
1104889567
397094
39
25300
26960
28200
27198
42289
11760
1992705438
397095
39
25300
26960
28200
27198
42289
11760
1437259611
397096
39
25300
26960
28200
27198
42289
11760
1588693410
397097
39
25300
26960
28200
27198
42289
11760
1710941471
397101
39
25300
26960
28200
27198
42289
11760
1265857130
397102
7610
25858
24862
25831
24724
35855
13915
1972577617
397104
6160
30243
29068
30212
28901
41904
16276
1902825896
397105
240
27588
26519
27555
26374
38244
14852
1578503090
397107
6160
30243
29068
30212
28901
41904
16276
1790758928
397116
39
25300
26960
28200
27198
42289
11760
1265438733
397120
39
25300
26960
28200
27198
42289
11760
1992746366
397125
6160
30243
29068
30212
28901
41904
16276
1093702938
397126
8050
27897
26811
27860
26660
38657
15011
1265487029
397128
3240
27243
26188
27213
26039
37760
14667
1508139817
397129
39
25300
26960
28200
27198
42289
11760
1689673022
397130
39
25300
26960
28200
27198
42289
11760
1144203811
397133
39
25300
26960
28200
27198
42289
11760
1336485655
397134
6280
28158
27073
28132
26917
39032
15160
1598719379
397139
6280
28158
27073
28132
26917
39032
15160
1205839156
397141
6280
28158
27073
28132
26917
39032
15160
1164403358
397145
6160
30243
29068
30212
28901
41904
16276
1881004026
397157
2360
26185
25165
26159
25033
36306
14100
1801893219
397167
7560
25635
24645
25605
24509
35540
13797
1366431520
397173
39
25300
26960
28200
27198
42289
11760
1033213186
397183
6280
28158
27073
28132
26917
39032
15160
1659376887
397184
6160
30243
29068
30212
28901
41904
16276
1821027939
397188
6280
28158
27073
28132
26917
39032
15160
1982601852
397196
3680
25701
24705
25671
24573
35635
13840
1598810848
397197
6160
30243
29068
30212
28901
41904
16276
1245282714
397202
280
26209
25195
26185
25058
36337
14107
1306882709
397203
6160
30243
29068
30212
28901
41904
16276
1619956117
397212
6160
30243
29068
30212
28901
41904
16276
1457350548
397214
6680
25862
24863
25832
24729
35858
13918
1881108272
397221
6280
28158
27073
28132
26917
39032
15160
1598711038
397231
6160
30243
29068
30212
28901
41904
16276
1508823923
397232
39
25300
26960
28200
27198
42289
11760
1871590992
397234
6160
30243
29068
30212
28901
41904
16276
1780614412
397237
4000
26519
25491
26493
25351
36766
14276
1174519979
397250
3240
27243
26188
27213
26039
37760
14667
1134171309
397255
6280
28158
27073
28132
26917
39032
15160
1053362012
397259
6280
28158
27073
28132
26917
39032
15160
1366496556
397265
6160
30243
29068
30212
28901
41904
16276
1639103534
397272
7560
25635
24645
25605
24509
35540
13797
1407809114
397278
6280
28158
27073
28132
26917
39032
15160
1942255237
397282
6160
30243
29068
30212
28901
41904
16276
1053304345
397286
7560
25635
24645
25605
24509
35540
13797
1972642551
397294
6280
28158
27073
28132
26917
39032
15160
1518952456
397302
6160
30243
29068
30212
28901
41904
16276