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Medical Fee Review
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Fee Schedule
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Fee Schedule D Part I
Begin Main Content Area
Page Content
2019 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
22497
21628
22470
21511
31192
12107
1386645323
397002
280
22798
21917
22778
21797
31608
12272
1437172301
397004
9280
22512
21635
22485
21519
31208
12116
1871548560
397006
9140
21875
21022
21851
20910
30330
11772
1912983974
397008
6160
26307
25285
26280
25141
36451
14158
1386631513
397009
6160
26307
25285
26280
25141
36451
14158
1215967468
397012
6160
26307
25285
26280
25141
36451
14158
1891755393
397013
4000
23068
22174
23046
22051
31982
12418
1225218761
397014
240
23998
23068
23969
22942
33267
12919
1467412296
397015
6160
26307
25285
26280
25141
36451
14158
1710129762
397021
7560
22299
21437
22274
21320
30916
12002
1821061979
397023
240
23998
23068
23969
22942
33267
12919
1831193598
397025
6160
26307
25285
26280
25141
36451
14158
1598725210
397028
39
22008
23452
24531
23659
36786
10230
1255328191
397029
39
22008
23452
24531
23659
36786
10230
1851394571
397031
7560
22299
21437
22274
21320
30916
12002
1184682528
397032
6160
26307
25285
26280
25141
36451
14158
1932196136
397034
2360
22778
21890
22755
21775
31581
12265
1396797163
397047
3240
23697
22781
23671
22651
32846
12758
1508946948
397050
7560
22299
21437
22274
21320
30916
12002
1043278500
397051
6160
26307
25285
26280
25141
36451
14158
1386631216
397053
39
22008
23452
24531
23659
36786
10230
1891817458
397061
9280
22512
21635
22485
21519
31208
12116
1891741138
397061
9280
22512
21635
22485
21519
31208
12116
1023098985
397071
6280
24494
23550
24470
23414
33952
13187
1811997315
397076
6280
24494
23550
24470
23414
33952
13187
1073579900
397083
6160
26307
25285
26280
25141
36451
14158
1366448268
397086
7560
22299
21437
22274
21320
30916
12002
1730250689
397087
280
22798
21917
22778
21797
31608
12272
1780687913
397089
2360
22778
21890
22755
21775
31581
12265
1063583797
397090
6280
24494
23550
24470
23414
33952
13187
1538143268
397091
39
22008
23452
24531
23659
36786
10230
1760471551
397092
39
22008
23452
24531
23659
36786
10230
1104889567
397094
39
22008
23452
24531
23659
36786
10230
1992705438
397095
39
22008
23452
24531
23659
36786
10230
1437259611
397096
39
22008
23452
24531
23659
36786
10230
1588693410
397097
39
22008
23452
24531
23659
36786
10230
1710941471
397101
39
22008
23452
24531
23659
36786
10230
1265857130
397102
7610
22493
21627
22469
21506
31189
12104
1972577617
397104
6160
26307
25285
26280
25141
36451
14158
1902825896
397105
240
23998
23068
23969
22942
33267
12919
1578503090
397107
6160
26307
25285
26280
25141
36451
14158
1790758928
397116
39
22008
23452
24531
23659
36786
10230
1265438733
397120
39
22008
23452
24531
23659
36786
10230
1992746366
397125
6160
26307
25285
26280
25141
36451
14158
1093702938
397126
8050
24267
23322
24235
23190
33627
13058
1265487029
397128
3240
23697
22781
23671
22651
32846
12758
1508139817
397129
39
22008
23452
24531
23659
36786
10230
1689673022
397130
39
22008
23452
24531
23659
36786
10230
1144203811
397133
39
22008
23452
24531
23659
36786
10230
1336485655
397134
6280
24494
23550
24470
23414
33952
13187
1598719379
397139
6280
24494
23550
24470
23414
33952
13187
1205839156
397141
6280
24494
23550
24470
23414
33952
13187
1164403358
397145
6160
26307
25285
26280
25141
36451
14158
1881004026
397157
2360
22778
21890
22755
21775
31581
12265
1801893219
397167
7560
22299
21437
22274
21320
30916
12002
1366431520
397173
39
22008
23452
24531
23659
36786
10230
1033213186
397183
6280
24494
23550
24470
23414
33952
13187
1659376887
397184
6160
26307
25285
26280
25141
36451
14158
1821027939
397188
6280
24494
23550
24470
23414
33952
13187
1982601852
397196
3680
22357
21490
22331
21375
30998
12039
1598810848
397197
6160
26307
25285
26280
25141
36451
14158
1245282714
397202
280
22798
21917
22778
21797
31608
12272
1306882709
397203
6160
26307
25285
26280
25141
36451
14158
1619956117
397212
6160
26307
25285
26280
25141
36451
14158
1457350548
397214
6680
22497
21628
22470
21511
31192
12107
1700997244
397221
6280
24494
23550
24470
23414
33952
13187
1598711038
397231
6160
26307
25285
26280
25141
36451
14158
1508823923
397232
39
22008
23452
24531
23659
36786
10230
1871590992
397234
6160
26307
25285
26280
25141
36451
14158
1780614412
397237
4000
23068
22174
23046
22051
31982
12418
1174519979
397250
3240
23697
22781
23671
22651
32846
12758
1134171309
397255
6280
24494
23550
24470
23414
33952
13187
1053362012
397259
6280
24494
23550
24470
23414
33952
13187
1366496556
397265
6160
26307
25285
26280
25141
36451
14158
1639103534
397272
7560
22299
21437
22274
21320
30916
12002
1407809114
397278
6280
24494
23550
24470
23414
33952
13187
1942255237
397282
6160
26307
25285
26280
25141
36451
14158
1053304345
397286
7560
22299
21437
22274
21320
30916
12002
1972642551
397294
6280
24494
23550
24470
23414
33952
13187
1518952456
397302
6160
26307
25285
26280
25141
36451
14158