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Health Care Services Review
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Fee Schedule
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Fee Schedule D Part I
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2023 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
27336
26280
27304
26139
37902
14711
1386645323
397002
280
27703
26631
27678
26486
38408
14911
1437172301
397004
9280
27355
26290
27321
26149
37921
14723
1871548560
397006
9140
26580
25545
26551
25408
36854
14304
1912983974
397008
6160
31967
30725
31934
30548
44293
17204
1386631513
397009
6160
31967
30725
31934
30548
44293
17204
1215967468
397012
6160
31967
30725
31934
30548
44293
17204
1891755393
397013
4000
28031
26944
28003
26796
38862
15090
1225218761
397014
240
29161
28031
29126
27877
40424
15699
1467412296
397015
6160
31967
30725
31934
30548
44293
17204
1710129762
397021
7560
27096
26050
27064
25906
37566
14583
1821061979
397023
240
29161
28031
29126
27877
40424
15699
1831193598
397025
6160
31967
30725
31934
30548
44293
17204
1598725210
397028
39
26742
28497
29807
28748
44699
12430
1255328191
397029
39
26742
28497
29807
28748
44699
12430
1851394571
397031
7560
27096
26050
27064
25906
37566
14583
1184682528
397032
6160
31967
30725
31934
30548
44293
17204
1932196136
397034
2360
27678
26599
27650
26460
38375
14904
1396797163
397047
3240
28796
27681
28764
27523
39912
15503
1508946948
397050
7560
27096
26050
27064
25906
37566
14583
1043278500
397051
6160
31967
30725
31934
30548
44293
17204
1386631216
397053
39
26742
28497
29807
28748
44699
12430
1891817458
397061
9280
27355
26290
27321
26149
37921
14723
1891741138
397061
9280
27355
26290
27321
26149
37921
14723
1023098985
397071
6280
29763
28616
29736
28451
41257
16024
1811997315
397076
6280
29763
28616
29736
28451
41257
16024
1073579900
397083
6160
31967
30725
31934
30548
44293
17204
1366448268
397086
7560
27096
26050
27064
25906
37566
14583
1730250689
397087
280
27703
26631
27678
26486
38408
14911
1780687913
397089
2360
27678
26599
27650
26460
38375
14904
1063583797
397090
6280
29763
28616
29736
28451
41257
16024
1538143268
397091
39
26742
28497
29807
28748
44699
12430
1760471551
397092
39
26742
28497
29807
28748
44699
12430
1104889567
397094
39
26742
28497
29807
28748
44699
12430
1992705438
397095
39
26742
28497
29807
28748
44699
12430
1437259611
397096
39
26742
28497
29807
28748
44699
12430
1588693410
397097
39
26742
28497
29807
28748
44699
12430
1710941471
397101
39
26742
28497
29807
28748
44699
12430
1265857130
397102
7610
27332
26279
27303
26133
37899
14708
1972577617
397104
6160
31967
30725
31934
30548
44293
17204
1902825896
397105
240
29161
28031
29126
27877
40424
15699
1578503090
397107
6160
31967
30725
31934
30548
44293
17204
1790758928
397116
39
26742
28497
29807
28748
44699
12430
1265438733
397120
39
26742
28497
29807
28748
44699
12430
1992746366
397125
6160
31967
30725
31934
30548
44293
17204
1093702938
397126
8050
29487
28339
29448
28180
40860
15867
1265487029
397128
3240
28796
27681
28764
27523
39912
15503
1508139817
397129
39
26742
28497
29807
28748
44699
12430
1689673022
397130
39
26742
28497
29807
28748
44699
12430
1144203811
397133
39
26742
28497
29807
28748
44699
12430
1336485655
397134
6280
29763
28616
29736
28451
41257
16024
1598719379
397139
6280
29763
28616
29736
28451
41257
16024
1205839156
397141
6280
29763
28616
29736
28451
41257
16024
1164403358
397145
6160
31967
30725
31934
30548
44293
17204
1881004026
397157
2360
27678
26599
27650
26460
38375
14904
1801893219
397167
7560
27096
26050
27064
25906
37566
14583
1366431520
397173
39
26742
28497
29807
28748
44699
12430
1033213186
397183
6280
29763
28616
29736
28451
41257
16024
1659376887
397184
6160
31967
30725
31934
30548
44293
17204
1821027939
397188
6280
29763
28616
29736
28451
41257
16024
1982601852
397196
3680
27166
26113
27134
25974
37666
14629
1598810848
397197
6160
31967
30725
31934
30548
44293
17204
1245282714
397202
280
27703
26631
27678
26486
38408
14911
1306882709
397203
6160
31967
30725
31934
30548
44293
17204
1619956117
397212
6160
31967
30725
31934
30548
44293
17204
1457350548
397214
6680
27336
26280
27304
26139
37902
14711
1881108272
397221
6280
29763
28616
29736
28451
41257
16024
1598711038
397231
6160
31967
30725
31934
30548
44293
17204
1508823923
397232
39
26742
28497
29807
28748
44699
12430
1871590992
397234
6160
31967
30725
31934
30548
44293
17204
1780614412
397237
4000
28031
26944
28003
26796
38862
15090
1174519979
397250
3240
28796
27681
28764
27523
39912
15503
1134171309
397255
6280
29763
28616
29736
28451
41257
16024
1053362012
397259
6280
29763
28616
29736
28451
41257
16024
1366496556
397265
6160
31967
30725
31934
30548
44293
17204
1639103534
397272
7560
27096
26050
27064
25906
37566
14583
1407809114
397278
6280
29763
28616
29736
28451
41257
16024
1942255237
397282
6160
31967
30725
31934
30548
44293
17204
1053304345
397286
7560
27096
26050
27064
25906
37566
14583
1972642551
397294
6280
29763
28616
29736
28451
41257
16024
1518952456
397302
6160
31967
30725
31934
30548
44293
17204