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PA Bulletin, Doc. No. 18-155

NOTICES

DEPARTMENT OF HUMAN SERVICES

Fee Schedule Rates and Department-Established Fees for Consolidated and Person/Family Directed Support Waivers Services, Targeted Services Management and the Community Intellectual Disability Base-Funded Program

[48 Pa.B. 688]
[Saturday, January 27, 2018]

 The Department of Human Services (Department) is providing final notice of the Fee Schedule Rates for Targeted Service Management and select services funded through the Consolidated and Person/Family Directed Support waivers and Department-established fees for residential ineligible services, effective July 1, 2017, as well as new services the Department will be placing on the Medical Assistance program fee schedule beginning January 1, 2018, and services that will no longer be available effective January 1, 2018.

 These Fee Schedule Rates also serve as the Department-established fees under 55 Pa. Code § 4300.115(a) (relating to Department established fees) for base-funded services managed through county programs for individuals with an intellectual disability under the Mental Health and Intellectual Disability Act of 1966 (50 P.S. §§ 4101—4704), 55 Pa. Code Chapter 4300 (relating to county mental health and intellectual disability fiscal manual) and 55 Pa. Code Chapter 51 (relating to Office of Developmental Programs home and community-based services).

 The Department published its proposed Fee Schedule Rates and Department-established fees for residential ineligible services at 47 Pa.B 4905 (August 19, 2017). The Department received comments from 33 people and organizations. As a result of the comments received, the Department made changes to Agency with Choice/Financial Management Services (AWC/FMS) rates for In-Home and Community Support and Respite (15-minute and Day) services effective July 1, 2017. In addition, the following errors have been corrected from the proposed Fee Schedule Rates:

 • The rates for Enhanced Communication for Supports Coordination and Targeted Services Management were removed.

 • There was a typographical error in the proposed rate for Community Participation Support procedure code W5967. The proposed rate was listed as $5.59 when the actual rate developed was $6.59.

 A summary of the comments received and the Department's responses is available at http://dhs.pa.gov/cs/groups/webcontent/documents/document/c_268077.pdf.

Fee Schedule Rates for Community-Based Services Effective July 1, 2017

 The Supports Coordination fee identified as follows is also applicable to base-funded supports coordination.

 Modifier SE is used to identify the amount of units that are being billed when the individual spent time in the community during the provision of Community Participation Support services.

 Modifier SE is used when billing for Benefits Counseling to identify that it is an ODP service.

 Modifier SE is used when billing for Music Therapy.

 Modifier SE is used when billing for Consultative Nutritional Services to identify that it is an ODP service.

 Modifier SE is used when billing for Family Caregiver Support Counseling to identify that it is an ODP service.

 Modifier TD is used to identify services rendered by a Registered Nurse (RN).

 Modifier TE is used to identify services rendered by a Licensed Practical Nurse (LPN).

 Modifiers U5, U6, U7 and U8 are Support Intensity Scale Needs Group Modifiers.

 Modifier UD is used to when billing for Advanced Supported Employment.

 Modifier GP is used to identify services rendered by a Physical Therapist.

 Modifier GO is used to identify services rendered by an Occupational Therapist.

 Modifier GN is used to identify services rendered by a Speech and Language Therapist.

 Modifier UN is used to identify shift nursing at the 1:2 ratio.

 Modifier UA is used to identify the Homemaker/Chore service when it authorized as a temporary service.

 Modifier U1 is utilized with the appropriate procedure code to allow providers, who are approved by the Department, to receive the Enhanced Communication Services Rate.

 All rates in the table are per 15-minute unit unless otherwise noted.

Service Name Staffing Level Procedure Code Modifier 1 Modifier 2 Statewide Fee Enhanced Communication Statewide Fee (U1 modifier)
Companion Services 1:3 W1724 $2.64 $3.03
1:2 W1725 $3.67 $4.25
1:1 W1726 $6.33 $7.43
Homemaker/Chore 1:1 W7283 $16.73 (per hour) N/A
1:1 (temporary) W7283 UA $16.73 (per hour) N/A
In-Home and Community Supports 1:3 W7058 $3.17 $3.67
1:2 W7059 $4.52 $5.27
1:1 W7060 $8.08 $9.48
1:1 enhanced W7061 TD and TE $11.44 $13.74
2:1 W7068 $15.72 $18.52
2:1 enhanced W7069 TD and TE $19.07 $22.77
Older Adult Daily Living Centers N/A W7094 $2.73 $3.08
Community Participation Support <25% Community 1:2 or 1:3 and >75% Facility 1:11 to 1:15 W5945 SE $2.45 $2.75
<25% Community 1:2 or 1:3 and >75% Facility 1:7 to 1:10 W5946 SE $2.75 $3.10
<25% Community 1:2 or 1:3 and >75% Facility 1:2 to 1:6 W5947 SE $4.45 $5.10
<25% Community 1:1 and >75% Facility 1:7 to 1:15 W5948 SE $3.70 $4.23
<25% Community 1:1 and >75% Facility 1:2 to 1:6 W5950 SE $5.58 $6.44
<25% Community 1:1 and >75% Facility 1:1 W5951 SE $9.55 $11.17
<25% Community 1:1 Enhanced and >75% Facility 1:1 Enhanced W5952 SE TD and TE $13.28 $15.91
<25% Community 2:1 and >75% Facility 2:1 to 1:1 W5943 SE $18.32 $21.55
<25% Community 2:1 Enhanced and >75% Facility 2:1 Enhanced W5944 SE TD and TE $22.05 $26.29
<25% Community 2:3 and >75% Facility 1:11 to 1:15 W5940 SE $3.14 $3.57
<25% Community 2:3 and >75% Facility 1:7 to 1:10 W5941 SE $3.43 $3.92
<25% Community 2:3 and >75% Facility 1:2 to 1:6 W5942 SE $5.14 $5.92
25% Community 1:2 or 1:3 and 75% Facility 1:11 to 1:15 W5958 SE $2.93 $3.32
25% Community 1:2 or 1:3 and 75% Facility 1:7 to 1:10 W5959 SE $3.17 $3.60
25% Community 1:2 or 1:3 and 75% Facility 1:2 to 1:6 W5960 SE $4.57 $5.25
25% Community 1:1 and 75% Facility 1:7 to 1:15 W5961 SE $4.79 $5.53
25% Community 1:1 and 75% Facility 1:2 to 1:6 W5962 SE $6.33 $7.35
25% Community 1:1 and 75% Facility 1:1 W5963 SE $9.60 $11.23
Community Participation Support (Continued) 25% Community 1:1 Enhanced and 75% Facility 1:1 Enhanced W5964 SE TD and TE $13.36 $16.00
25% Community 2:1 and 75% Facility 2:1 W5956 SE $18.43 $21.68
25% Community 2:1 Enhanced and 75% Facility 2:1 Enhanced W5957 SE TD and TE $22.18 $26.45
25% Community 2:3 and 75% Facility 1:11 to 1:15 W5953 SE $4.00 $4.60
25% Community 2:3 and 75% Facility 1:7 to 1:10 W5954 SE $4.25 $4.88
25% Community 2:3 and 75% Facility 1:2 to 1:6 W5955 SE $5.65 $6.53
50% Community 1:2 or 1:3 and 50% Facility 1:11 to 1:15 W5970 SE $3.81 $4.36
50% Community 1:2 or 1:3 and 50% Facility 1:7 to 1:10 W5971 SE $3.96 $4.53
50% Community 1:2 or 1:3 and 50% Facility 1:2 to 1:6 W5972 SE $4.80 $5.52
50% Community 1:1 and 50% Facility 1:7 to 1:15 W5973 SE $6.81 $7.92
50% Community 1:1 and 50% Facility 1:2 to 1:6 W5974 SE $7.74 $9.02
50% Community 1:1 and 50% Facility 1:1 W5975 SE $9.70 $11.35
50% Community 1:1 Enhanced and 50% Facility 1:1 Enhanced W5976 SE TD and TE $13.49 $16.16
50% Community 2:1 and 50% Facility 2:1 W5968 SE $18.63 $21.93
50% Community 2:1 Enhanced and 50% Facility 2:1 Enhanced W5969 SE TD and TE $22.42 $26.74
50% Community 2:3 and 50% Facility 1:11 to 1:15 W5965 SE $5.61 $6.50
50% Community 2:3 and 50% Facility 1:7 to 1:10 W5966 SE $5.75 $6.67
50% Community 2:3 and 50% Facility 1:2 to 1:6 W5967 SE $6.59 $7.66
Community Participation Support (Continued) 75% Community 1:2 or 1:3 and 25% Facility 1:11 to 1:15 W5982 SE $4.70 $5.41
75% Community 1:2 or 1:3 and 25% Facility 1:7 to 1:10 W5983 SE $4.75 $5.46
75% Community 1:2 or 1:3 and 25% Facility 1:2 to 1:6 W5984 SE $5.03 $5.79
75% Community 1:1 and 25% Facility 1:7 to 1:15 W5985 SE $8.83 $10.32
75% Community 1:1 and 25% Facility 1:2 to 1:6 W5990 SE $9.14 $10.69
75% Community 1:1 and 25% Facility 1:1 W5991 SE $9.79 $11.46
75% Community 1:1 Enhanced and 25% Facility 1:1 Enhanced W5992 SE TD and TE $13.62 $16.32
75% Community 2:1 and 25% Facility 2:1 W5980 SE $18.84 $22.18
75% Community 2:1 Enhanced and 25% Facility 2:1 Enhanced W5981 SE TD and TE $22.66 $27.03
75% Community 2:3 and 25% Facility 1:11 to 1:15 W5977 SE $7.21 $8.40
75% Community 2:3 and 25% Facility 1:7 to 1:10 W5978 SE $7.26 $8.46
75% Community 2:3 and 25% Facility 1:2 to 1:6 W5979 SE $7.54 $8.79
100% Community 1:2 or 1:3 W5995 $5.14 $5.93
100% Community 2:3 H2015 $8.01 $9.35
100% Community 1:1 W5996 $9.84 $11.52
100% Community 1:1 Enhanced W5997 TD and TE $13.68 $16.40
100% Community 2:1 W5993 $18.94 $22.30
100% Community 2:1 Enhanced W5994 TD and TE $22.78 $27.18
Small Group Employment 1:10 to 1:6 W7237 $2.21 $2.65
< 1:6 to 1:3.5 W7239 $3.40 $4.09
< 1:3.5 to > 1:1 W7241 $6.60 $7.95
1:1 W7245 $12.05 $14.53
Benefits Counseling 1:1 W1740 SE $11.40 $13.57
Supported Employment—Career Assessment 1:1 W7235 $17.75 $21.12
Supported Employment—Job Finding and Development 1:1 H2023 $17.75 $21.12
Supported Employment—Job Coaching and Support 1:2 H2025 $10.45 $12.40
1:1 W9794 $17.75 $21.12
Advanced Supported Employment 1:1 (Discovery Profile Outcome) W7235 UD $3,810.00 $4,594.00
Advanced Supported Employment 1:1 (Job Acquisition Outcome) H2023 UD $3,810.00 $4,594.00
Advanced Supported Employment 1:1 (Job Retention Outcome) H2025 UD $9,144.00 $11,025.60
Service Name Staffing Level Procedure Code Modifier 1 Modifier 2 Statewide Fee Enhanced Communication Statewide Fee (U1 modifier)
Shift Nursing—RN 1:2 T2025 TD UN $8.06 $9.90
1:1 T2025 TD $15.78 $19.46
Shift Nursing—LPN 1:2 T2025 TE UN $5.88 $7.13
1:1 T2025 TE $11.41 $13.92
Therapies—Physical 1:1 T2025 GP $21.29 $26.46
Therapies—Occupational 1:1 T2025 GO $19.71 $24.45
Therapies—Speech/ Language 1:1 T2025 GN $19.12 $23.71
Therapies—Orientation, Mobility, and Vision 1:1 W7246 $18.16 $22.48
Music Therapy 1:1 G0176 SE $15.34 $18.93
Art Therapy 1:1 G0176 $15.34 $18.93
Equine Assisted Therapy 1:1 S8940 $10.36 $12.30
Behavioral Supports—
Level 1 		1:1 W7095 $21.12 $25.44
Behavioral Supports—
Level 2 		1:1 W8996 $21.39 $26.42
Communication Specialist 1:1 T1013 $15.32 $18.90
Consultative Nutritional Services 1:1 S9470 SE $12.36 $15.15
Family Caregiver Support Counseling 1:1 without participant present 90846 SE $12.12 N/A
1:1 with participant present 90847 SE $12.12 $14.85
24 Hour Respite (In-Home Respite and Unlicensed Out-of-Home Respite Services) 1:4 W9795 $69.86
(per day) 		$83.12
(per day)
1:3 W9796 $93.09
(per day) 		$110.78
(per day)
1:2 W9797 $139.56 (per day) $166.10
(per day)
1:1 W9798 $245.13 (per day) $291.75
(per day)
1:1 Enhanced W9799 $416.93 (per day) $509.93
(per day)
2:1 W9800 $490.11
(per day) 		$583.34
(per day)
2:1 Enhanced W9801 $661.90 (per day) $801.53
(per day)
15 Minute Respite (In-Home Respite and Unlicensed Out-of-Home Respite Services) 1:4 W8096 $1.75 $2.08
1:3 W9860 $2.33 $2.77
1:2 W9861 $3.49 $4.15
1:1 W9862 $6.13 $7.29
1:1 Enhanced W9863 $10.42 $12.75
2:1 W9864 $12.25 $14.58
2:1 Enhanced W8095 $16.55 $20.04
24 Hour Respite (Licensed Respite Group Homes) Needs Group
1-2 Person 		W9791 U5 $456.17 (per day) $543.52
(per day)
Needs Group
1-3 Person 		W9792 U5 $331.94 (per day) $395.06
(per day)
Needs Group
1-4 Person 		W9793 U5 $263.76 (per day) $313.54
(per day)
Needs Group
2-2 Person 		W9791 U6 $538.09 (per day) $643.36
(per day)
Needs Group
2-3 Person 		W9792 U6 $365.87 (per day) $436.50
(per day)
Needs Group
2-4 Person 		W9793 U6 $292.42 (per day) $348.59
(per day)
Needs Group
3-1 Person 		W9790 U7 $787.76 (per day) $940.81
(per day)
Needs Group
3-2 Person 		W9791 U7 $644.77 (per day) $774.54
(per day)
Needs Group
3-3 Person 		W9792 U7 $457.38 (per day) $548.81
(per day)
Needs Group
3-4 Person 		W9793 U7 $360.12 (per day) $431.68
(per day)
Needs Group
4-1 Person 		W9790 U8 $861.70 (per day) $1,034.28
(per day)
Needs Group
4-2 Person 		W9791 U8 $702.24 (per day) $847.32
(per day)
Needs Group
4-3 Person 		W9792 U8 $499.39 (per day) $601.96
(per day)
Needs Group
4-4 Person 		W9793 U8 $393.36 (per day) $473.69
(per day)
24 Hour Respite (Respite Only Home) Needs Group 1-2 Person W9865 U5 $520.58 (per day) $620.26
(per day)
Needs Group 1-3 Person W9866 U5 $378.80 (per day) $450.83
(per day)
Needs Group 1-4 Person W9871 U5 $300.98 (per day) $357.79
(per day)
Needs Group 2-2 Person W9865 U6 $614.06 (per day) $734.20
(per day)
Needs Group 2-3 Person W9866 U6 $417.52 (per day) $498.13
(per day)
Needs Group 2-4 Person W9871 U6 $333.70 (per day) $397.80
(per day)
Needs Group 3-2 Person W9865 U7 $735.80 (per day) $883.89
(per day)
Needs Group 3-3 Person W9866 U7 $521.94 (per day) $626.29
(per day)
Needs Group 3-4 Person W9871 U7 $410.95 (per day) $492.62
(per day)
Needs Group 4-2 Person W9865 U8 $801.39 (per day) $966.95
(per day)
Needs Group 4-3 Person W9866 U8 $569.89 (per day) $686.95
(per day)
Needs Group 4-4 Person W9871 U8 $448.88 (per day) $540.56
(per day)
Supports Broker Services 1:1 W7096 $16.88 $19.66
Supports Coordination 1:1 W7210 $23.62 N/A
Targeted Services Management 1:1 T1017 $23.62 N/A
Housing Transition and Tenancy Sustaining 1:1 H0043 $10.48 $12.50
Supplemental Habilitation 1:1 W7070 $5.46 $6.67
2:1 W7084 $10.93 $13.32
Additional Individualized Staffing (effective July 1, 2017 through December 31, 2017) 1:1 W7085 $5.46 $6.67
2:1 W7086 $10.93 $13.32
Service Group Needs Group Procedure Code Modifier 1 Modifier 2 Approved Program Capacity or Staffing Level Statewide Fee Enhanced Communication Statewide Fee (U1 modifier)
Supported Living Needs Group 1 W9872 U5 1 Person $133.10 $156.12
W9873 U5 2 People $93.17 $109.29
W9874 U5 3 People $66.55 $78.06
Needs Group 2 W9872 U6 1 Person $208.26 $244.33
W9873 U6 2 People $166.61 $195.47
W9874 U6 3 People $110.79 $129.97
Needs Group 3 W9872 U7 1 Person $341.36 $400.46
W9873 U7 2 People $286.40 $335.98
W9874 U7 3 People $198.17 $232.47
Needs Group 4 W9872 U8 1 Person $428.58 $502.87
W9873 U8 2 People $428.58 $502.87
W9874 U8 3 People $299.32 $351.20

Department-Established Fees Effective July 1, 2017, through December 31, 2017

 All rates in the table are per day.

Service Procedure Code Modifier Unit Statewide Fee
Licensed Community Homes—Ineligible W6091 Day $84.15
W6093 $45.88
W6095 $30.59
W6097 $23.03
W6099 $16.82
Licensed Child Residential Services—Ineligible W7011 Day $84.15
W7013 $45.88
W7015 $30.59
W7017 $23.03
W7019 $16.82
Licensed Community Residential Rehabilitation Services—Ineligible W7021 Day $84.15
W7023 $45.88
W7025 $30.59
W7027 $23.03
W7029 $16.82
Unlicensed Residential Services—Ineligible W7079 Day $20.57
W7081 $12.39
W7083 $6.36

Agency with Choice Financial Management Services, Including Benefit Allowance** Effective July 1, 2017

**No modifier is needed to indicate the benefit allowance is included.

 Modifier TD is used to identify services rendered by a RN.

 Modifier TE is used to identify services rendered by a LPN.

 Modifier U1 is utilized with the appropriate procedure code to allow providers, who are approved by the Department, to receive the Enhanced Communication Services Rate.

 All rates in the table are per 15-minute unit unless otherwise noted.

Service Name Staffing Level Procedure Code Modifier 1 Modifier 2 Statewide Fee Enhanced Communication Statewide Fee (U1 modifier)
In-Home and Community supports 1:1 W7060 $5.74 $6.97
2:1 W7068 $11.48 $13.95
In-Home and Community supports—Enhanced 1:1 (Enhanced) W7061 TD and TE $7.55 $9.34
2:1 (Enhanced) W7069 TD and TE $11.31 $13.86
Companion Services 1:1 W1726 $4.54 $5.51
In-Home Respite and Unlicensed Out-of-Home Respite Services 1:1 W9862 $4.15 $4.84
2:1 W9864 $8.29 $9.66
1:1 W9798 $315.10 (per day) $367.42
(per day)
2:1 W9800 $529.51 (per day) $634.14
(per day)
In-Home Respite and Unlicensed Out-of-Home Respite Services—Enhanced 1:1 W9863 $7.50 $9.28
2:1 W8095 $10.99 $13.45
1:1 W9799 $570.23 (per day) $705.01
(per day)
2:1 W9801 $834.98 (per day) $1,022.08
(per day)
Supported Employment—Career Assessment 1:1 W7235 $6.96 $7.67
Supported Employment—Job Finding and Development 1:1 H2023 $6.96 $7.67
Supported Employment—Job Coaching and Support 1:1 W9794 $6.96 $7.67
Supports Broker 1:1 W7096 $5.42 $6.63
Homemaker/Chore 1:1 W7283 $13.78
(per hour) 		N/A
AWC/FMS Monthly
Administrative Fee 		Per Person
Per Month 		W7319 $231.21 N/A

Agency with Choice Financial Management Services, Excluding Benefit Allowance Effective July 1, 2017

**Modifier U4 must be used with all procedures codes when billing for services excluding benefit allowance.

 Modifier TD is used to identify services rendered by a RN.

 Modifier TE is used to identify services rendered by a LPN.

 Modifier U1 is utilized with the appropriate procedure code to allow providers, who are approved by the Department, to receive the Enhanced Communication Services Rate.

 All rates in the table are per 15 minute unit unless otherwise noted.

Service Name Staffing Level Procedure Code Modifier 1 Modifier 2 Statewide Fee Enhanced Communication Statewide Fee (U1 Modifier)
In-Home and Community supports 1:1 W7060 U4 $5.11 $6.34
2:1 W7068 U4 $10.22 $12.69
Companion Services 1:1 W1726 U4 $3.92 $4.89
In-Home Respite and Unlicensed Out-of-Home Respite Services 1:1 W9862 U4 $3.52 $4.27
2:1 W9864 U4 $7.03 $8.40
1:1 W9798 U4 $267.22 (per day) $319.54
(per day)
2:1 W9800 U4 $445.36 (per day) $549.99
(per day)
In-Home and Community supports—Enhanced 1:1 W7061 U4 TD and TE $6.93 $8.72
2:1 W7069 U4 TD and TE $10.07 $12.61
In-Home Respite and Unlicensed Out-of-Home Respite Services—Enhanced 1:1 W9863 U4 $6.88 $8.66
2:1 W8095 U4 $9.75 $12.21
1:1 W9799 U4 $523.05 (per day) $657.84
(per day)
2:1 W9801 U4 $740.63 (per day) $927.74
(per day)
Supported Employment—Career Assessment 1:1 W7235 U4 $6.34 $7.04
Supported Employment—Job Finding and Development 1:1 H2023 U4 $6.34 $7.04
Supported Employment—Job Coaching and Support 1:1 W9794 U4 $6.34 $7.04
Supports Broker 1:1 W7096 U4 $4.80 $6.00
Homemaker/Chore 1:1 W7283 U4 $11.29
(per hour) 		N/A
AWC/FMS Monthly
Administrative Fee 		Per Person
Per Month 		W7319 $231.21 N/A

Fee Schedule Rates Effective January 1, 2018

 The modifier HI is used when the individual is not receiving Waiver-funded service during the day.

 The modifier SE is used when the Life Sharing Service is being provided by a family member.

 Modifier TD is used to identify services rendered by a RN.

 Modifier TE is used to identify services rendered by a LPN.

 Modifiers U5, U6, U7 and U8 are Needs Group Modifiers.

 Modifier U1 is utilized with the appropriate procedure code to allow providers, who are approved by the Department, to receive the Enhanced Communication Services Rate.

 All rates in the table are per day.

Service Group Needs Group Procedure Code Modifier 1 Modifier 2 Approved Program Capacity or Staffing Level Statewide Fee Enhanced Communication Statewide Fee (U1 Modifier)
Licensed Residential Habilitation with Day Needs Group 1 W9000 U5 1 Person $392.42 $479.77
W9029 U5 2 People $392.42 $479.77
W9045 U5 3 People $283.48 $346.60
W9047 U5 4 People $222.86 $272.64
W9064 U5 5—8 People $204.55 $250.24
Needs Group 2 W9000 U6 1 Person $474.34 $579.61
W9029 U6 2 People $474.34 $579.61
W9045 U6 3 People $317.41 $388.94
W9047 U6 4 People $251.52 $307.69
W9064 U6 5—8 People $226.72 $277.25
Licensed Residential Habilitation with Day (Continued) Needs Group 3 W9000 U7 1 Person $685.74 $838.79
W9029 U7 2 People $581.02 $710.79
W9045 U7 3 People $408.92 $500.35
W9047 U7 4 People $319.22 $390.78
W9064 U7 5—8 People $285.32 $349.20
Needs Group 4 W9000 U8 1 Person $759.68 $932.26
W9029 U8 2 People $638.49 $783.57
W9045 U8 3 People $450.93 $553.50
W9047 U8 4 People $352.46 $432.79
W9064 U8 5—8 People $309.17 $379.49
Licensed Residential Habilitation without Day Needs Group 1 W9000 U5 HI 1 Person $488.16 $596.00
W9029 U5 HI 2 People $488.16 $596.00
W9045 U5 HI 3 People $362.28 $442.29
W9047 U5 HI 4 People $283.94 $346.82
W9064 U5 HI 5—8 People $250.13 $305.55
Needs Group 2 W9000 U6 HI 1 Person $548.26 $669.42
W9029 U6 HI 2 People $548.26 $669.42
W9045 U6 HI 3 People $399.23 $487.46
W9047 U6 HI 4 People $313.60 $383.05
W9064 U6 HI 5—8 People $282.01 $344.58
Needs Group 3 W9000 U7 HI 1 Person $838.54 $1,025.06
W9029 U7 HI 2 People $621.80 $760.35
W9045 U7 HI 3 People $466.30 $570.16
W9047 U7 HI 4 People $364.15 $445.40
W9064 U7 HI 5—8 People $326.81 $399.83
Needs Group 4 W9000 U8 HI 1 Person $1,021.19 $1,252.44
W9029 U8 HI 2 People $748.70 $918.39
W9045 U8 HI 3 People $570.30 $699.55
W9047 U8 HI 4 People $439.74 $539.52
W9064 U8 HI 5—8 People $391.70 $480.60
Unlicensed Residential Habilitation N/A W7078 TD and TE 1 Person $120.05 $147.27
W7080 TD and TE 2 People $75.40 $92.33
W7082 TD and TE 3 People $54.46 $66.62
Life Sharing—over 30 hours per week on average Needs Group 1 W8593 U5 SE (provided by relative) 1 Person $144.22 $180.99
W8595 U5 SE (provided by relative) 2 People $102.45 $128.80
Needs Group 2 W8593 U6 SE (provided by relative) 1 Person $171.82 $215.60
W8595 U6 SE (provided by relative) 2 People $122.88 $154.54
Needs Group 3 W8593 U7 SE (provided by relative) 1 Person $262.95 $328.60
W8595 U7 SE (provided by relative) 2 People $184.93 $231.69
Needs Group 4 W8593 U8 SE (provided by relative) 1 Person $321.74 $401.75
W8595 U8 SE (provided by relative) 2 People $220.57 $276.14
Life Sharing—under 30 hours per week on average N/A W7037 SE (provided by relative) TD and TE 1 Person $142.23 $178.45
W7039 SE (provided by relative) TD and TE 2 People $100.72 $126.60

Department-Established Fees Effective January 1, 2018

 All rates in the table are per day.

Service Name Procedure Code Approved Program Capacity Statewide Fee
Licensed—Residential Habilitation Ineligible
 
Needs Groups 1—4 		W9001 1 Person $84.15
W9030 2 People $45.88
W9046 3 People $30.59
W9048 4 People $23.03
W9065 5—8 People $16.82
Unlicensed Residential Habilitation Ineligible
 
Needs Groups 1—4 		W7079 1 Person $20.57
W7081 2 People $12.39
W7083 3 People $6.36

 Copies of this notice may be obtained at the local Mental Health/Intellectual Disability (MH/ID) County Program, Administrative Entity (AE) or regional Office of Developmental Programs (ODP) in the corresponding regions:

 • Western region: Piatt Place, Room 4900, 301 5th Avenue, Pittsburgh, PA 15222, (412) 565-5144

 • Northeast region: Room 315, Scranton State Office Building, 100 Lackawanna Avenue, Scranton, PA 18503, (570) 963-4749

 • Southeast region: 801 Market Street, Suite 5071, Philadelphia, PA 19107, (215) 560-2242 or (215) 560-2245

 • Central region: P.O. Box 2675, DGS Annex Complex, Harrisburg, PA 17105, (717) 772-6507

 Contact information for the local MH/ID County Program or AE may be found at https://www.hcsis.state.pa.us/hcsis-ssd/pgm/asp/PRCNT.ASP or contact the previously referenced regional ODP.

Fiscal Impact

 It is estimated that there will be an additional cost to the Commonwealth of $361.394 million ($174.183 million in State funds) in Fiscal Year (FY) 2017-2018 and $475.732 million ($229.380 million in State funds) in FY 2018-2019 and subsequent years.

TERESA D. MILLER, 
Acting Secretary

 Fiscal Note: 14-NOT-1203. (1) General Fund;

 (7) ID—Community Waiver Program; (2) Implementing Year 2017-18 is $173,886,000; (3) 1st Succeeding Year 2018-19 through 5th Succeeding Year 2022-23 are $228,786,000; (4) 2016-17 Program—$1,349,000,000; 2015-16 Program—$1,203,000,000; 2014-15 Program—$1,075,000,000;

 (7) ID—Community Base Program; (2) Implementing Year 2017-18 is $297,000; (3) 1st Succeeding Year 2018-19 through 5th Succeeding Year 2022-23 are $594,000; (4) 2016-17 Program—$149,950,000; 2015-16 Program—$148,229,000; 2014-15 Program—$149,681,000;

 (8) recommends adoption. Funds have been included in the budget to cover this increase.

[Pa.B. Doc. No. 18-155. Filed for public inspection January 26, 2018, 9:00 a.m.]


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