Attachment 4 Medicaid Pricing Schedule.pdf

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Amended Sioux Falls 2024 Nursing Home Open & Continuous Solicitation 36C26324R0011 0002
Solicitation number
36C26324R0011
Issued by

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This document is the Medicaid Pricing Schedule (Attachment 4) for the Sioux Falls 2024 Nursing Home Open & Continuous Solicitation 36C26324R0011 issued by the Department of Veterans Affairs, Veterans Health Administration, Network Contracting Office (NCO 23).

The solicitation is seeking proposals from nursing homes to provide community nursing home services to the VA Sioux Falls Health Care System under Indefinite Delivery Indefinite Quantity (IDIQ) contracts. The solicitation is open through January 31, 2025, and proposals will be accepted at any time during this period. The NAICS code is 623110 (Nursing Care Facilities) with a small business size standard of $34.0M. Multiple awards are anticipated on an as-needed basis. The Medicaid Pricing Schedule attachment provides a template for offerors to insert their direct and non-direct care rates for various levels of care.

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Level of Care-LOC C-M WT Direct Care Non-Direct

Medicaid VA Contract Daily Drug Costs

SE3

SE2

SE1

RAD

RAC

RAB

RAA

SSC

SSB

SSA

CC2

CC1

CB2

CB1

CA2

CA1

IB2

IB1

IA2

IA1

BB2

BB1

BA2

BA1

PE2

PE1

PD2

PD1

PC2

PC1

PB2

PB1

PA2

PA1

South Dakota Medicaid Rates

Insert Direct & Non-Direct Rates Here:

11/25/2020

Attachment 4: South Dakota Medicaid Pricing Schedule

Sheet1

File details come from the government source that posted it. Updated .