S02 ILLINOIS PRICING SCHEDULE - FINAL.pdf

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Attached to
Q402--VISN 23 CNH Open and Continuous Medicaid Solicitation- Period of Performance: 05 March 2021 to 04 March 2023.
Solicitation number
36C26320R0126
Issued by

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File Type Posted
Attachment 4d Nebraska Medicaid Pricing Schedule.pdf PDF
Attachment 4e North Dakota Medicaid Pricing Schedule.pdf PDF
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Attachment 4b Iowa Medicaid Pricing Schedule.pdf PDF
Attachment 4c Minnesota Medicaid Pricing Schedule.pdf PDF
Attachment 4f South Dakota Medicaid Pricing Schedule.pdf PDF
Attachment 1 Quality Assurance Surveillance Plan (QASP).pdf PDF
Attachment 4 Medicaid Pricing Schedule Information and State Schedules.pdf PDF
Attachment 3 RUGs IV and III Description.pdf PDF
Attachment 4a Illinois Medicaid Pricing Schedule.pdf PDF
Attachment 2 Wage Determination E 98 1973 0126 Rev 64 12 Dec 2020.pdf PDF
Attachment 6 South Dakota Pricing Schedule Final.pdf PDF
Attachment 10 RUGs IV Levels of Care.pdf PDF
4 May Amended Medicaid Solicitation 202136C26320R0126 0001.pdf PDF
Attachment 7 Illinois Pricing Schedule Final.pdf PDF
Attachment 5 North Dakota Pricing Schedule Final.pdf PDF
Attachment 4 Iowa Pricing Schedule Final.pdf PDF
Attachment 2 WAGE DETERMINATION E 98 DECEMBER 21 2020 19730126 Rev No 64.pdf PDF
Attachment 9 CNH SOP RUGs III Descriptions.pdf PDF
Attachment 1 QASP Medicaid Final.pdf PDF
36C26320R0126 0001_1.docx DOCX document
Attachment 8 Minnesota Pricing Schedule Final.pdf PDF
Attachment 3 Nebraska Pricing Schedule Final.pdf PDF
S02 NEBRASKA PRICING SCHEDULE - FINAL.pdf PDF
RUGs IV Levels of Care.pdf PDF
S02 NORTH DAKOTA PRICING SCHEDULE - FINAL.pdf PDF
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S02 SOUTH DAKOTA PRICING SCHEDULE - FINAL.pdf PDF
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QASP - MEDICAID - FINAL.pdf PDF
S02 IOWA PRICING SCHEDULE - FINAL.pdf PDF
P07 WAGE DETERMINATION E98 DECEMBER 21 2020 1973 0126 Rev No 64.pdf PDF
S02 MINNESOTA PRICING SCHEDULE - FINAL.pdf PDF
S02 36C26320R0126 - MEDICAID.pdf PDF
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Illinois Nursing Homes Please List Your Medicaid Price/Cost Schedule Reimbursement Rate Box (D3) MEDICAID RATE RUG 48 Category

CLIN

Medicaid Base Rates

Percentage Add-On

Medicaid Per Diem Rates

0001 VA Basic Care Rate 0001A VA Reduced Phy Functioning PA1, PA2, PB1, PB2, PC1

PC2, PD1, PD2, PE1, PE2

0001B VA Cognitive Performance BA1, BA2

0001C VA Behavior Symptoms BB1, BB2

0002 VA Clinically Complex CA1, CA2, CB1, CB2, CC1

CC2, CD1, CD2, CE1, CE2

0003 VA Special Care Low LB1, LB2, LC1, LC2, LD1

LD2, LE1, LE2

0004 VA Special Care High HB1, HB2, HC1, HC2,HD1

HD2, HE1, HE2

0005 VA Extensive Service ES1, ES2, ES3

0006 VA Light Rehabilitation RAA, RAB

0007 VA Heavy Rehabilitation RAC, RAD, RAE

0008 VA Specialized Care N/A 0008A Dementia/Alzheimer's Unit 0008B Young Adult Program 0008C HIV/AIDS Unit 0008D Clinitron Dependent

Calculations utilized are based upon Illinois Department of Public Health Medicare Reimbursement Rates, effective Date:

ILLINOIS 48 Grouper CLINS

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