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Attachment 4d Nebraska Medicaid Pricing Schedule.pdf PDF
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Attachment 4f South Dakota Medicaid Pricing Schedule.pdf PDF
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Attachment 4 Medicaid Pricing Schedule Information and State Schedules.pdf PDF
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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
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S02 NORTH DAKOTA PRICING SCHEDULE - FINAL.pdf PDF
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S02 SOUTH DAKOTA PRICING SCHEDULE - FINAL.pdf PDF
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Text version

Price/Cost Schedule Reimbursement Rate box (D3) MEDICAID RATE RUGS III 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 Behavior Problems BA1, BA2, BB1, BB2

0001C VA Impaired Cognition IA1, IA2, IB1, IB2

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

CC2

0003 VA Special Care SSA, SSB, SSC

0004 VA Extensive Service SE1, SE2, SE3

0005 VA Light Rehabilitation RAA, RAB

0006 VA Heavy Rehabilitation RAC, RAD

0007 VA Rehabilitation + N/A Extensive Services

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 Iowa Department of Human Services Medicaid Reimbursement Rates, effective Date:

IOWA RUGS III CLINS

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