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Provider Demographic Information - COMMUNITY INTERACTIONS INC

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PROVIDER DEMOGRAPHIC INFORMATION Supporting line for group header


Name:	COMMUNITY INTERACTIONS INC
Address:	740 S CHESTER RD SWARTHMORE, PA 19081-2226
Phone:	(610) 328-9008
E-mail:	clynn@ciinc.org
Web Site:	N/A

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PROVIDER CERTIFICATION INFORMATION Supporting line for group header

Click here to view Provider Certification Information

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PROVIDER'S PARENT/ REGIONAL OFFICE Supporting line for group header


Type:	Regional/Field Office	Counties Served:
Name:	War Trophy
Address:	8 WAR TROPHY LN MEDIA, PA 19063-5227
Phone:	(610) 328-9008

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PROVIDER SERVICES AND RATES Supporting line for group header


County : Berks
\|Service Name / Level	\|Rate

Res Hab-3 Person-NG 1-Elig	$411.03 / 1 Day
Res Hab-3 Person-NG 1-Elig-w/Day Supports	$312.16 / 1 Day
Res Hab-3 Person-NG 2-Elig	$468.38 / 1 Day
Res Hab-3 Person-NG 2-Elig-w/Day Supports	$361.68 / 1 Day
Res Hab-3 Person-NG 3-Elig	$545.05 / 1 Day
Res Hab-3 Person-NG 3-Elig-w/Day Supports	$467.35 / 1 Day
Res Hab-3 Person-NG 4-Elig	$662.22 / 1 Day
Res Hab-3 Person-NG 4-Elig-w/Day Supports	$513.07 / 1 Day
Res Hab-Lic-3 Person-Inelig	$41.06 / 1 Day
Supplemental Habilitation 1:1 - 15 min	$6.12 / 15 min.
Supplemental Habilitation 2:1 - 15 min	$12.22 / 15 min.

County : Bucks
\|Service Name / Level	\|Rate

Res Hab-3 Person-NG 1-Elig	$411.03 / 1 Day
Res Hab-3 Person-NG 1-Elig-w/Day Supports	$312.16 / 1 Day
Res Hab-3 Person-NG 2-Elig	$468.38 / 1 Day
Res Hab-3 Person-NG 2-Elig-w/Day Supports	$361.68 / 1 Day
Res Hab-3 Person-NG 3-Elig	$545.05 / 1 Day
Res Hab-3 Person-NG 3-Elig-w/Day Supports	$467.35 / 1 Day
Res Hab-3 Person-NG 4-Elig	$662.22 / 1 Day
Res Hab-3 Person-NG 4-Elig-w/Day Supports	$513.07 / 1 Day
Res Hab-Lic-3 Person-Inelig	$41.06 / 1 Day
Supplemental Habilitation 1:1 - 15 min	$6.12 / 15 min.
Supplemental Habilitation 2:1 - 15 min	$12.22 / 15 min.

County : Centre
\|Service Name / Level	\|Rate

In-Home & Commnty Supprts (Lvl 1)	$6.22 / 15 min.
In-Home & Commnty Supprts (Lvl 2)	$11.10 / 15 min.
Res Hab-3 Person-NG 1-Elig	$411.03 / 1 Day
Res Hab-3 Person-NG 1-Elig-w/Day Supports	$312.16 / 1 Day
Res Hab-3 Person-NG 2-Elig	$468.38 / 1 Day
Res Hab-3 Person-NG 2-Elig-w/Day Supports	$361.68 / 1 Day
Res Hab-3 Person-NG 3-Elig	$545.05 / 1 Day
Res Hab-3 Person-NG 3-Elig-w/Day Supports	$467.35 / 1 Day
Res Hab-3 Person-NG 4-Elig	$662.22 / 1 Day
Res Hab-3 Person-NG 4-Elig-w/Day Supports	$513.07 / 1 Day
Res Hab-Lic-3 Person-Inelig	$35.47 / 1 Day
Supplemental Habilitation 1:1 - 15 min	$6.12 / 15 min.
Supplemental Habilitation 2:1 - 15 min	$12.22 / 15 min.

County : Chester
\|Service Name / Level	\|Rate

CPS Community 1:1	$13.83 / 15 min.
CPS Community 1:1 Enhanced	$19.26 / 15 min.
CPS Community 1:2 or 1:3	$7.54 / 15 min.
CPS Community 2:1	$26.59 / 15 min.
CPS Community 2:1 Enhanced	$32.08 / 15 min.
CPS Community 2:3	$11.26 / 15 min.
CPS Facility 1:1	$13.39 / 15 min.
CPS Facility 1:1 Enhanced	$18.65 / 15 min.
CPS Facility 1:1 Enhcd LPN	$18.65 / 15 min.
CPS Facility 1:1 Enhcd RN	$18.65 / 15 min.
CPS Facility 1:11 to 1:15	$3.20 / 15 min.
CPS Facility 1:2 to 1:3	$7.39 / 15 min.
CPS Facility 1:4 to 1:6	$5.65 / 15 min.
CPS Facility 1:7 to 1:10	$3.43 / 15 min.
CPS Facility 2:1	$25.67 / 15 min.
CPS Facility 2:1 Enhcd	$30.94 / 15 min.
CPS Facility 2:1 Enhcd LPN	$30.94 / 15 min.
CPS Facility 2:1 Enhcd RN	$30.94 / 15 min.
CPS:Community OnCall/Remote Support	$1.77 / 15 min.
In-Home & Commnty Supprts (Basic)	$4.42 / 15 min.
In-Home & Commnty Supprts (Lvl 1)	$6.22 / 15 min.
In-Home & Commnty Supprts (Lvl 2 Enh)	$15.31 / 15 min.
In-Home & Commnty Supprts (Lvl 2)	$11.10 / 15 min.
Res Hab-2 Person-NG 1-Elig	$554.38 / 1 Day
Res Hab-2 Person-NG 1-Elig-w/Day Supports	$433.05 / 1 Day
Res Hab-2 Person-NG 2-Elig	$643.34 / 1 Day
Res Hab-2 Person-NG 2-Elig-w/Day Supports	$545.91 / 1 Day
Res Hab-2 Person-NG 3-Elig	$726.82 / 1 Day
Res Hab-2 Person-NG 3-Elig-w/Day Supports	$668.54 / 1 Day
Res Hab-2 Person-NG 4-Elig	$869.36 / 1 Day
Res Hab-2 Person-NG 4-Elig-w/Day Supports	$730.86 / 1 Day
Res Hab-3 Person-NG 1-Elig	$411.03 / 1 Day
Res Hab-3 Person-NG 1-Elig-w/Day Supports	$312.16 / 1 Day
Res Hab-3 Person-NG 2-Elig	$468.38 / 1 Day
Res Hab-3 Person-NG 2-Elig-w/Day Supports	$361.68 / 1 Day
Res Hab-3 Person-NG 3-Elig	$545.05 / 1 Day
Res Hab-3 Person-NG 3-Elig-w/Day Supports	$467.35 / 1 Day
Res Hab-3 Person-NG 4-Elig	$662.22 / 1 Day
Res Hab-3 Person-NG 4-Elig-w/Day Supports	$513.07 / 1 Day
Res Hab-3 Person-NG5-Elig	$1,004.32 / 1 Day
Res Hab-3 Person-NG5-Elig-w/Day Supports	$835.46 / 1 Day
Res Hab-Lic-2 Person-Inelig	$57.29 / 1 Day
Res Hab-Lic-3 Person-Inelig	$41.06 / 1 Day
Supplemental Habilitation 1:1 - 15 min	$6.12 / 15 min.
Supplemental Habilitation 2:1 - 15 min	$12.22 / 15 min.
Supported Emplymnt-Job Support - 1:1	$19.34 / 15 min.
Supported Emplymnt-Job Support-1:2	$11.58 / 15 min.

County : Dauphin
\|Service Name / Level	\|Rate

In-Home & Commnty Supprts (Basic)	$4.42 / 15 min.
In-Home & Commnty Supprts (Lvl 1)	$6.22 / 15 min.
In-Home & Commnty Supprts (Lvl 2 Enh)	$15.31 / 15 min.
In-Home & Commnty Supprts (Lvl 2)	$11.10 / 15 min.
Res Hab-2 Person-NG 1-Elig	$554.38 / 1 Day
Res Hab-2 Person-NG 1-Elig-w/Day Supports	$433.05 / 1 Day
Res Hab-2 Person-NG 2-Elig	$643.34 / 1 Day
Res Hab-2 Person-NG 2-Elig-w/Day Supports	$545.91 / 1 Day
Res Hab-2 Person-NG 3-Elig	$726.82 / 1 Day
Res Hab-2 Person-NG 3-Elig-w/Day Supports	$668.54 / 1 Day
Res Hab-2 Person-NG 4-Elig	$869.36 / 1 Day
Res Hab-2 Person-NG 4-Elig-w/Day Supports	$730.86 / 1 Day
Res Hab-2 Person-NG5-Elig	$1,312.57 / 1 Day
Res Hab-2 Person-NG5-Elig-w/Day Supports	$1,215.16 / 1 Day
Res Hab-Lic-2 Person-Inelig	$50.22 / 1 Day
Respite-Lic-Day-2 person-NG 1-Emergency	$503.18 / 1 Day
Respite-Lic-Day-2 person-NG 2	$616.04 / 1 Day
Respite-Lic-Day-2 person-NG 2-Emergency	$616.04 / 1 Day
Respite-Lic-Day-2 person-NG 3	$738.67 / 1 Day
Respite-Lic-Day-2 person-NG 3-Emergency	$738.67 / 1 Day
Respite-Lic-Day-2 person-NG 4	$800.99 / 1 Day
Respite-Lic-Day-2 person-NG 4-Emergency	$800.99 / 1 Day
Respite-Lic-Day-2 person-NG1	$503.18 / 1 Day
Respite-Lic-Day-2 person-NG5	$800.99 / 1 Day
Respite-Lic-Day-2 person-NG5-Emergency	$800.99 / 1 Day
Supplemental Habilitation 1:1 - 15 min	$6.12 / 15 min.
Supplemental Habilitation 2:1 - 15 min	$12.22 / 15 min.

County : Delaware
\|Service Name / Level	\|Rate

CPS Community 1:1	$13.83 / 15 min.
CPS Community 1:1 Enhanced	$19.26 / 15 min.
CPS Community 1:1 Enhanced	$19.26 / 15 min.
CPS Community 1:2 or 1:3	$7.54 / 15 min.
CPS Community 2:1	$26.59 / 15 min.
CPS Community 2:1 Enhanced	$32.08 / 15 min.
CPS Community 2:3	$11.26 / 15 min.
CPS Facility 1:1	$13.39 / 15 min.
CPS Facility 1:1 Enhanced	$18.65 / 15 min.
CPS Facility 1:1 Enhcd LPN	$18.65 / 15 min.
CPS Facility 1:1 Enhcd RN	$18.65 / 15 min.
CPS Facility 1:11 to 1:15	$3.20 / 15 min.
CPS Facility 1:2 to 1:3	$7.39 / 15 min.
CPS Facility 1:4 to 1:6	$5.65 / 15 min.
CPS Facility 1:7 to 1:10	$3.43 / 15 min.
CPS Facility 2:1	$25.67 / 15 min.
CPS Facility 2:1 Enhcd	$30.94 / 15 min.
CPS Facility 2:1 Enhcd LPN	$30.94 / 15 min.
CPS Facility 2:1 Enhcd RN	$30.94 / 15 min.
CPS:Community OnCall/Remote Support	$1.77 / 15 min.
In-Home & Commnty Supprts (Basic)	$4.42 / 15 min.
In-Home & Commnty Supprts (Lvl 1)	$6.22 / 15 min.
In-Home & Commnty Supprts (Lvl 2)	$11.10 / 15 min.
In-Home & Commnty Supprts (Lvl 3)	$21.42 / 15 min.
Life Sharing-1 per-Elig-Unlic < 30 Hrs	$156.49 / 1 Day
Needs Exception Allowance (NEA)-Adult Res (6400)	$1,240.28 / 1 Day
Needs Excptn Allowance (NEA)-Adult Res (6400)-521	Not Set
Res Hab-1 Person-NG 1-Elig	$554.38 / 1 Day
Res Hab-1 Person-NG 1-Elig-w/Day Supports	$433.05 / 1 Day
Res Hab-1 Person-NG 2-Elig	$643.34 / 1 Day
Res Hab-1 Person-NG 2-Elig-w/Day Supports	$545.91 / 1 Day
Res Hab-1 Person-NG 3-Elig	$980.38 / 1 Day
Res Hab-1 Person-NG 3-Elig-w/Day Supports	$790.99 / 1 Day
Res Hab-1 Person-NG 4-Elig	$1,185.86 / 1 Day
Res Hab-1 Person-NG 4-Elig-w/Day Supports	$871.56 / 1 Day
Res Hab-1 Person-NG5-Elig	$1,754.51 / 1 Day
Res Hab-1 Person-NG5-Elig-w/Day Supports	$1,341.85 / 1 Day
Res Hab-2 Person-NG 1-Elig	$554.38 / 1 Day
Res Hab-2 Person-NG 1-Elig-w/Day Supports	$433.05 / 1 Day
Res Hab-2 Person-NG 2-Elig	$643.34 / 1 Day
Res Hab-2 Person-NG 2-Elig-w/Day Supports	$545.91 / 1 Day
Res Hab-2 Person-NG 3-Elig	$726.82 / 1 Day
Res Hab-2 Person-NG 3-Elig-w/Day Supports	$668.54 / 1 Day
Res Hab-2 Person-NG 4-Elig	$869.36 / 1 Day
Res Hab-2 Person-NG 4-Elig-w/Day Supports	$730.86 / 1 Day
Res Hab-2 Person-NG5-Elig	$1,312.57 / 1 Day
Res Hab-2 Person-NG5-Elig-w/Day Supports	$1,215.16 / 1 Day
Res Hab-3 Person-NG 1-Elig	$411.03 / 1 Day
Res Hab-3 Person-NG 1-Elig-w/Day Supports	$312.16 / 1 Day
Res Hab-3 Person-NG 2-Elig	$468.38 / 1 Day
Res Hab-3 Person-NG 2-Elig-w/Day Supports	$361.68 / 1 Day
Res Hab-3 Person-NG 3-Elig	$545.05 / 1 Day
Res Hab-3 Person-NG 3-Elig-w/Day Supports	$467.35 / 1 Day
Res Hab-3 Person-NG 4-Elig	$662.22 / 1 Day
Res Hab-3 Person-NG 4-Elig-w/Day Supports	$513.07 / 1 Day
Res Hab-3 Person-NG5-Elig	$1,004.32 / 1 Day
Res Hab-3 Person-NG5-Elig-w/Day Supports	$835.46 / 1 Day
Res Hab-4 Person-NG 1-Elig-w/Day Supports	$245.99 / 1 Day
Res Hab-4 Person-NG 2-Elig-w/Day Supports	$284.31 / 1 Day
Res Hab-4 Person-NG 3-Elig-w/Day Supports	$362.42 / 1 Day
Res Hab-4 Person-NG 4-Elig-w/Day Supports	$398.69 / 1 Day
Res Hab-5-8 Person-NG 1-Elig	$283.18 / 1 Day
Res Hab-5-8 Person-NG 1-Elig-w/Day Supports	$224.75 / 1 Day
Res Hab-5-8 Person-NG 2-Elig	$330.71 / 1 Day
Res Hab-5-8 Person-NG 2-Elig-w/Day Supports	$265.75 / 1 Day
Res Hab-5-8 Person-NG 3-Elig	$381.85 / 1 Day
Res Hab-5-8 Person-NG 3-Elig-w/Day Supports	$333.29 / 1 Day
Res Hab-5-8 Person-NG 4-Elig	$454.78 / 1 Day
Res Hab-5-8 Person-NG 4-Elig-w/Day Supports	$358.89 / 1 Day
Res Hab-Lic-1 Person-Inelig	$105.05 / 1 Day
Res Hab-Lic-2 Person-Inelig	$57.29 / 1 Day
Res Hab-Lic-3 Person-Inelig	$41.06 / 1 Day
Res Hab-Lic-4 Person-Elig-NG 1	$322.49 / 1 Day
Res Hab-Lic-4 Person-Elig-NG 2	$367.82 / 1 Day
Res Hab-Lic-4 Person-Elig-NG 3	$425.56 / 1 Day
Res Hab-Lic-4 Person-Elig-NG 4	$510.56 / 1 Day
Res Hab-Lic-4 Person-Inelig	$31.91 / 1 Day
Res Hab-Lic-5-8 Person-Inelig	$22.87 / 1 Day
Resid Hab-Unlic 1-Indiv Home (Eligible)	$140.44 / 1 Day
Resid Hab-Unlic 1-Indiv Home (Inelig)	$28.29 / 1 Day
Resid Hab-Unlic 2-Indiv Home (Eligible)	$88.19 / 1 Day
Resid Hab-Unlic 2-Indiv Home (Inelig)	$16.38 / 1 Day
Respite-Lic-Day-2 person-NG 1-Emergency	$503.18 / 1 Day
Respite-Lic-Day-2 person-NG 2	$616.04 / 1 Day
Respite-Lic-Day-2 person-NG 2-Emergency	$616.04 / 1 Day
Respite-Lic-Day-2 person-NG 3	$738.67 / 1 Day
Respite-Lic-Day-2 person-NG 3-Emergency	$738.67 / 1 Day
Respite-Lic-Day-2 person-NG 4	$800.99 / 1 Day
Respite-Lic-Day-2 person-NG 4-Emergency	$800.99 / 1 Day
Respite-Lic-Day-2 person-NG1	$503.18 / 1 Day
Respite-Lic-Day-2 person-NG5	$800.99 / 1 Day
Respite-Lic-Day-2 person-NG5-Emergency	$800.99 / 1 Day
Respite-Lic-Day-3 person-NG 1	$369.73 / 1 Day
Respite-Lic-Day-3 person-NG 1-Emergency	$369.73 / 1 Day
Respite-Lic-Day-3 person-NG 2	$419.25 / 1 Day
Respite-Lic-Day-3 person-NG 2-Emergency	$419.25 / 1 Day
Respite-Lic-Day-3 person-NG 3	$524.92 / 1 Day
Respite-Lic-Day-3 person-NG 3-Emergency	$524.92 / 1 Day
Respite-Lic-Day-3 person-NG 4	$570.64 / 1 Day
Respite-Lic-Day-3 person-NG 4-Emergency	$570.64 / 1 Day
Respite-Lic-Day-3 person-NG5	$570.64 / 1 Day
Respite-Lic-Day-3 person-NG5-Emergency	$570.64 / 1 Day
Respite-Lic-Day-4 person-NG 1	$295.27 / 1 Day
Respite-Lic-Day-4 person-NG 1-Emergency	$295.27 / 1 Day
Respite-Lic-Day-4 person-NG 2	$333.59 / 1 Day
Respite-Lic-Day-4 person-NG 2-Emergency	$333.59 / 1 Day
Respite-Lic-Day-4 person-NG 3	$411.70 / 1 Day
Respite-Lic-Day-4 person-NG 3-Emergency	$411.70 / 1 Day
Respite-Lic-Day-4 person-NG 4	$447.97 / 1 Day
Respite-Lic-Day-4 person-NG 4-Emergency	$447.97 / 1 Day
Respite-Unlic-Day (Basic 1:4) Out-of-Home	$97.84 / 1 Day
Respite-Unlic-Day (Level 1, 1:3) Out-of-Home	$128.64 / 1 Day
Respite-Unlic-Day (Level 2, 1:2) Out-of-Home	$190.26 / 1 Day
Respite-Unlic-Day (Level 3, 1:1 Enh) Out-of-Home	$531.24 / 1 Day
Respite-Unlic-Day (Level 3, 1:1 Enh)Out-of-Hme -TD	$531.24 / 1 Day
Respite-Unlic-Day (Level 3, 1:1 Enh)Out-of-Hme -TE	$531.24 / 1 Day
Respite-Unlic-Day (Level 3, 1:1) Out-of-Home	$343.22 / 1 Day
Respite-Unlic-Day (Level 4, 2:1) Out-of-Home	$681.46 / 1 Day
Respite-Unlic-Day(Level 4, 2:1 Enh) Out-of-Home-TD	$869.48 / 1 Day
Respite-Unlic-Day(Level 4, 2:1 Enh) Out-of-Home-TE	$869.48 / 1 Day
Respite-Unlic-Day(Level 4, 2:1 Enhcd) Out-of-Home	$869.48 / 1 Day
Supplemental Habilitation 1:1 - 15 min	$6.12 / 15 min.
Supplemental Habilitation 2:1 - 15 min	$12.22 / 15 min.
Supported Emplymnt-Job Support - 1:1	$19.34 / 15 min.
Supported Emplymnt-Job Support-1:2	$11.58 / 15 min.

County : Lackawanna/Susquehanna
\|Service Name / Level	\|Rate

CPS Community 1:1	$13.83 / 15 min.
CPS Community 1:2 or 1:3	$7.54 / 15 min.
Res Hab-3 Person-NG 1-Elig	$411.03 / 1 Day
Res Hab-3 Person-NG 1-Elig-w/Day Supports	$312.16 / 1 Day
Res Hab-3 Person-NG 2-Elig	$468.38 / 1 Day
Res Hab-3 Person-NG 2-Elig-w/Day Supports	$361.68 / 1 Day
Res Hab-3 Person-NG 3-Elig	$545.05 / 1 Day
Res Hab-3 Person-NG 3-Elig-w/Day Supports	$467.35 / 1 Day
Res Hab-3 Person-NG 4-Elig	$662.22 / 1 Day
Res Hab-3 Person-NG 4-Elig-w/Day Supports	$513.07 / 1 Day
Res Hab-Lic-3 Person-Inelig	$41.06 / 1 Day

County : Lancaster
\|Service Name / Level	\|Rate

CPS Community 1:2 or 1:3	$7.54 / 15 min.
CPS Community 2:1	$26.59 / 15 min.
CPS Community 2:1 Enhanced	$32.08 / 15 min.
CPS Community 2:3	$11.26 / 15 min.
CPS Facility 1:1	$13.39 / 15 min.
CPS Facility 1:1 Enhanced	$18.65 / 15 min.
CPS Facility 1:1 Enhcd LPN	$18.65 / 15 min.
CPS Facility 1:1 Enhcd RN	$18.65 / 15 min.
CPS Facility 1:11 to 1:15	$3.20 / 15 min.
CPS Facility 1:2 to 1:3	$7.39 / 15 min.
CPS Facility 1:4 to 1:6	$5.65 / 15 min.
CPS Facility 1:7 to 1:10	$3.43 / 15 min.
CPS Facility 2:1	$25.67 / 15 min.
CPS Facility 2:1 Enhcd	$30.94 / 15 min.
CPS Facility 2:1 Enhcd LPN	$30.94 / 15 min.
CPS Facility 2:1 Enhcd RN	$30.94 / 15 min.
CPS:Community OnCall/Remote Support	$1.77 / 15 min.
Res Hab-2 Person-NG 1-Elig	$554.38 / 1 Day
Res Hab-2 Person-NG 1-Elig-w/Day Supports	$433.05 / 1 Day
Res Hab-2 Person-NG 2-Elig	$643.34 / 1 Day
Res Hab-2 Person-NG 2-Elig-w/Day Supports	$545.91 / 1 Day
Res Hab-2 Person-NG 3-Elig	$726.82 / 1 Day
Res Hab-2 Person-NG 3-Elig-w/Day Supports	$668.54 / 1 Day
Res Hab-2 Person-NG 4-Elig	$869.36 / 1 Day
Res Hab-2 Person-NG 4-Elig-w/Day Supports	$730.86 / 1 Day
Res Hab-Lic-2 Person-Inelig	$57.29 / 1 Day
Supplemental Habilitation 1:1 - 15 min	$6.12 / 15 min.
Supplemental Habilitation 2:1 - 15 min	$12.22 / 15 min.

County : Lebanon
\|Service Name / Level	\|Rate

In-Home & Commnty Supprts (Lvl 2)	$11.10 / 15 min.
Res Hab-2 Person-NG 1-Elig	$554.38 / 1 Day
Res Hab-2 Person-NG 1-Elig-w/Day Supports	$433.05 / 1 Day
Res Hab-2 Person-NG 2-Elig	$643.34 / 1 Day
Res Hab-2 Person-NG 2-Elig-w/Day Supports	$545.91 / 1 Day
Res Hab-2 Person-NG 3-Elig	$726.82 / 1 Day
Res Hab-2 Person-NG 3-Elig-w/Day Supports	$668.54 / 1 Day
Res Hab-2 Person-NG 4-Elig	$869.36 / 1 Day
Res Hab-2 Person-NG 4-Elig-w/Day Supports	$730.86 / 1 Day
Res Hab-3 Person-NG 1-Elig	$411.03 / 1 Day
Res Hab-3 Person-NG 1-Elig-w/Day Supports	$312.16 / 1 Day
Res Hab-3 Person-NG 2-Elig	$468.38 / 1 Day
Res Hab-3 Person-NG 2-Elig-w/Day Supports	$361.68 / 1 Day
Res Hab-3 Person-NG 3-Elig	$545.05 / 1 Day
Res Hab-3 Person-NG 3-Elig-w/Day Supports	$467.35 / 1 Day
Res Hab-3 Person-NG 4-Elig	$662.22 / 1 Day
Res Hab-3 Person-NG 4-Elig-w/Day Supports	$513.07 / 1 Day
Res Hab-Lic-2 Person-Inelig	$50.22 / 1 Day
Res Hab-Lic-3 Person-Inelig	$41.06 / 1 Day
Respite-Base Out-of-Home 24 Hours (Level 1)-Day	$503.18 / 1 Day
Respite-Lic-Day-2 person-NG 1-Emergency	$503.18 / 1 Day
Respite-Lic-Day-2 person-NG 2	$616.04 / 1 Day
Respite-Lic-Day-2 person-NG 2-Emergency	$616.04 / 1 Day
Respite-Lic-Day-2 person-NG 3	$738.67 / 1 Day
Respite-Lic-Day-2 person-NG 3-Emergency	$738.67 / 1 Day
Respite-Lic-Day-2 person-NG 4	$800.99 / 1 Day
Respite-Lic-Day-2 person-NG 4-Emergency	$800.99 / 1 Day
Respite-Lic-Day-2 person-NG1	$503.18 / 1 Day
Respite-Lic-Day-2 person-NG5	$800.99 / 1 Day
Respite-Lic-Day-2 person-NG5-Emergency	$800.99 / 1 Day
Supplemental Habilitation 1:1 - 15 min	$6.12 / 15 min.
Supplemental Habilitation 2:1 - 15 min	$12.22 / 15 min.

County : Lycoming/Clinton
\|Service Name / Level	\|Rate

Res Hab-2 Person-NG 1-Elig	$554.38 / 1 Day
Res Hab-2 Person-NG 1-Elig-w/Day Supports	$433.05 / 1 Day
Res Hab-2 Person-NG 2-Elig	$643.34 / 1 Day
Res Hab-2 Person-NG 2-Elig-w/Day Supports	$545.91 / 1 Day
Res Hab-2 Person-NG 3-Elig	$726.82 / 1 Day
Res Hab-2 Person-NG 3-Elig-w/Day Supports	$668.54 / 1 Day
Res Hab-2 Person-NG 4-Elig	$869.36 / 1 Day
Res Hab-2 Person-NG 4-Elig-w/Day Supports	$730.86 / 1 Day
Res Hab-3 Person-NG 1-Elig	$411.03 / 1 Day
Res Hab-3 Person-NG 1-Elig-w/Day Supports	$312.16 / 1 Day
Res Hab-3 Person-NG 2-Elig	$468.38 / 1 Day
Res Hab-3 Person-NG 2-Elig-w/Day Supports	$361.68 / 1 Day
Res Hab-3 Person-NG 3-Elig	$545.05 / 1 Day
Res Hab-3 Person-NG 3-Elig-w/Day Supports	$467.35 / 1 Day
Res Hab-3 Person-NG 4-Elig	$662.22 / 1 Day
Res Hab-3 Person-NG 4-Elig-w/Day Supports	$513.07 / 1 Day
Res Hab-Lic-2 Person-Inelig	$50.22 / 1 Day
Res Hab-Lic-3 Person-Inelig	$35.47 / 1 Day
Supplemental Habilitation 1:1 - 15 min	$6.12 / 15 min.
Supplemental Habilitation 2:1 - 15 min	$12.22 / 15 min.

County : Montgomery
\|Service Name / Level	\|Rate

CPS Community 1:2 or 1:3	$7.54 / 15 min.
CPS Community 2:1	$26.59 / 15 min.
CPS Community 2:1 Enhanced	$32.08 / 15 min.
CPS Community 2:3	$11.26 / 15 min.
CPS Facility 1:1	$13.39 / 15 min.
CPS Facility 1:1 Enhanced	$18.65 / 15 min.
CPS Facility 1:1 Enhcd LPN	$18.65 / 15 min.
CPS Facility 1:1 Enhcd RN	$18.65 / 15 min.
CPS Facility 1:11 to 1:15	$3.20 / 15 min.
CPS Facility 1:2 to 1:3	$7.39 / 15 min.
CPS Facility 1:4 to 1:6	$5.65 / 15 min.
CPS Facility 1:7 to 1:10	$3.43 / 15 min.
CPS Facility 2:1	$25.67 / 15 min.
CPS Facility 2:1 Enhcd	$30.94 / 15 min.
CPS Facility 2:1 Enhcd LPN	$30.94 / 15 min.
CPS Facility 2:1 Enhcd RN	$30.94 / 15 min.
CPS:Community OnCall/Remote Support	$1.77 / 15 min.
In-Home & Commnty Supprts (Basic)	$4.42 / 15 min.
In-Home & Commnty Supprts (Lvl 1)	$6.22 / 15 min.
In-Home & Commnty Supprts (Lvl 2)	$11.10 / 15 min.
NEA - Adult Res (6400) - No Day - NG5	$0.01 / 1 Day
Needs Except. Allowance (NEA)-Adult Res (6400) NG5	$0.01 / 1 Day
Needs Exception Allowance (NEA)-Adult Res (6400)	$1,187.56 / 1 Day
Needs Excptn Allowance (NEA)-Adult Res (6400)-521	$1,484.07 / 1 Day
Res Hab-1 Person-NG5-Elig	$1,754.51 / 1 Day
Res Hab-1 Person-NG5-Elig-w/Day Supports	$1,341.85 / 1 Day
Res Hab-2 Person-NG 1-Elig	$554.38 / 1 Day
Res Hab-2 Person-NG 1-Elig-w/Day Supports	$433.05 / 1 Day
Res Hab-2 Person-NG 2-Elig	$643.34 / 1 Day
Res Hab-2 Person-NG 2-Elig-w/Day Supports	$545.91 / 1 Day
Res Hab-2 Person-NG 3-Elig	$726.82 / 1 Day
Res Hab-2 Person-NG 3-Elig-w/Day Supports	$668.54 / 1 Day
Res Hab-2 Person-NG 4-Elig	$869.36 / 1 Day
Res Hab-2 Person-NG 4-Elig-w/Day Supports	$730.86 / 1 Day
Res Hab-2 Person-NG5-Elig	$1,312.57 / 1 Day
Res Hab-2 Person-NG5-Elig-w/Day Supports	$1,215.16 / 1 Day
Res Hab-3 Person-NG 1-Elig	$411.03 / 1 Day
Res Hab-3 Person-NG 1-Elig-w/Day Supports	$312.16 / 1 Day
Res Hab-3 Person-NG 2-Elig	$468.38 / 1 Day
Res Hab-3 Person-NG 2-Elig-w/Day Supports	$361.68 / 1 Day
Res Hab-3 Person-NG 3-Elig	$545.05 / 1 Day
Res Hab-3 Person-NG 3-Elig-w/Day Supports	$467.35 / 1 Day
Res Hab-3 Person-NG 4-Elig	$662.22 / 1 Day
Res Hab-3 Person-NG 4-Elig-w/Day Supports	$513.07 / 1 Day
Res Hab-3 Person-NG5-Elig	$1,004.32 / 1 Day
Res Hab-3 Person-NG5-Elig-w/Day Supports	$835.46 / 1 Day
Res Hab-Lic-1 Person-Inelig	$105.05 / 1 Day
Res Hab-Lic-2 Person-Inelig	$57.29 / 1 Day
Res Hab-Lic-3 Person-Inelig	$41.06 / 1 Day
Respite, Base-Emerg Licen 6400 24 Hrs Lvl 1-U2	Not Set
Respite-Lic-Day-2 person-NG 1-Emergency	$503.18 / 1 Day
Respite-Lic-Day-2 person-NG 2	$616.04 / 1 Day
Respite-Lic-Day-2 person-NG 2-Emergency	$616.04 / 1 Day
Respite-Lic-Day-2 person-NG 3	$738.67 / 1 Day
Respite-Lic-Day-2 person-NG 3-Emergency	$738.67 / 1 Day
Respite-Lic-Day-2 person-NG 4	$800.99 / 1 Day
Respite-Lic-Day-2 person-NG1	$503.18 / 1 Day
Respite-Lic-Day-3 person-NG 1	$369.73 / 1 Day
Respite-Lic-Day-3 person-NG 1-Emergency	$369.73 / 1 Day
Respite-Lic-Day-3 person-NG 2	$419.25 / 1 Day
Respite-Lic-Day-3 person-NG 2-Emergency	$419.25 / 1 Day
Respite-Lic-Day-3 person-NG 3	$524.92 / 1 Day
Respite-Lic-Day-3 person-NG 3-Emergency	$524.92 / 1 Day
Respite-Lic-Day-3 person-NG 4	$570.64 / 1 Day
Respite-Lic-Day-3 person-NG 4-Emergency	$570.64 / 1 Day
Respite-Lic-Day-4 person-NG 1	$295.27 / 1 Day
Respite-Lic-Day-4 person-NG 1-Emergency	$295.27 / 1 Day
Respite-Lic-Day-4 person-NG 2	$333.59 / 1 Day
Respite-Lic-Day-4 person-NG 2-Emergency	$333.59 / 1 Day
Respite-Lic-Day-4 person-NG 3	$411.70 / 1 Day
Respite-Lic-Day-4 person-NG 3-Emergency	$411.70 / 1 Day
Respite-Lic-Day-4 person-NG 4	$447.97 / 1 Day
Respite-Lic-Day-4 person-NG 4-Emergency	$447.97 / 1 Day
Respite-Unlic-Day (Level 2, 1:2) Out-of-Home	$190.26 / 1 Day
Supplemental Habilitation 1:1 - 15 min	$6.12 / 15 min.
Supplemental Habilitation 2:1 - 15 min	$12.22 / 15 min.

County : Northumberland
\|Service Name / Level	\|Rate

In-Home & Commnty Supprts (Lvl 2)	$11.10 / 15 min.

County : Philadelphia
\|Service Name / Level	\|Rate

CPS Community 1:1	$13.83 / 15 min.
CPS Community 1:2 or 1:3	$7.54 / 15 min.
CPS Community 2:1	$26.59 / 15 min.
CPS Community 2:3	$11.26 / 15 min.
CPS Facility 1:1	$13.39 / 15 min.
CPS Facility 1:11 to 1:15	$3.20 / 15 min.
CPS Facility 1:2 to 1:3	$7.39 / 15 min.
CPS Facility 1:4 to 1:6	$5.65 / 15 min.
CPS Facility 1:7 to 1:10	$3.43 / 15 min.
CPS Facility 2:1	$25.67 / 15 min.
CPS:Community OnCall/Remote Support	$1.77 / 15 min.
In-Home & Commnty Supprts (Basic)	$4.42 / 15 min.
In-Home & Commnty Supprts (Lvl 2)	$11.10 / 15 min.
In-Home & Commnty Supprts (Lvl 3 Enh)	$25.64 / 15 min.
In-Home & Commnty Supprts (Lvl 3)	$21.42 / 15 min.
Res Hab-2 Person-NG 3-Elig	$726.82 / 1 Day
Res Hab-2 Person-NG 3-Elig-w/Day Supports	$668.54 / 1 Day
Res Hab-2 Person-NG 4-Elig	$869.36 / 1 Day
Res Hab-2 Person-NG 4-Elig-w/Day Supports	$730.86 / 1 Day
Res Hab-2 Person-NG5-Elig	$1,312.57 / 1 Day
Res Hab-2 Person-NG5-Elig-w/Day Supports	$1,215.16 / 1 Day
Res Hab-3 Person-NG 1-Elig	$411.03 / 1 Day
Res Hab-3 Person-NG 1-Elig-w/Day Supports	$312.16 / 1 Day
Res Hab-3 Person-NG 2-Elig	$468.38 / 1 Day
Res Hab-3 Person-NG 2-Elig-w/Day Supports	$361.68 / 1 Day
Res Hab-3 Person-NG 3-Elig	$545.05 / 1 Day
Res Hab-3 Person-NG 3-Elig-w/Day Supports	$467.35 / 1 Day
Res Hab-3 Person-NG 4-Elig	$662.22 / 1 Day
Res Hab-3 Person-NG 4-Elig-w/Day Supports	$513.07 / 1 Day
Res Hab-4 Person-NG 1-Elig-w/Day Supports	$245.99 / 1 Day
Res Hab-4 Person-NG 2-Elig-w/Day Supports	$284.31 / 1 Day
Res Hab-4 Person-NG 3-Elig-w/Day Supports	$362.42 / 1 Day
Res Hab-4 Person-NG 4-Elig-w/Day Supports	$398.69 / 1 Day
Res Hab-Lic-2 Person-Inelig	$57.29 / 1 Day
Res Hab-Lic-3 Person-Inelig	$41.06 / 1 Day
Res Hab-Lic-4 Person-Elig-NG 1	$322.49 / 1 Day
Res Hab-Lic-4 Person-Elig-NG 2	$367.82 / 1 Day
Res Hab-Lic-4 Person-Elig-NG 3	$425.56 / 1 Day
Res Hab-Lic-4 Person-Elig-NG 4	$510.56 / 1 Day
Res Hab-Lic-4 Person-Inelig	$31.91 / 1 Day
Respite-Lic-Day-2 person-NG 1-Emergency	$503.18 / 1 Day
Respite-Lic-Day-2 person-NG 2	$616.04 / 1 Day
Respite-Lic-Day-2 person-NG 2-Emergency	$616.04 / 1 Day
Respite-Lic-Day-2 person-NG 3	$738.67 / 1 Day
Respite-Lic-Day-2 person-NG 3-Emergency	$738.67 / 1 Day
Respite-Lic-Day-2 person-NG 4	$800.99 / 1 Day
Respite-Lic-Day-2 person-NG1	$503.18 / 1 Day
Respite-Lic-Day-4 person-NG 1	$295.27 / 1 Day
Respite-Lic-Day-4 person-NG 1-Emergency	$295.27 / 1 Day
Respite-Lic-Day-4 person-NG 2	$333.59 / 1 Day
Respite-Lic-Day-4 person-NG 2-Emergency	$333.59 / 1 Day
Respite-Lic-Day-4 person-NG 3	$411.70 / 1 Day
Respite-Lic-Day-4 person-NG 3-Emergency	$411.70 / 1 Day
Respite-Lic-Day-4 person-NG 4	$447.97 / 1 Day
Respite-Lic-Day-4 person-NG 4-Emergency	$447.97 / 1 Day
Respite-Unlic-Day (Level 2, 1:2) Out-of-Home	$190.26 / 1 Day
Supplemental Habilitation 1:1 - 15 min	$6.12 / 15 min.
Supported Emplymnt-Job Support - 1:1	$19.34 / 15 min.
Supported Emplymnt-Job Support-1:2	$11.58 / 15 min.

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