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Provider Demographic Information - ARC FAYETTE

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PROVIDER DEMOGRAPHIC INFORMATION Supporting line for group header


Name:	ARC FAYETTE
Address:	80 OLD NEW SALEM RD UNIONTOWN, PA 15401-8902
Phone:	(724) 438-9042
Fax:	(724) 438-2405
E-mail:	mary.mossburg@arcfayette.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:	ARC, FAYETTE COUNTY
Address:	80 OLD NEW SALEM RD UNIONTOWN, PA 15401-8902
Phone:	(724) 438-8416
Fax:	(724) 438-2405

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PROVIDER SERVICES AND RATES Supporting line for group header


County : Allegheny
\|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 1:1 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 (Lvl 2)	$11.10 / 15 min.
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 4-Elig-w/Day Supports	$398.69 / 1 Day
Res Hab-Lic-3 Person-Inelig	$35.47 / 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	$27.15 / 1 Day
Respite-Lic-Day-1 person-NG 3	$906.68 / 1 Day
Respite-Lic-Day-1 person-NG 4	$987.25 / 1 Day
Respite-Lic-Day-3 person-NG 1	$369.73 / 1 Day
Respite-Lic-Day-3 person-NG 2	$419.25 / 1 Day
Respite-Lic-Day-3 person-NG 3	$524.92 / 1 Day
Respite-Lic-Day-3 person-NG 4	$570.64 / 1 Day
Respite-Lic-Day-4 person-NG 1	$295.27 / 1 Day
Respite-Unlic-Day (Level 3, 1:1) Out-of-Home	$343.22 / 1 Day

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

In-Home & Commnty Supprts (Lvl 2)	$11.10 / 15 min.
Life Sharing-1 Person-Elig-NG 1-by Relative >30Hrs	$181.63 / 1 Day
Life Sharing-1 per-Elig-NG 2-by Relative > 30 Hrs	$216.55 / 1 Day
Life Sharing-1 per-Elig-NG 3-By Relative > 30 Hrs	$296.35 / 1 Day
Life Sharing-1 per-Elig-Unlic by Relative < 30Hrs	$156.49 / 1 Day

County : Bedford/Somerset
\|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 1:1 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 (Lvl 2)	$11.10 / 15 min.
Res Hab-Lic-4 Person-Elig-NG 1	$322.49 / 1 Day
Respite-Lic-Day-1 person-NG 3	$906.68 / 1 Day
Respite-Lic-Day-1 person-NG 4	$987.25 / 1 Day
Respite-Lic-Day-2 person-NG 2	$616.04 / 1 Day
Respite-Lic-Day-2 person-NG 3	$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 2	$333.59 / 1 Day
Respite-Lic-Day-4 person-NG 3	$411.70 / 1 Day
Respite-Lic-Day-4 person-NG 4	$447.97 / 1 Day
Respite-Unlic-Day (Level 3, 1:1) Out-of-Home	$343.22 / 1 Day
Supported Employment-Career Assessment	$19.34 / 15 min.
Supported Emplymnt-Job Finding/Job Development	$19.34 / 15 min.
Supported Emplymnt-Job Support - 1:1	$19.34 / 15 min.
Supported Emplymnt-Job Support-1:2	$11.58 / 15 min.
Transportation(Zone 1)-Trip	$36.54 / Trip
Transportation(Zone 2)-Trip	$65.78 / Trip

County : Butler
\|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 1:1 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.

County : Fayette
\|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 1:1 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.
Chore, Permanent - 1 Hour	$24.55 / 1 hr.
Chore, Temporary - 1 Hour	$24.55 / 1 hr.
Companion Services (Basic Staff Support)	$3.45 / 15 min.
Companion Services (Level 1)	$4.77 / 15 min.
Companion Services (Level 2)	$8.33 / 15 min.
Homemaker, Permanent - 1 Hour	$24.55 / 1 hr.
Homemaker, Temporary - 1 Hour	$24.55 / 1 hr.
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.
In-Home & Commnty Supprts (Lvl 3)	$21.42 / 15 min.
Licen Day Hab., Older Adult Daily Living Centers	$4.02 / 15 min.
Life Sharing-1 Person-Elig-NG 1-by Relative >30Hrs	$181.63 / 1 Day
Life Sharing-1 per-Elig-NG 2-by Relative > 30 Hrs	$216.55 / 1 Day
Life Sharing-1 per-Elig-NG 3-By Relative > 30 Hrs	$296.35 / 1 Day
Life Sharing-1 per-Elig-NG 4-by Relative > 30 Hrs	$376.95 / 1 Day
Life Sharing-1 per-NG2-Relative >30Hrs WithOut	$230.47 / 1 Day
Life Sharing-1 per-NG3-Relative >30Hrs WithOut	$325.99 / 1 Day
Life Sharing-1 per-NG4-Relative > 30 Hrs WithOut	$414.65 / 1 Day
Life Sharing-1 person-Elig-NG 1 > 30 Hrs	$181.63 / 1 Day
Life Sharing-1 person-Elig-NG 2 > 30 Hrs	$216.55 / 1 Day
Life Sharing-1 person-Elig-NG 3 > 30 Hrs	$296.35 / 1 Day
Life Sharing-1 person-Elig-NG 4 > 30 Hrs	$376.95 / 1 Day
Life Sharing-1 person-NG2 > 30 Hrs WithOut	$230.47 / 1 Day
Life Sharing-1 person-NG3 > 30 Hrs WithOut	$325.99 / 1 Day
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-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-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-1 Person-Inelig	$93.64 / 1 Day
Res Hab-Lic-2 Person-Inelig	$50.22 / 1 Day
Res Hab-Lic-3 Person-Inelig	$35.47 / 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	$27.15 / 1 Day
Respite-Base Out-of-Home 24 Hours (Level 2)-Day	Not Set
Respite-Lic-Day-1 person-NG 3	$906.68 / 1 Day
Respite-Lic-Day-1 person-NG 4	$987.25 / 1 Day
Respite-Lic-Day-2 person-NG 2	$616.04 / 1 Day
Respite-Lic-Day-2 person-NG 3	$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 2	$419.25 / 1 Day
Respite-Lic-Day-3 person-NG 3	$524.92 / 1 Day
Respite-Lic-Day-3 person-NG 4	$570.64 / 1 Day
Respite-Lic-Day-3 person-NG5	$570.64 / 1 Day
Respite-Lic-Day-4 person-NG 1	$295.27 / 1 Day
Respite-Lic-Day-4 person-NG 2	$333.59 / 1 Day
Respite-Lic-Day-4 person-NG 3	$411.70 / 1 Day
Respite-Lic-Day-4 person-NG 4	$447.97 / 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) In-Home	$343.22 / 1 Day
Respite-Unlic-Day (Level 3, 1:1) Out-of-Home	$343.22 / 1 Day
Supplemental Habilitation 1:1 - 15 min	$6.12 / 15 min.
Supplemental Habilitation 2:1 - 15 min	$12.22 / 15 min.
Supported Employment-Career Assessment	$19.34 / 15 min.
Supported Emplymnt-Job Finding/Job Development	$19.34 / 15 min.
Supported Emplymnt-Job Support - 1:1	$19.34 / 15 min.
Supported Emplymnt-Job Support-1:2	$11.58 / 15 min.
Transportation(Zone 1)-Trip	$36.54 / Trip
Transportation(Zone 2)-Trip	$65.78 / Trip
Transportation(Zone 3)-Trip	$74.73 / Trip

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

CPS Community 1:1	$13.83 / 15 min.

County : Lancaster
\|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 2:3	$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 2-Elig	$643.34 / 1 Day
Res Hab-2 Person-NG 3-Elig	$726.82 / 1 Day
Res Hab-Lic-2 Person-Inelig	$50.22 / 1 Day

County : Washington
\|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 1:1 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.
Respite-Lic-Day-1 person-NG 3	$906.68 / 1 Day
Respite-Lic-Day-1 person-NG 4	$987.25 / 1 Day

County : Westmoreland
\|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 1:1 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 (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-Lic-2 Person-Inelig	$50.22 / 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	$27.15 / 1 Day
Respite-Lic-Day-1 person-NG 3	$906.68 / 1 Day
Respite-Lic-Day-1 person-NG 4	$987.25 / 1 Day
Respite-Lic-Day-4 person-NG 2	$333.59 / 1 Day
Respite-Unlic-Day (Level 3, 1:1) In-Home	$343.22 / 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 Finding/Job Development	$19.34 / 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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