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Provider Demographic Information - GODS GLORY INC

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PROVIDER DEMOGRAPHIC INFORMATION Supporting line for group header


Name:	GODS GLORY INC
Address:	8033 OLD YORK RD STE 218 ELKINS PARK, PA 19027-1422
Phone:	(267) 339-2684
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:	Corporate Office
Name:	God's Glory
Address:	628 E ANNSBURY ST PHILADELPHIA, PA 19120-4602
Phone:	(267) 339-2684

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PROVIDER SERVICES AND RATES Supporting line for group header


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

Companion Services (Basic Staff Support)	Not Set
Companion Services (Level 1)	Not Set
Companion Services (Level 2)	Not Set
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 Enh)	$25.64 / 15 min.
In-Home & Commnty Supprts (Lvl 3)	$21.42 / 15 min.
NEA - Adult Res (6400) - No Day - NG5	Not Set
Needs Exception Allowance (NEA)-Adult Res (6400)	Not Set
Needs Excptn Allowance (NEA)-Adult Res (6400)-521	Not Set
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-Lic-1 Person-Inelig	$105.05 / 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.
Support (Medical Environment) (Basic)-15 Mins	Not Set
Support (Medical Environment) (Level 1)-15 Mins	Not Set
Support (Medical Environment) (Level 2)-15 Mins	Not Set
Support (Medical Environment) (Level 3 Enh)	Not Set
Support (Medical Environment) (Level 3 Enh)-TD	Not Set
Support (Medical Environment) (Level 3 Enh)-TE	Not Set
Support (Medical Environment) (Level 3)-15 Mins	Not Set
Support (Medical Environment) (Level 4 Enh)	Not Set
Support (Medical Environment) (Level 4 Enh)-TD	Not Set
Support (Medical Environment) (Level 4 Enh)-TE	Not Set
Support (Medical Environment) (Level 4)-15 Mins	Not Set

County : Armstrong/Indiana
\|Service Name / Level	\|Rate

Companion Services (Basic Staff Support)	Not Set
Companion Services (Level 1)	Not Set
Companion Services (Level 2)	Not Set
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 Enh)	$25.64 / 15 min.
In-Home & Commnty Supprts (Lvl 3)	$21.42 / 15 min.
NEA - Adult Res (6400) - No Day - NG5	Not Set
Needs Exception Allowance (NEA)-Adult Res (6400)	Not Set
Needs Excptn Allowance (NEA)-Adult Res (6400)-521	Not Set
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-Lic-1 Person-Inelig	$105.05 / 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.
Support (Medical Environment) (Basic)-15 Mins	Not Set
Support (Medical Environment) (Level 1)-15 Mins	Not Set
Support (Medical Environment) (Level 2)-15 Mins	Not Set
Support (Medical Environment) (Level 3 Enh)	Not Set
Support (Medical Environment) (Level 3 Enh)-TD	Not Set
Support (Medical Environment) (Level 3 Enh)-TE	Not Set
Support (Medical Environment) (Level 3)-15 Mins	Not Set
Support (Medical Environment) (Level 4 Enh)	Not Set
Support (Medical Environment) (Level 4 Enh)-TD	Not Set
Support (Medical Environment) (Level 4 Enh)-TE	Not Set
Support (Medical Environment) (Level 4)-15 Mins	Not Set

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

Companion Services (Basic Staff Support)	Not Set
Companion Services (Level 1)	Not Set
Companion Services (Level 2)	Not Set
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 Enh)	$25.64 / 15 min.
In-Home & Commnty Supprts (Lvl 3)	$21.42 / 15 min.
NEA - Adult Res (6400) - No Day - NG5	Not Set
Needs Exception Allowance (NEA)-Adult Res (6400)	Not Set
Needs Excptn Allowance (NEA)-Adult Res (6400)-521	Not Set
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-Lic-1 Person-Inelig	$105.05 / 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.
Support (Medical Environment) (Basic)-15 Mins	Not Set
Support (Medical Environment) (Level 1)-15 Mins	Not Set
Support (Medical Environment) (Level 2)-15 Mins	Not Set
Support (Medical Environment) (Level 3 Enh)	Not Set
Support (Medical Environment) (Level 3 Enh)-TD	Not Set
Support (Medical Environment) (Level 3 Enh)-TE	Not Set
Support (Medical Environment) (Level 3)-15 Mins	Not Set
Support (Medical Environment) (Level 4 Enh)	Not Set
Support (Medical Environment) (Level 4 Enh)-TD	Not Set
Support (Medical Environment) (Level 4 Enh)-TE	Not Set
Support (Medical Environment) (Level 4)-15 Mins	Not Set

County : Bedford/Somerset
\|Service Name / Level	\|Rate

Companion Services (Basic Staff Support)	Not Set
Companion Services (Level 1)	Not Set
Companion Services (Level 2)	Not Set
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 Enh)	$25.64 / 15 min.
In-Home & Commnty Supprts (Lvl 3)	$21.42 / 15 min.
NEA - Adult Res (6400) - No Day - NG5	Not Set
Needs Exception Allowance (NEA)-Adult Res (6400)	Not Set
Needs Excptn Allowance (NEA)-Adult Res (6400)-521	Not Set
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-Lic-1 Person-Inelig	$105.05 / 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.
Support (Medical Environment) (Basic)-15 Mins	Not Set
Support (Medical Environment) (Level 1)-15 Mins	Not Set
Support (Medical Environment) (Level 2)-15 Mins	Not Set
Support (Medical Environment) (Level 3 Enh)	Not Set
Support (Medical Environment) (Level 3 Enh)-TD	Not Set
Support (Medical Environment) (Level 3 Enh)-TE	Not Set
Support (Medical Environment) (Level 3)-15 Mins	Not Set
Support (Medical Environment) (Level 4 Enh)	Not Set
Support (Medical Environment) (Level 4 Enh)-TD	Not Set
Support (Medical Environment) (Level 4 Enh)-TE	Not Set
Support (Medical Environment) (Level 4)-15 Mins	Not Set

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

Companion Services (Basic Staff Support)	Not Set
Companion Services (Level 1)	Not Set
Companion Services (Level 2)	Not Set
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 Enh)	$25.64 / 15 min.
In-Home & Commnty Supprts (Lvl 3)	$21.42 / 15 min.
NEA - Adult Res (6400) - No Day - NG5	Not Set
Needs Exception Allowance (NEA)-Adult Res (6400)	Not Set
Needs Excptn Allowance (NEA)-Adult Res (6400)-521	Not Set
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-Lic-1 Person-Inelig	$105.05 / 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.
Support (Medical Environment) (Basic)-15 Mins	Not Set
Support (Medical Environment) (Level 1)-15 Mins	Not Set
Support (Medical Environment) (Level 2)-15 Mins	Not Set
Support (Medical Environment) (Level 3 Enh)	Not Set
Support (Medical Environment) (Level 3 Enh)-TD	Not Set
Support (Medical Environment) (Level 3 Enh)-TE	Not Set
Support (Medical Environment) (Level 3)-15 Mins	Not Set
Support (Medical Environment) (Level 4 Enh)	Not Set
Support (Medical Environment) (Level 4 Enh)-TD	Not Set
Support (Medical Environment) (Level 4 Enh)-TE	Not Set
Support (Medical Environment) (Level 4)-15 Mins	Not Set

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

Companion Services (Basic Staff Support)	Not Set
Companion Services (Level 1)	Not Set
Companion Services (Level 2)	Not Set
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 Enh)	$25.64 / 15 min.
In-Home & Commnty Supprts (Lvl 3)	$21.42 / 15 min.
NEA - Adult Res (6400) - No Day - NG5	Not Set
Needs Exception Allowance (NEA)-Adult Res (6400)	Not Set
Needs Excptn Allowance (NEA)-Adult Res (6400)-521	Not Set
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-Lic-1 Person-Inelig	$105.05 / 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.
Support (Medical Environment) (Basic)-15 Mins	Not Set
Support (Medical Environment) (Level 1)-15 Mins	Not Set
Support (Medical Environment) (Level 2)-15 Mins	Not Set
Support (Medical Environment) (Level 3 Enh)	Not Set
Support (Medical Environment) (Level 3 Enh)-TD	Not Set
Support (Medical Environment) (Level 3 Enh)-TE	Not Set
Support (Medical Environment) (Level 3)-15 Mins	Not Set
Support (Medical Environment) (Level 4 Enh)	Not Set
Support (Medical Environment) (Level 4 Enh)-TD	Not Set
Support (Medical Environment) (Level 4 Enh)-TE	Not Set
Support (Medical Environment) (Level 4)-15 Mins	Not Set

County : Bradford/Sullivan
\|Service Name / Level	\|Rate

Companion Services (Basic Staff Support)	Not Set
Companion Services (Level 1)	Not Set
Companion Services (Level 2)	Not Set
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 Enh)	$25.64 / 15 min.
In-Home & Commnty Supprts (Lvl 3)	$21.42 / 15 min.
NEA - Adult Res (6400) - No Day - NG5	Not Set
Needs Exception Allowance (NEA)-Adult Res (6400)	Not Set
Needs Excptn Allowance (NEA)-Adult Res (6400)-521	Not Set
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-Lic-1 Person-Inelig	$105.05 / 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.
Support (Medical Environment) (Basic)-15 Mins	Not Set
Support (Medical Environment) (Level 1)-15 Mins	Not Set
Support (Medical Environment) (Level 2)-15 Mins	Not Set
Support (Medical Environment) (Level 3 Enh)	Not Set
Support (Medical Environment) (Level 3 Enh)-TD	Not Set
Support (Medical Environment) (Level 3 Enh)-TE	Not Set
Support (Medical Environment) (Level 3)-15 Mins	Not Set
Support (Medical Environment) (Level 4 Enh)	Not Set
Support (Medical Environment) (Level 4 Enh)-TD	Not Set
Support (Medical Environment) (Level 4 Enh)-TE	Not Set
Support (Medical Environment) (Level 4)-15 Mins	Not Set

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

Companion Services (Basic Staff Support)	Not Set
Companion Services (Level 1)	Not Set
Companion Services (Level 2)	Not Set
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 Enh)	$25.64 / 15 min.
In-Home & Commnty Supprts (Lvl 3)	$21.42 / 15 min.
NEA - Adult Res (6400) - No Day - NG5	Not Set
Needs Exception Allowance (NEA)-Adult Res (6400)	Not Set
Needs Excptn Allowance (NEA)-Adult Res (6400)-521	Not Set
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-Lic-1 Person-Inelig	$105.05 / 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.
Support (Medical Environment) (Basic)-15 Mins	Not Set
Support (Medical Environment) (Level 1)-15 Mins	Not Set
Support (Medical Environment) (Level 2)-15 Mins	Not Set
Support (Medical Environment) (Level 3 Enh)	Not Set
Support (Medical Environment) (Level 3 Enh)-TD	Not Set
Support (Medical Environment) (Level 3 Enh)-TE	Not Set
Support (Medical Environment) (Level 3)-15 Mins	Not Set
Support (Medical Environment) (Level 4 Enh)	Not Set
Support (Medical Environment) (Level 4 Enh)-TD	Not Set
Support (Medical Environment) (Level 4 Enh)-TE	Not Set
Support (Medical Environment) (Level 4)-15 Mins	Not Set

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

Companion Services (Basic Staff Support)	Not Set
Companion Services (Level 1)	Not Set
Companion Services (Level 2)	Not Set
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 Enh)	$25.64 / 15 min.
In-Home & Commnty Supprts (Lvl 3)	$21.42 / 15 min.
NEA - Adult Res (6400) - No Day - NG5	Not Set
Needs Exception Allowance (NEA)-Adult Res (6400)	Not Set
Needs Excptn Allowance (NEA)-Adult Res (6400)-521	Not Set
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-Lic-1 Person-Inelig	$105.05 / 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.
Support (Medical Environment) (Basic)-15 Mins	Not Set
Support (Medical Environment) (Level 1)-15 Mins	Not Set
Support (Medical Environment) (Level 2)-15 Mins	Not Set
Support (Medical Environment) (Level 3 Enh)	Not Set
Support (Medical Environment) (Level 3 Enh)-TD	Not Set
Support (Medical Environment) (Level 3 Enh)-TE	Not Set
Support (Medical Environment) (Level 3)-15 Mins	Not Set
Support (Medical Environment) (Level 4 Enh)	Not Set
Support (Medical Environment) (Level 4 Enh)-TD	Not Set
Support (Medical Environment) (Level 4 Enh)-TE	Not Set
Support (Medical Environment) (Level 4)-15 Mins	Not Set

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

Companion Services (Basic Staff Support)	Not Set
Companion Services (Level 1)	Not Set
Companion Services (Level 2)	Not Set
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 Enh)	$25.64 / 15 min.
In-Home & Commnty Supprts (Lvl 3)	$21.42 / 15 min.
NEA - Adult Res (6400) - No Day - NG5	Not Set
Needs Exception Allowance (NEA)-Adult Res (6400)	Not Set
Needs Excptn Allowance (NEA)-Adult Res (6400)-521	Not Set
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-Lic-1 Person-Inelig	$105.05 / 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.
Support (Medical Environment) (Basic)-15 Mins	Not Set
Support (Medical Environment) (Level 1)-15 Mins	Not Set
Support (Medical Environment) (Level 2)-15 Mins	Not Set
Support (Medical Environment) (Level 3 Enh)	Not Set
Support (Medical Environment) (Level 3 Enh)-TD	Not Set
Support (Medical Environment) (Level 3 Enh)-TE	Not Set
Support (Medical Environment) (Level 3)-15 Mins	Not Set
Support (Medical Environment) (Level 4 Enh)	Not Set
Support (Medical Environment) (Level 4 Enh)-TD	Not Set
Support (Medical Environment) (Level 4 Enh)-TE	Not Set
Support (Medical Environment) (Level 4)-15 Mins	Not Set

County : Cameron/Elk
\|Service Name / Level	\|Rate

Companion Services (Basic Staff Support)	Not Set
Companion Services (Level 1)	Not Set
Companion Services (Level 2)	Not Set
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 Enh)	$25.64 / 15 min.
In-Home & Commnty Supprts (Lvl 3)	$21.42 / 15 min.
NEA - Adult Res (6400) - No Day - NG5	Not Set
Needs Exception Allowance (NEA)-Adult Res (6400)	Not Set
Needs Excptn Allowance (NEA)-Adult Res (6400)-521	Not Set
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-Lic-1 Person-Inelig	$105.05 / 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.
Support (Medical Environment) (Basic)-15 Mins	Not Set
Support (Medical Environment) (Level 1)-15 Mins	Not Set
Support (Medical Environment) (Level 2)-15 Mins	Not Set
Support (Medical Environment) (Level 3 Enh)	Not Set
Support (Medical Environment) (Level 3 Enh)-TD	Not Set
Support (Medical Environment) (Level 3 Enh)-TE	Not Set
Support (Medical Environment) (Level 3)-15 Mins	Not Set
Support (Medical Environment) (Level 4 Enh)	Not Set
Support (Medical Environment) (Level 4 Enh)-TD	Not Set
Support (Medical Environment) (Level 4 Enh)-TE	Not Set
Support (Medical Environment) (Level 4)-15 Mins	Not Set

County : Carbon/Monroe/Pike
\|Service Name / Level	\|Rate

Companion Services (Basic Staff Support)	Not Set
Companion Services (Level 1)	Not Set
Companion Services (Level 2)	Not Set
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 Enh)	$25.64 / 15 min.
In-Home & Commnty Supprts (Lvl 3)	$21.42 / 15 min.
NEA - Adult Res (6400) - No Day - NG5	Not Set
Needs Exception Allowance (NEA)-Adult Res (6400)	Not Set
Needs Excptn Allowance (NEA)-Adult Res (6400)-521	Not Set
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-Lic-1 Person-Inelig	$105.05 / 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.
Support (Medical Environment) (Basic)-15 Mins	Not Set
Support (Medical Environment) (Level 1)-15 Mins	Not Set
Support (Medical Environment) (Level 2)-15 Mins	Not Set
Support (Medical Environment) (Level 3 Enh)	Not Set
Support (Medical Environment) (Level 3 Enh)-TD	Not Set
Support (Medical Environment) (Level 3 Enh)-TE	Not Set
Support (Medical Environment) (Level 3)-15 Mins	Not Set
Support (Medical Environment) (Level 4 Enh)	Not Set
Support (Medical Environment) (Level 4 Enh)-TD	Not Set
Support (Medical Environment) (Level 4 Enh)-TE	Not Set
Support (Medical Environment) (Level 4)-15 Mins	Not Set

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

Companion Services (Basic Staff Support)	Not Set
Companion Services (Level 1)	Not Set
Companion Services (Level 2)	Not Set
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 Enh)	$25.64 / 15 min.
In-Home & Commnty Supprts (Lvl 3)	$21.42 / 15 min.
NEA - Adult Res (6400) - No Day - NG5	Not Set
Needs Exception Allowance (NEA)-Adult Res (6400)	Not Set
Needs Excptn Allowance (NEA)-Adult Res (6400)-521	Not Set
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-Lic-1 Person-Inelig	$105.05 / 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.
Support (Medical Environment) (Basic)-15 Mins	Not Set
Support (Medical Environment) (Level 1)-15 Mins	Not Set
Support (Medical Environment) (Level 2)-15 Mins	Not Set
Support (Medical Environment) (Level 3 Enh)	Not Set
Support (Medical Environment) (Level 3 Enh)-TD	Not Set
Support (Medical Environment) (Level 3 Enh)-TE	Not Set
Support (Medical Environment) (Level 3)-15 Mins	Not Set
Support (Medical Environment) (Level 4 Enh)	Not Set
Support (Medical Environment) (Level 4 Enh)-TD	Not Set
Support (Medical Environment) (Level 4 Enh)-TE	Not Set
Support (Medical Environment) (Level 4)-15 Mins	Not Set

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

Companion Services (Basic Staff Support)	Not Set
Companion Services (Level 1)	Not Set
Companion Services (Level 2)	Not Set
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 Enh)	$25.64 / 15 min.
In-Home & Commnty Supprts (Lvl 3)	$21.42 / 15 min.
NEA - Adult Res (6400) - No Day - NG5	Not Set
Needs Exception Allowance (NEA)-Adult Res (6400)	Not Set
Needs Excptn Allowance (NEA)-Adult Res (6400)-521	Not Set
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-Lic-1 Person-Inelig	$105.05 / 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.
Support (Medical Environment) (Basic)-15 Mins	Not Set
Support (Medical Environment) (Level 1)-15 Mins	Not Set
Support (Medical Environment) (Level 2)-15 Mins	Not Set
Support (Medical Environment) (Level 3 Enh)	Not Set
Support (Medical Environment) (Level 3 Enh)-TD	Not Set
Support (Medical Environment) (Level 3 Enh)-TE	Not Set
Support (Medical Environment) (Level 3)-15 Mins	Not Set
Support (Medical Environment) (Level 4 Enh)	Not Set
Support (Medical Environment) (Level 4 Enh)-TD	Not Set
Support (Medical Environment) (Level 4 Enh)-TE	Not Set
Support (Medical Environment) (Level 4)-15 Mins	Not Set

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

Companion Services (Basic Staff Support)	Not Set
Companion Services (Level 1)	Not Set
Companion Services (Level 2)	Not Set
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 Enh)	$25.64 / 15 min.
In-Home & Commnty Supprts (Lvl 3)	$21.42 / 15 min.
NEA - Adult Res (6400) - No Day - NG5	Not Set
Needs Exception Allowance (NEA)-Adult Res (6400)	Not Set
Needs Excptn Allowance (NEA)-Adult Res (6400)-521	Not Set
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-Lic-1 Person-Inelig	$105.05 / 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.
Support (Medical Environment) (Basic)-15 Mins	Not Set
Support (Medical Environment) (Level 1)-15 Mins	Not Set
Support (Medical Environment) (Level 2)-15 Mins	Not Set
Support (Medical Environment) (Level 3 Enh)	Not Set
Support (Medical Environment) (Level 3 Enh)-TD	Not Set
Support (Medical Environment) (Level 3 Enh)-TE	Not Set
Support (Medical Environment) (Level 3)-15 Mins	Not Set
Support (Medical Environment) (Level 4 Enh)	Not Set
Support (Medical Environment) (Level 4 Enh)-TD	Not Set
Support (Medical Environment) (Level 4 Enh)-TE	Not Set
Support (Medical Environment) (Level 4)-15 Mins	Not Set

County : Clearfield/Jefferson
\|Service Name / Level	\|Rate

Companion Services (Basic Staff Support)	Not Set
Companion Services (Level 1)	Not Set
Companion Services (Level 2)	Not Set
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 Enh)	$25.64 / 15 min.
In-Home & Commnty Supprts (Lvl 3)	$21.42 / 15 min.
NEA - Adult Res (6400) - No Day - NG5	Not Set
Needs Exception Allowance (NEA)-Adult Res (6400)	Not Set
Needs Excptn Allowance (NEA)-Adult Res (6400)-521	Not Set
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-Lic-1 Person-Inelig	$105.05 / 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.
Support (Medical Environment) (Basic)-15 Mins	Not Set
Support (Medical Environment) (Level 1)-15 Mins	Not Set
Support (Medical Environment) (Level 2)-15 Mins	Not Set
Support (Medical Environment) (Level 3 Enh)	Not Set
Support (Medical Environment) (Level 3 Enh)-TD	Not Set
Support (Medical Environment) (Level 3 Enh)-TE	Not Set
Support (Medical Environment) (Level 3)-15 Mins	Not Set
Support (Medical Environment) (Level 4 Enh)	Not Set
Support (Medical Environment) (Level 4 Enh)-TD	Not Set
Support (Medical Environment) (Level 4 Enh)-TE	Not Set
Support (Medical Environment) (Level 4)-15 Mins	Not Set

County : Columbia/Montour/Snyder/Union
\|Service Name / Level	\|Rate

Companion Services (Basic Staff Support)	Not Set
Companion Services (Level 1)	Not Set
Companion Services (Level 2)	Not Set
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 Enh)	$25.64 / 15 min.
In-Home & Commnty Supprts (Lvl 3)	$21.42 / 15 min.
NEA - Adult Res (6400) - No Day - NG5	Not Set
Needs Exception Allowance (NEA)-Adult Res (6400)	Not Set
Needs Excptn Allowance (NEA)-Adult Res (6400)-521	Not Set
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-Lic-1 Person-Inelig	$105.05 / 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.
Support (Medical Environment) (Basic)-15 Mins	Not Set
Support (Medical Environment) (Level 1)-15 Mins	Not Set
Support (Medical Environment) (Level 2)-15 Mins	Not Set
Support (Medical Environment) (Level 3 Enh)	Not Set
Support (Medical Environment) (Level 3 Enh)-TD	Not Set
Support (Medical Environment) (Level 3 Enh)-TE	Not Set
Support (Medical Environment) (Level 3)-15 Mins	Not Set
Support (Medical Environment) (Level 4 Enh)	Not Set
Support (Medical Environment) (Level 4 Enh)-TD	Not Set
Support (Medical Environment) (Level 4 Enh)-TE	Not Set
Support (Medical Environment) (Level 4)-15 Mins	Not Set

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

Companion Services (Basic Staff Support)	Not Set
Companion Services (Level 1)	Not Set
Companion Services (Level 2)	Not Set
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 Enh)	$25.64 / 15 min.
In-Home & Commnty Supprts (Lvl 3)	$21.42 / 15 min.
NEA - Adult Res (6400) - No Day - NG5	Not Set
Needs Exception Allowance (NEA)-Adult Res (6400)	Not Set
Needs Excptn Allowance (NEA)-Adult Res (6400)-521	Not Set
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-Lic-1 Person-Inelig	$105.05 / 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.
Support (Medical Environment) (Basic)-15 Mins	Not Set
Support (Medical Environment) (Level 1)-15 Mins	Not Set
Support (Medical Environment) (Level 2)-15 Mins	Not Set
Support (Medical Environment) (Level 3 Enh)	Not Set
Support (Medical Environment) (Level 3 Enh)-TD	Not Set
Support (Medical Environment) (Level 3 Enh)-TE	Not Set
Support (Medical Environment) (Level 3)-15 Mins	Not Set
Support (Medical Environment) (Level 4 Enh)	Not Set
Support (Medical Environment) (Level 4 Enh)-TD	Not Set
Support (Medical Environment) (Level 4 Enh)-TE	Not Set
Support (Medical Environment) (Level 4)-15 Mins	Not Set

County : Cumberland/Perry
\|Service Name / Level	\|Rate

Companion Services (Basic Staff Support)	Not Set
Companion Services (Level 1)	Not Set
Companion Services (Level 2)	Not Set
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 Enh)	$25.64 / 15 min.
In-Home & Commnty Supprts (Lvl 3)	$21.42 / 15 min.
NEA - Adult Res (6400) - No Day - NG5	Not Set
Needs Exception Allowance (NEA)-Adult Res (6400)	Not Set
Needs Excptn Allowance (NEA)-Adult Res (6400)-521	Not Set
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-Lic-1 Person-Inelig	$105.05 / 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.
Support (Medical Environment) (Basic)-15 Mins	Not Set
Support (Medical Environment) (Level 1)-15 Mins	Not Set
Support (Medical Environment) (Level 2)-15 Mins	Not Set
Support (Medical Environment) (Level 3 Enh)	Not Set
Support (Medical Environment) (Level 3 Enh)-TD	Not Set
Support (Medical Environment) (Level 3 Enh)-TE	Not Set
Support (Medical Environment) (Level 3)-15 Mins	Not Set
Support (Medical Environment) (Level 4 Enh)	Not Set
Support (Medical Environment) (Level 4 Enh)-TD	Not Set
Support (Medical Environment) (Level 4 Enh)-TE	Not Set
Support (Medical Environment) (Level 4)-15 Mins	Not Set

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

Companion Services (Basic Staff Support)	Not Set
Companion Services (Level 1)	Not Set
Companion Services (Level 2)	Not Set
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 Enh)	$25.64 / 15 min.
In-Home & Commnty Supprts (Lvl 3)	$21.42 / 15 min.
NEA - Adult Res (6400) - No Day - NG5	Not Set
Needs Exception Allowance (NEA)-Adult Res (6400)	Not Set
Needs Excptn Allowance (NEA)-Adult Res (6400)-521	Not Set
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-Lic-1 Person-Inelig	$105.05 / 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.
Support (Medical Environment) (Basic)-15 Mins	Not Set
Support (Medical Environment) (Level 1)-15 Mins	Not Set
Support (Medical Environment) (Level 2)-15 Mins	Not Set
Support (Medical Environment) (Level 3 Enh)	Not Set
Support (Medical Environment) (Level 3 Enh)-TD	Not Set
Support (Medical Environment) (Level 3 Enh)-TE	Not Set
Support (Medical Environment) (Level 3)-15 Mins	Not Set
Support (Medical Environment) (Level 4 Enh)	Not Set
Support (Medical Environment) (Level 4 Enh)-TD	Not Set
Support (Medical Environment) (Level 4 Enh)-TE	Not Set
Support (Medical Environment) (Level 4)-15 Mins	Not Set

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

Companion Services (Basic Staff Support)	Not Set
Companion Services (Level 1)	Not Set
Companion Services (Level 2)	Not Set
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 Enh)	$25.64 / 15 min.
In-Home & Commnty Supprts (Lvl 3)	$21.42 / 15 min.
NEA - Adult Res (6400) - No Day - NG5	Not Set
Needs Exception Allowance (NEA)-Adult Res (6400)	Not Set
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 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-Lic-1 Person-Inelig	$105.05 / 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.
Support (Medical Environment) (Basic)-15 Mins	Not Set
Support (Medical Environment) (Level 1)-15 Mins	Not Set
Support (Medical Environment) (Level 2)-15 Mins	Not Set
Support (Medical Environment) (Level 3 Enh)	Not Set
Support (Medical Environment) (Level 3 Enh)-TD	Not Set
Support (Medical Environment) (Level 3 Enh)-TE	Not Set
Support (Medical Environment) (Level 3)-15 Mins	Not Set
Support (Medical Environment) (Level 4 Enh)	Not Set
Support (Medical Environment) (Level 4 Enh)-TD	Not Set
Support (Medical Environment) (Level 4 Enh)-TE	Not Set
Support (Medical Environment) (Level 4)-15 Mins	Not Set

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

Companion Services (Basic Staff Support)	Not Set
Companion Services (Level 1)	Not Set
Companion Services (Level 2)	Not Set
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 Enh)	$25.64 / 15 min.
In-Home & Commnty Supprts (Lvl 3)	$21.42 / 15 min.
NEA - Adult Res (6400) - No Day - NG5	Not Set
Needs Exception Allowance (NEA)-Adult Res (6400)	Not Set
Needs Excptn Allowance (NEA)-Adult Res (6400)-521	Not Set
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-Lic-1 Person-Inelig	$105.05 / 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.
Support (Medical Environment) (Basic)-15 Mins	Not Set
Support (Medical Environment) (Level 1)-15 Mins	Not Set
Support (Medical Environment) (Level 2)-15 Mins	Not Set
Support (Medical Environment) (Level 3 Enh)	Not Set
Support (Medical Environment) (Level 3 Enh)-TD	Not Set
Support (Medical Environment) (Level 3 Enh)-TE	Not Set
Support (Medical Environment) (Level 3)-15 Mins	Not Set
Support (Medical Environment) (Level 4 Enh)	Not Set
Support (Medical Environment) (Level 4 Enh)-TD	Not Set
Support (Medical Environment) (Level 4 Enh)-TE	Not Set
Support (Medical Environment) (Level 4)-15 Mins	Not Set

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

Companion Services (Basic Staff Support)	Not Set
Companion Services (Level 1)	Not Set
Companion Services (Level 2)	Not Set
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 Enh)	$25.64 / 15 min.
In-Home & Commnty Supprts (Lvl 3)	$21.42 / 15 min.
NEA - Adult Res (6400) - No Day - NG5	Not Set
Needs Exception Allowance (NEA)-Adult Res (6400)	Not Set
Needs Excptn Allowance (NEA)-Adult Res (6400)-521	Not Set
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-Lic-1 Person-Inelig	$105.05 / 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.
Support (Medical Environment) (Basic)-15 Mins	Not Set
Support (Medical Environment) (Level 1)-15 Mins	Not Set
Support (Medical Environment) (Level 2)-15 Mins	Not Set
Support (Medical Environment) (Level 3 Enh)	Not Set
Support (Medical Environment) (Level 3 Enh)-TD	Not Set
Support (Medical Environment) (Level 3 Enh)-TE	Not Set
Support (Medical Environment) (Level 3)-15 Mins	Not Set
Support (Medical Environment) (Level 4 Enh)	Not Set
Support (Medical Environment) (Level 4 Enh)-TD	Not Set
Support (Medical Environment) (Level 4 Enh)-TE	Not Set
Support (Medical Environment) (Level 4)-15 Mins	Not Set

County : Forest/Warren
\|Service Name / Level	\|Rate

Companion Services (Basic Staff Support)	Not Set
Companion Services (Level 1)	Not Set
Companion Services (Level 2)	Not Set
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 Enh)	$25.64 / 15 min.
In-Home & Commnty Supprts (Lvl 3)	$21.42 / 15 min.
NEA - Adult Res (6400) - No Day - NG5	Not Set
Needs Exception Allowance (NEA)-Adult Res (6400)	Not Set
Needs Excptn Allowance (NEA)-Adult Res (6400)-521	Not Set
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-Lic-1 Person-Inelig	$105.05 / 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.
Support (Medical Environment) (Basic)-15 Mins	Not Set
Support (Medical Environment) (Level 1)-15 Mins	Not Set
Support (Medical Environment) (Level 2)-15 Mins	Not Set
Support (Medical Environment) (Level 3 Enh)	Not Set
Support (Medical Environment) (Level 3 Enh)-TD	Not Set
Support (Medical Environment) (Level 3 Enh)-TE	Not Set
Support (Medical Environment) (Level 3)-15 Mins	Not Set
Support (Medical Environment) (Level 4 Enh)	Not Set
Support (Medical Environment) (Level 4 Enh)-TD	Not Set
Support (Medical Environment) (Level 4 Enh)-TE	Not Set
Support (Medical Environment) (Level 4)-15 Mins	Not Set

County : Franklin/Fulton
\|Service Name / Level	\|Rate

Companion Services (Basic Staff Support)	Not Set
Companion Services (Level 1)	Not Set
Companion Services (Level 2)	Not Set
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 Enh)	$25.64 / 15 min.
In-Home & Commnty Supprts (Lvl 3)	$21.42 / 15 min.
NEA - Adult Res (6400) - No Day - NG5	Not Set
Needs Exception Allowance (NEA)-Adult Res (6400)	Not Set
Needs Excptn Allowance (NEA)-Adult Res (6400)-521	Not Set
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-Lic-1 Person-Inelig	$105.05 / 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.
Support (Medical Environment) (Basic)-15 Mins	Not Set
Support (Medical Environment) (Level 1)-15 Mins	Not Set
Support (Medical Environment) (Level 2)-15 Mins	Not Set
Support (Medical Environment) (Level 3 Enh)	Not Set
Support (Medical Environment) (Level 3 Enh)-TD	Not Set
Support (Medical Environment) (Level 3 Enh)-TE	Not Set
Support (Medical Environment) (Level 3)-15 Mins	Not Set
Support (Medical Environment) (Level 4 Enh)	Not Set
Support (Medical Environment) (Level 4 Enh)-TD	Not Set
Support (Medical Environment) (Level 4 Enh)-TE	Not Set
Support (Medical Environment) (Level 4)-15 Mins	Not Set

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

Companion Services (Basic Staff Support)	Not Set
Companion Services (Level 1)	Not Set
Companion Services (Level 2)	Not Set
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 Enh)	$25.64 / 15 min.
In-Home & Commnty Supprts (Lvl 3)	$21.42 / 15 min.
NEA - Adult Res (6400) - No Day - NG5	Not Set
Needs Exception Allowance (NEA)-Adult Res (6400)	Not Set
Needs Excptn Allowance (NEA)-Adult Res (6400)-521	Not Set
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-Lic-1 Person-Inelig	$105.05 / 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.
Support (Medical Environment) (Basic)-15 Mins	Not Set
Support (Medical Environment) (Level 1)-15 Mins	Not Set
Support (Medical Environment) (Level 2)-15 Mins	Not Set
Support (Medical Environment) (Level 3 Enh)	Not Set
Support (Medical Environment) (Level 3 Enh)-TD	Not Set
Support (Medical Environment) (Level 3 Enh)-TE	Not Set
Support (Medical Environment) (Level 3)-15 Mins	Not Set
Support (Medical Environment) (Level 4 Enh)	Not Set
Support (Medical Environment) (Level 4 Enh)-TD	Not Set
Support (Medical Environment) (Level 4 Enh)-TE	Not Set
Support (Medical Environment) (Level 4)-15 Mins	Not Set

County : Huntingdon/Mifflin/Juniata
\|Service Name / Level	\|Rate

Companion Services (Basic Staff Support)	Not Set
Companion Services (Level 1)	Not Set
Companion Services (Level 2)	Not Set
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 Enh)	$25.64 / 15 min.
In-Home & Commnty Supprts (Lvl 3)	$21.42 / 15 min.
NEA - Adult Res (6400) - No Day - NG5	Not Set
Needs Exception Allowance (NEA)-Adult Res (6400)	Not Set
Needs Excptn Allowance (NEA)-Adult Res (6400)-521	Not Set
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-Lic-1 Person-Inelig	$105.05 / 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.
Support (Medical Environment) (Basic)-15 Mins	Not Set
Support (Medical Environment) (Level 1)-15 Mins	Not Set
Support (Medical Environment) (Level 2)-15 Mins	Not Set
Support (Medical Environment) (Level 3 Enh)	Not Set
Support (Medical Environment) (Level 3 Enh)-TD	Not Set
Support (Medical Environment) (Level 3 Enh)-TE	Not Set
Support (Medical Environment) (Level 3)-15 Mins	Not Set
Support (Medical Environment) (Level 4 Enh)	Not Set
Support (Medical Environment) (Level 4 Enh)-TD	Not Set
Support (Medical Environment) (Level 4 Enh)-TE	Not Set
Support (Medical Environment) (Level 4)-15 Mins	Not Set

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

Companion Services (Basic Staff Support)	Not Set
Companion Services (Level 1)	Not Set
Companion Services (Level 2)	Not Set
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 Enh)	$25.64 / 15 min.
In-Home & Commnty Supprts (Lvl 3)	$21.42 / 15 min.
NEA - Adult Res (6400) - No Day - NG5	Not Set
Needs Exception Allowance (NEA)-Adult Res (6400)	Not Set
Needs Excptn Allowance (NEA)-Adult Res (6400)-521	Not Set
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-Lic-1 Person-Inelig	$105.05 / 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.
Support (Medical Environment) (Basic)-15 Mins	Not Set
Support (Medical Environment) (Level 1)-15 Mins	Not Set
Support (Medical Environment) (Level 2)-15 Mins	Not Set
Support (Medical Environment) (Level 3 Enh)	Not Set
Support (Medical Environment) (Level 3 Enh)-TD	Not Set
Support (Medical Environment) (Level 3 Enh)-TE	Not Set
Support (Medical Environment) (Level 3)-15 Mins	Not Set
Support (Medical Environment) (Level 4 Enh)	Not Set
Support (Medical Environment) (Level 4 Enh)-TD	Not Set
Support (Medical Environment) (Level 4 Enh)-TE	Not Set
Support (Medical Environment) (Level 4)-15 Mins	Not Set

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

Companion Services (Basic Staff Support)	Not Set
Companion Services (Level 1)	Not Set
Companion Services (Level 2)	Not Set
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 Enh)	$25.64 / 15 min.
In-Home & Commnty Supprts (Lvl 3)	$21.42 / 15 min.
NEA - Adult Res (6400) - No Day - NG5	Not Set
Needs Exception Allowance (NEA)-Adult Res (6400)	Not Set
Needs Excptn Allowance (NEA)-Adult Res (6400)-521	Not Set
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-Lic-1 Person-Inelig	$105.05 / 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.
Support (Medical Environment) (Basic)-15 Mins	Not Set
Support (Medical Environment) (Level 1)-15 Mins	Not Set
Support (Medical Environment) (Level 2)-15 Mins	Not Set
Support (Medical Environment) (Level 3 Enh)	Not Set
Support (Medical Environment) (Level 3 Enh)-TD	Not Set
Support (Medical Environment) (Level 3 Enh)-TE	Not Set
Support (Medical Environment) (Level 3)-15 Mins	Not Set
Support (Medical Environment) (Level 4 Enh)	Not Set
Support (Medical Environment) (Level 4 Enh)-TD	Not Set
Support (Medical Environment) (Level 4 Enh)-TE	Not Set
Support (Medical Environment) (Level 4)-15 Mins	Not Set

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

Companion Services (Basic Staff Support)	Not Set
Companion Services (Level 1)	Not Set
Companion Services (Level 2)	Not Set
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 Enh)	$25.64 / 15 min.
In-Home & Commnty Supprts (Lvl 3)	$21.42 / 15 min.
NEA - Adult Res (6400) - No Day - NG5	Not Set
Needs Exception Allowance (NEA)-Adult Res (6400)	Not Set
Needs Excptn Allowance (NEA)-Adult Res (6400)-521	Not Set
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-Lic-1 Person-Inelig	$105.05 / 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.
Support (Medical Environment) (Basic)-15 Mins	Not Set
Support (Medical Environment) (Level 1)-15 Mins	Not Set
Support (Medical Environment) (Level 2)-15 Mins	Not Set
Support (Medical Environment) (Level 3 Enh)	Not Set
Support (Medical Environment) (Level 3 Enh)-TD	Not Set
Support (Medical Environment) (Level 3 Enh)-TE	Not Set
Support (Medical Environment) (Level 3)-15 Mins	Not Set
Support (Medical Environment) (Level 4 Enh)	Not Set
Support (Medical Environment) (Level 4 Enh)-TD	Not Set
Support (Medical Environment) (Level 4 Enh)-TE	Not Set
Support (Medical Environment) (Level 4)-15 Mins	Not Set

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

Companion Services (Basic Staff Support)	Not Set
Companion Services (Level 1)	Not Set
Companion Services (Level 2)	Not Set
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 Enh)	$25.64 / 15 min.
In-Home & Commnty Supprts (Lvl 3)	$21.42 / 15 min.
NEA - Adult Res (6400) - No Day - NG5	Not Set
Needs Exception Allowance (NEA)-Adult Res (6400)	Not Set
Needs Excptn Allowance (NEA)-Adult Res (6400)-521	Not Set
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-Lic-1 Person-Inelig	$105.05 / 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.
Support (Medical Environment) (Basic)-15 Mins	Not Set
Support (Medical Environment) (Level 1)-15 Mins	Not Set
Support (Medical Environment) (Level 2)-15 Mins	Not Set
Support (Medical Environment) (Level 3 Enh)	Not Set
Support (Medical Environment) (Level 3 Enh)-TD	Not Set
Support (Medical Environment) (Level 3 Enh)-TE	Not Set
Support (Medical Environment) (Level 3)-15 Mins	Not Set
Support (Medical Environment) (Level 4 Enh)	Not Set
Support (Medical Environment) (Level 4 Enh)-TD	Not Set
Support (Medical Environment) (Level 4 Enh)-TE	Not Set
Support (Medical Environment) (Level 4)-15 Mins	Not Set

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

Companion Services (Basic Staff Support)	Not Set
Companion Services (Level 1)	Not Set
Companion Services (Level 2)	Not Set
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 Enh)	$25.64 / 15 min.
In-Home & Commnty Supprts (Lvl 3)	$21.42 / 15 min.
NEA - Adult Res (6400) - No Day - NG5	Not Set
Needs Exception Allowance (NEA)-Adult Res (6400)	Not Set
Needs Excptn Allowance (NEA)-Adult Res (6400)-521	Not Set
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-Lic-1 Person-Inelig	$105.05 / 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.
Support (Medical Environment) (Basic)-15 Mins	Not Set
Support (Medical Environment) (Level 1)-15 Mins	Not Set
Support (Medical Environment) (Level 2)-15 Mins	Not Set
Support (Medical Environment) (Level 3 Enh)	Not Set
Support (Medical Environment) (Level 3 Enh)-TD	Not Set
Support (Medical Environment) (Level 3 Enh)-TE	Not Set
Support (Medical Environment) (Level 3)-15 Mins	Not Set
Support (Medical Environment) (Level 4 Enh)	Not Set
Support (Medical Environment) (Level 4 Enh)-TD	Not Set
Support (Medical Environment) (Level 4 Enh)-TE	Not Set
Support (Medical Environment) (Level 4)-15 Mins	Not Set

County : Luzerne/Wyoming
\|Service Name / Level	\|Rate

Companion Services (Basic Staff Support)	Not Set
Companion Services (Level 1)	Not Set
Companion Services (Level 2)	Not Set
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 Enh)	$25.64 / 15 min.
In-Home & Commnty Supprts (Lvl 3)	$21.42 / 15 min.
NEA - Adult Res (6400) - No Day - NG5	Not Set
Needs Exception Allowance (NEA)-Adult Res (6400)	Not Set
Needs Excptn Allowance (NEA)-Adult Res (6400)-521	Not Set
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-Lic-1 Person-Inelig	$105.05 / 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.
Support (Medical Environment) (Basic)-15 Mins	Not Set
Support (Medical Environment) (Level 1)-15 Mins	Not Set
Support (Medical Environment) (Level 2)-15 Mins	Not Set
Support (Medical Environment) (Level 3 Enh)	Not Set
Support (Medical Environment) (Level 3 Enh)-TD	Not Set
Support (Medical Environment) (Level 3 Enh)-TE	Not Set
Support (Medical Environment) (Level 3)-15 Mins	Not Set
Support (Medical Environment) (Level 4 Enh)	Not Set
Support (Medical Environment) (Level 4 Enh)-TD	Not Set
Support (Medical Environment) (Level 4 Enh)-TE	Not Set
Support (Medical Environment) (Level 4)-15 Mins	Not Set

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

Companion Services (Basic Staff Support)	Not Set
Companion Services (Level 1)	Not Set
Companion Services (Level 2)	Not Set
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 Enh)	$25.64 / 15 min.
In-Home & Commnty Supprts (Lvl 3)	$21.42 / 15 min.
NEA - Adult Res (6400) - No Day - NG5	Not Set
Needs Exception Allowance (NEA)-Adult Res (6400)	Not Set
Needs Excptn Allowance (NEA)-Adult Res (6400)-521	Not Set
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-Lic-1 Person-Inelig	$105.05 / 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.
Support (Medical Environment) (Basic)-15 Mins	Not Set
Support (Medical Environment) (Level 1)-15 Mins	Not Set
Support (Medical Environment) (Level 2)-15 Mins	Not Set
Support (Medical Environment) (Level 3 Enh)	Not Set
Support (Medical Environment) (Level 3 Enh)-TD	Not Set
Support (Medical Environment) (Level 3 Enh)-TE	Not Set
Support (Medical Environment) (Level 3)-15 Mins	Not Set
Support (Medical Environment) (Level 4 Enh)	Not Set
Support (Medical Environment) (Level 4 Enh)-TD	Not Set
Support (Medical Environment) (Level 4 Enh)-TE	Not Set
Support (Medical Environment) (Level 4)-15 Mins	Not Set

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

Companion Services (Basic Staff Support)	Not Set
Companion Services (Level 1)	Not Set
Companion Services (Level 2)	Not Set
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 Enh)	$25.64 / 15 min.
In-Home & Commnty Supprts (Lvl 3)	$21.42 / 15 min.
NEA - Adult Res (6400) - No Day - NG5	Not Set
Needs Exception Allowance (NEA)-Adult Res (6400)	Not Set
Needs Excptn Allowance (NEA)-Adult Res (6400)-521	Not Set
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-Lic-1 Person-Inelig	$105.05 / 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.
Support (Medical Environment) (Basic)-15 Mins	Not Set
Support (Medical Environment) (Level 1)-15 Mins	Not Set
Support (Medical Environment) (Level 2)-15 Mins	Not Set
Support (Medical Environment) (Level 3 Enh)	Not Set
Support (Medical Environment) (Level 3 Enh)-TD	Not Set
Support (Medical Environment) (Level 3 Enh)-TE	Not Set
Support (Medical Environment) (Level 3)-15 Mins	Not Set
Support (Medical Environment) (Level 4 Enh)	Not Set
Support (Medical Environment) (Level 4 Enh)-TD	Not Set
Support (Medical Environment) (Level 4 Enh)-TE	Not Set
Support (Medical Environment) (Level 4)-15 Mins	Not Set

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

Companion Services (Basic Staff Support)	Not Set
Companion Services (Level 1)	Not Set
Companion Services (Level 2)	Not Set
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 Enh)	$25.64 / 15 min.
In-Home & Commnty Supprts (Lvl 3)	$21.42 / 15 min.
NEA - Adult Res (6400) - No Day - NG5	Not Set
Needs Exception Allowance (NEA)-Adult Res (6400)	Not Set
Needs Excptn Allowance (NEA)-Adult Res (6400)-521	Not Set
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-Lic-1 Person-Inelig	$105.05 / 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.
Support (Medical Environment) (Basic)-15 Mins	Not Set
Support (Medical Environment) (Level 1)-15 Mins	Not Set
Support (Medical Environment) (Level 2)-15 Mins	Not Set
Support (Medical Environment) (Level 3 Enh)	Not Set
Support (Medical Environment) (Level 3 Enh)-TD	Not Set
Support (Medical Environment) (Level 3 Enh)-TE	Not Set
Support (Medical Environment) (Level 3)-15 Mins	Not Set
Support (Medical Environment) (Level 4 Enh)	Not Set
Support (Medical Environment) (Level 4 Enh)-TD	Not Set
Support (Medical Environment) (Level 4 Enh)-TE	Not Set
Support (Medical Environment) (Level 4)-15 Mins	Not Set

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

Companion Services (Basic Staff Support)	Not Set
Companion Services (Level 1)	Not Set
Companion Services (Level 2)	Not Set
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 Enh)	$25.64 / 15 min.
In-Home & Commnty Supprts (Lvl 3)	$21.42 / 15 min.
NEA - Adult Res (6400) - No Day - NG5	Not Set
Needs Exception Allowance (NEA)-Adult Res (6400)	Not Set
Needs Excptn Allowance (NEA)-Adult Res (6400)-521	$1,382.67 / 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-Lic-1 Person-Inelig	$105.05 / 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.
Support (Medical Environment) (Basic)-15 Mins	Not Set
Support (Medical Environment) (Level 1)-15 Mins	Not Set
Support (Medical Environment) (Level 2)-15 Mins	Not Set
Support (Medical Environment) (Level 3 Enh)	Not Set
Support (Medical Environment) (Level 3 Enh)-TD	Not Set
Support (Medical Environment) (Level 3 Enh)-TE	Not Set
Support (Medical Environment) (Level 3)-15 Mins	Not Set
Support (Medical Environment) (Level 4 Enh)	Not Set
Support (Medical Environment) (Level 4 Enh)-TD	Not Set
Support (Medical Environment) (Level 4 Enh)-TE	Not Set
Support (Medical Environment) (Level 4)-15 Mins	Not Set

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

Companion Services (Basic Staff Support)	Not Set
Companion Services (Level 1)	Not Set
Companion Services (Level 2)	Not Set
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 Enh)	$25.64 / 15 min.
In-Home & Commnty Supprts (Lvl 3)	$21.42 / 15 min.
NEA - Adult Res (6400) - No Day - NG5	Not Set
Needs Exception Allowance (NEA)-Adult Res (6400)	Not Set
Needs Excptn Allowance (NEA)-Adult Res (6400)-521	Not Set
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-Lic-1 Person-Inelig	$105.05 / 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.
Support (Medical Environment) (Basic)-15 Mins	Not Set
Support (Medical Environment) (Level 1)-15 Mins	Not Set
Support (Medical Environment) (Level 2)-15 Mins	Not Set
Support (Medical Environment) (Level 3 Enh)	Not Set
Support (Medical Environment) (Level 3 Enh)-TD	Not Set
Support (Medical Environment) (Level 3 Enh)-TE	Not Set
Support (Medical Environment) (Level 3)-15 Mins	Not Set
Support (Medical Environment) (Level 4 Enh)	Not Set
Support (Medical Environment) (Level 4 Enh)-TD	Not Set
Support (Medical Environment) (Level 4 Enh)-TE	Not Set
Support (Medical Environment) (Level 4)-15 Mins	Not Set

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

Companion Services (Basic Staff Support)	Not Set
Companion Services (Level 1)	Not Set
Companion Services (Level 2)	Not Set
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 Enh)	$25.64 / 15 min.
In-Home & Commnty Supprts (Lvl 3)	$21.42 / 15 min.
NEA - Adult Res (6400) - No Day - NG5	Not Set
Needs Exception Allowance (NEA)-Adult Res (6400)	Not Set
Needs Excptn Allowance (NEA)-Adult Res (6400)-521	Not Set
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-Lic-1 Person-Inelig	$105.05 / 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.
Support (Medical Environment) (Basic)-15 Mins	Not Set
Support (Medical Environment) (Level 1)-15 Mins	Not Set
Support (Medical Environment) (Level 2)-15 Mins	Not Set
Support (Medical Environment) (Level 3 Enh)	Not Set
Support (Medical Environment) (Level 3 Enh)-TD	Not Set
Support (Medical Environment) (Level 3 Enh)-TE	Not Set
Support (Medical Environment) (Level 3)-15 Mins	Not Set
Support (Medical Environment) (Level 4 Enh)	Not Set
Support (Medical Environment) (Level 4 Enh)-TD	Not Set
Support (Medical Environment) (Level 4 Enh)-TE	Not Set
Support (Medical Environment) (Level 4)-15 Mins	Not Set

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

Companion Services (Basic Staff Support)	Not Set
Companion Services (Level 1)	Not Set
Companion Services (Level 2)	Not Set
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 Enh)	$25.64 / 15 min.
In-Home & Commnty Supprts (Lvl 3)	$21.42 / 15 min.
NEA - Adult Res (6400) - No Day - NG5	Not Set
Needs Exception Allowance (NEA)-Adult Res (6400)	Not Set
Needs Excptn Allowance (NEA)-Adult Res (6400)-521	Not Set
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-Lic-1 Person-Inelig	$105.05 / 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.
Support (Medical Environment) (Basic)-15 Mins	Not Set
Support (Medical Environment) (Level 1)-15 Mins	Not Set
Support (Medical Environment) (Level 2)-15 Mins	Not Set
Support (Medical Environment) (Level 3 Enh)	Not Set
Support (Medical Environment) (Level 3 Enh)-TD	Not Set
Support (Medical Environment) (Level 3 Enh)-TE	Not Set
Support (Medical Environment) (Level 3)-15 Mins	Not Set
Support (Medical Environment) (Level 4 Enh)	Not Set
Support (Medical Environment) (Level 4 Enh)-TD	Not Set
Support (Medical Environment) (Level 4 Enh)-TE	Not Set
Support (Medical Environment) (Level 4)-15 Mins	Not Set

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

Companion Services (Basic Staff Support)	Not Set
Companion Services (Level 1)	Not Set
Companion Services (Level 2)	Not Set
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 Enh)	$25.64 / 15 min.
In-Home & Commnty Supprts (Lvl 3)	$21.42 / 15 min.
NEA - Adult Res (6400) - No Day - NG5	Not Set
Needs Exception Allowance (NEA)-Adult Res (6400)	Not Set
Needs Excptn Allowance (NEA)-Adult Res (6400)-521	Not Set
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-Lic-1 Person-Inelig	$105.05 / 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.
Support (Medical Environment) (Basic)-15 Mins	Not Set
Support (Medical Environment) (Level 1)-15 Mins	Not Set
Support (Medical Environment) (Level 2)-15 Mins	Not Set
Support (Medical Environment) (Level 3 Enh)	Not Set
Support (Medical Environment) (Level 3 Enh)-TD	Not Set
Support (Medical Environment) (Level 3 Enh)-TE	Not Set
Support (Medical Environment) (Level 3)-15 Mins	Not Set
Support (Medical Environment) (Level 4 Enh)	Not Set
Support (Medical Environment) (Level 4 Enh)-TD	Not Set
Support (Medical Environment) (Level 4 Enh)-TE	Not Set
Support (Medical Environment) (Level 4)-15 Mins	Not Set

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

Companion Services (Basic Staff Support)	Not Set
Companion Services (Level 1)	Not Set
Companion Services (Level 2)	Not Set
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 Enh)	$25.64 / 15 min.
In-Home & Commnty Supprts (Lvl 3)	$21.42 / 15 min.
NEA - Adult Res (6400) - No Day - NG5	Not Set
Needs Exception Allowance (NEA)-Adult Res (6400)	Not Set
Needs Excptn Allowance (NEA)-Adult Res (6400)-521	Not Set
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-Lic-1 Person-Inelig	$105.05 / 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.
Support (Medical Environment) (Basic)-15 Mins	Not Set
Support (Medical Environment) (Level 1)-15 Mins	Not Set
Support (Medical Environment) (Level 2)-15 Mins	Not Set
Support (Medical Environment) (Level 3 Enh)	Not Set
Support (Medical Environment) (Level 3 Enh)-TD	Not Set
Support (Medical Environment) (Level 3 Enh)-TE	Not Set
Support (Medical Environment) (Level 3)-15 Mins	Not Set
Support (Medical Environment) (Level 4 Enh)	Not Set
Support (Medical Environment) (Level 4 Enh)-TD	Not Set
Support (Medical Environment) (Level 4 Enh)-TE	Not Set
Support (Medical Environment) (Level 4)-15 Mins	Not Set

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

Companion Services (Basic Staff Support)	Not Set
Companion Services (Level 1)	Not Set
Companion Services (Level 2)	Not Set
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 Enh)	$25.64 / 15 min.
In-Home & Commnty Supprts (Lvl 3)	$21.42 / 15 min.
NEA - Adult Res (6400) - No Day - NG5	Not Set
Needs Exception Allowance (NEA)-Adult Res (6400)	Not Set
Needs Excptn Allowance (NEA)-Adult Res (6400)-521	Not Set
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-Lic-1 Person-Inelig	$105.05 / 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.
Support (Medical Environment) (Basic)-15 Mins	Not Set
Support (Medical Environment) (Level 1)-15 Mins	Not Set
Support (Medical Environment) (Level 2)-15 Mins	Not Set
Support (Medical Environment) (Level 3 Enh)	Not Set
Support (Medical Environment) (Level 3 Enh)-TD	Not Set
Support (Medical Environment) (Level 3 Enh)-TE	Not Set
Support (Medical Environment) (Level 3)-15 Mins	Not Set
Support (Medical Environment) (Level 4 Enh)	Not Set
Support (Medical Environment) (Level 4 Enh)-TD	Not Set
Support (Medical Environment) (Level 4 Enh)-TE	Not Set
Support (Medical Environment) (Level 4)-15 Mins	Not Set

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

Companion Services (Basic Staff Support)	Not Set
Companion Services (Level 1)	Not Set
Companion Services (Level 2)	Not Set
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 Enh)	$25.64 / 15 min.
In-Home & Commnty Supprts (Lvl 3)	$21.42 / 15 min.
NEA - Adult Res (6400) - No Day - NG5	Not Set
Needs Exception Allowance (NEA)-Adult Res (6400)	Not Set
Needs Excptn Allowance (NEA)-Adult Res (6400)-521	Not Set
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-Lic-1 Person-Inelig	$105.05 / 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.
Support (Medical Environment) (Basic)-15 Mins	Not Set
Support (Medical Environment) (Level 1)-15 Mins	Not Set
Support (Medical Environment) (Level 2)-15 Mins	Not Set
Support (Medical Environment) (Level 3 Enh)	Not Set
Support (Medical Environment) (Level 3 Enh)-TD	Not Set
Support (Medical Environment) (Level 3 Enh)-TE	Not Set
Support (Medical Environment) (Level 3)-15 Mins	Not Set
Support (Medical Environment) (Level 4 Enh)	Not Set
Support (Medical Environment) (Level 4 Enh)-TD	Not Set
Support (Medical Environment) (Level 4 Enh)-TE	Not Set
Support (Medical Environment) (Level 4)-15 Mins	Not Set

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

Companion Services (Basic Staff Support)	Not Set
Companion Services (Level 1)	Not Set
Companion Services (Level 2)	Not Set
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 Enh)	$25.64 / 15 min.
In-Home & Commnty Supprts (Lvl 3)	$21.42 / 15 min.
NEA - Adult Res (6400) - No Day - NG5	Not Set
Needs Exception Allowance (NEA)-Adult Res (6400)	Not Set
Needs Excptn Allowance (NEA)-Adult Res (6400)-521	Not Set
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-Lic-1 Person-Inelig	$105.05 / 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.
Support (Medical Environment) (Basic)-15 Mins	Not Set
Support (Medical Environment) (Level 1)-15 Mins	Not Set
Support (Medical Environment) (Level 2)-15 Mins	Not Set
Support (Medical Environment) (Level 3 Enh)	Not Set
Support (Medical Environment) (Level 3 Enh)-TD	Not Set
Support (Medical Environment) (Level 3 Enh)-TE	Not Set
Support (Medical Environment) (Level 3)-15 Mins	Not Set
Support (Medical Environment) (Level 4 Enh)	Not Set
Support (Medical Environment) (Level 4 Enh)-TD	Not Set
Support (Medical Environment) (Level 4 Enh)-TE	Not Set
Support (Medical Environment) (Level 4)-15 Mins	Not Set

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

Companion Services (Basic Staff Support)	Not Set
Companion Services (Level 1)	Not Set
Companion Services (Level 2)	Not Set
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 Enh)	$25.64 / 15 min.
In-Home & Commnty Supprts (Lvl 3)	$21.42 / 15 min.
NEA - Adult Res (6400) - No Day - NG5	Not Set
Needs Exception Allowance (NEA)-Adult Res (6400)	Not Set
Needs Excptn Allowance (NEA)-Adult Res (6400)-521	Not Set
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-Lic-1 Person-Inelig	$105.05 / 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.
Support (Medical Environment) (Basic)-15 Mins	Not Set
Support (Medical Environment) (Level 1)-15 Mins	Not Set
Support (Medical Environment) (Level 2)-15 Mins	Not Set
Support (Medical Environment) (Level 3 Enh)	Not Set
Support (Medical Environment) (Level 3 Enh)-TD	Not Set
Support (Medical Environment) (Level 3 Enh)-TE	Not Set
Support (Medical Environment) (Level 3)-15 Mins	Not Set
Support (Medical Environment) (Level 4 Enh)	Not Set
Support (Medical Environment) (Level 4 Enh)-TD	Not Set
Support (Medical Environment) (Level 4 Enh)-TE	Not Set
Support (Medical Environment) (Level 4)-15 Mins	Not Set

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

Companion Services (Basic Staff Support)	Not Set
Companion Services (Level 1)	Not Set
Companion Services (Level 2)	Not Set
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 Enh)	$25.64 / 15 min.
In-Home & Commnty Supprts (Lvl 3)	$21.42 / 15 min.
NEA - Adult Res (6400) - No Day - NG5	Not Set
Needs Exception Allowance (NEA)-Adult Res (6400)	Not Set
Needs Excptn Allowance (NEA)-Adult Res (6400)-521	Not Set
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-Lic-1 Person-Inelig	$105.05 / 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.
Support (Medical Environment) (Basic)-15 Mins	Not Set
Support (Medical Environment) (Level 1)-15 Mins	Not Set
Support (Medical Environment) (Level 2)-15 Mins	Not Set
Support (Medical Environment) (Level 3 Enh)	Not Set
Support (Medical Environment) (Level 3 Enh)-TD	Not Set
Support (Medical Environment) (Level 3 Enh)-TE	Not Set
Support (Medical Environment) (Level 3)-15 Mins	Not Set
Support (Medical Environment) (Level 4 Enh)	Not Set
Support (Medical Environment) (Level 4 Enh)-TD	Not Set
Support (Medical Environment) (Level 4 Enh)-TE	Not Set
Support (Medical Environment) (Level 4)-15 Mins	Not Set

County : York/Adams
\|Service Name / Level	\|Rate

Companion Services (Basic Staff Support)	Not Set
Companion Services (Level 1)	Not Set
Companion Services (Level 2)	Not Set
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 Enh)	$25.64 / 15 min.
In-Home & Commnty Supprts (Lvl 3)	$21.42 / 15 min.
NEA - Adult Res (6400) - No Day - NG5	Not Set
Needs Exception Allowance (NEA)-Adult Res (6400)	Not Set
Needs Excptn Allowance (NEA)-Adult Res (6400)-521	Not Set
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-Lic-1 Person-Inelig	$105.05 / 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.
Support (Medical Environment) (Basic)-15 Mins	Not Set
Support (Medical Environment) (Level 1)-15 Mins	Not Set
Support (Medical Environment) (Level 2)-15 Mins	Not Set
Support (Medical Environment) (Level 3 Enh)	Not Set
Support (Medical Environment) (Level 3 Enh)-TD	Not Set
Support (Medical Environment) (Level 3 Enh)-TE	Not Set
Support (Medical Environment) (Level 3)-15 Mins	Not Set
Support (Medical Environment) (Level 4 Enh)	Not Set
Support (Medical Environment) (Level 4 Enh)-TD	Not Set
Support (Medical Environment) (Level 4 Enh)-TE	Not Set
Support (Medical Environment) (Level 4)-15 Mins	Not Set

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