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Provider Demographic Information - WISNA SERENITY HOMES CORP

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PROVIDER DEMOGRAPHIC INFORMATION Supporting line for group header


Name:	WISNA SERENITY HOMES CORP
Address:	444 N MOUNT VERNON ST POTTSTOWN, PA 19464-4431
Phone:	(610) 504-9217
E-mail:	INFO@WISNACARE.ORG
Web Site:	N/A

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PROVIDER CERTIFICATION INFORMATION Supporting line for group header

Click here to view Provider Certification Information

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


Type:	Corporate Office
Name:	WISNA SERENITY HOMES CORP
Address:	444 N MOUNT VERNON ST POTTSTOWN, PA 19464-4431
Phone:	(610) 504-9217

Type:	Regional/Field Office	Counties Served:
Name:	WISNA WERENITY HOMES CORP
Address:	20 CORNER KETCH RD DOWNINGTOWN, PA 19355
Phone:	(610) 504-9217
Fax:	(484) 245-6480


Type:	Regional/Field Office	Counties Served:
Name:	Spruce
Address:	29 SPRUCE ST MOHNTON, PA 19540-1803
Phone:	(610) 504-9217
Fax:	(484) 245-3177

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PROVIDER SERVICES AND RATES Supporting line for group header


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

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

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

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

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

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

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

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

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

CPS (1:1 to 1:5) Remote	$5.34 / 15 min.
CPS (1:1 to 1:5) Remote - ECS	Not Set
CPS (1:6 or >) Remote	$2.06 / 15 min.
CPS (1:6 or >) Remote - ECS	Not Set
CPS Community 1:1	$13.83 / 15 min.
CPS Community 1:1 ECS	Not Set
CPS Community 1:1 Enhanced	$19.26 / 15 min.
CPS Community 1:1 Enhcd LPN	$19.26 / 15 min.
CPS Community 1:1 Enhcd LPN ECS	Not Set
CPS Community 1:1 Enhcd RN	$19.26 / 15 min.
CPS Community 1:1 Enhcd RN ECS	Not Set
CPS Community 1:1 Enhcd-ESC	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 4-Elig	$869.36 / 1 Day
Res Hab-2 Person-NG 4-Elig-w/Day Supports	$730.86 / 1 Day
Res Hab-2 Person-NG5-Elig	$1,312.57 / 1 Day
Res Hab-2 Person-NG5-Elig-w/Day Supports	$1,215.16 / 1 Day
Res Hab-3 Person-NG 4-Elig	$662.22 / 1 Day
Res Hab-3 Person-NG 4-Elig-w/Day Supports	$513.07 / 1 Day
Res Hab-3 Person-NG5-Elig	$1,004.32 / 1 Day
Res Hab-3 Person-NG5-Elig-w/Day Supports	$835.46 / 1 Day
Res Hab-4 Person-NG5-Elig-w/Day Supports	$642.84 / 1 Day
Res Hab-5-8 Person-NG5-Elig	$683.54 / 1 Day
Res Hab-5-8 Person-NG5-Elig-w/Day Supports	$579.75 / 1 Day
Res Hab-Lic-1 Person-Inelig	$93.64 - $105.05 / 1 Day
Res Hab-Lic-2 Person-Inelig	$50.22 - $57.29 / 1 Day
Res Hab-Lic-3 Person-Inelig	$41.06 / 1 Day
Res Hab-Lic-4 Person-Elig-NG5	$766.28 / 1 Day
Res Hab-Lic-5-8 Person-Inelig	$22.87 / 1 Day
Respite-Base Out-of-Home 24 Hours (Basic)-Day	Not Set
Respite-Base Out-of-Home 24 Hours (Level 1)-Day	Not Set
Respite-Base Out-of-Home 24 Hours (Level 2 Enh)	Not Set
Respite-Base Out-of-Home 24 Hours (Level 2 Enh)-TD	Not Set
Respite-Base Out-of-Home 24 Hours (Level 2 Enh)-TE	Not Set
Respite-Base Out-of-Home 24 Hours (Level 2)-Day	Not Set
Respite-Base Out-of-Home 24 Hours (Level 3 Enh)	Not Set
Respite-Base Out-of-Home 24 Hours (Level 3 Enh)-TD	Not Set
Respite-Base Out-of-Home 24 Hours (Level 3 Enh)-TE	Not Set
Respite-Base Out-of-Home 24 Hours (Level 3)	Not Set
Respite-Lic-Day-1 person-NG 3	$906.68 / 1 Day
Respite-Lic-Day-1 person-NG 3-ECS	Not Set
Respite-Lic-Day-1 person-NG 3-Emergency	$906.68 / 1 Day
Respite-Lic-Day-1 person-NG 3-Emergency-ECS	Not Set
Respite-Lic-Day-1 person-NG 4	$987.27 / 1 Day
Respite-Lic-Day-1 person-NG 4-ECS	Not Set
Respite-Lic-Day-1 person-NG 4-Emergency	$987.27 / 1 Day
Respite-Lic-Day-1 person-NG 4-Emergency-ECS	Not Set
Respite-Lic-Day-1 person-NG5	$987.25 / 1 Day
Respite-Lic-Day-2 person-NG 4	$800.99 / 1 Day
Respite-Lic-Day-2 person-NG 4-ECS	Not Set
Respite-Lic-Day-2 person-NG 4-Emergency	$800.99 / 1 Day
Respite-Lic-Day-2 person-NG 4-Emergency-ECS	Not Set
Respite-Lic-Day-2 person-NG5	$800.99 / 1 Day
Respite-Lic-Day-2 person-NG5-ECS	Not Set
Respite-Lic-Day-2 person-NG5-Emergency	$800.99 / 1 Day
Respite-Lic-Day-2 person-NG5-Emergency-ECS	Not Set
Respite-Lic-Day-3 person-NG 4	$570.64 / 1 Day
Respite-Lic-Day-3 person-NG 4-ECS	Not Set
Respite-Lic-Day-3 person-NG 4-Emergency	$570.64 / 1 Day
Respite-Lic-Day-3 person-NG 4-Emergency-ECS	Not Set
Respite-Lic-Day-3 person-NG5	$570.64 / 1 Day
Respite-Lic-Day-3 person-NG5-ECS	Not Set
Respite-Lic-Day-3 person-NG5-Emergency	$570.64 / 1 Day
Respite-Lic-Day-3 person-NG5-Emergency-ECS	Not Set
Respite-Unlic,15-min(Level 3, 1:1 Enhcd)ECS	Not Set
Respite-Unlic,15-min(Level 3, 1:1 Enhcd)ECS - TD	Not Set
Respite-Unlic,15-min(Level 3, 1:1 Enhcd)ECS - TE	Not Set
Respite-Unlic- 15-min (Basic 1:4)	$2.44 / 15 min.
Respite-Unlic- 15-min (Basic 1:4) ECS	Not Set
Respite-Unlic- 15-min(Level 3, 1:1 Enhcd)	$13.28 / 15 min.
Respite-Unlic- 15-min(Level 3, 1:1 Enhcd) - TD	$13.28 / 15 min.
Respite-Unlic- 15-min(Level 3, 1:1 Enhcd) - TE	$13.28 / 15 min.
Supplemental Habilitation 1:1 - 15 min	$6.12 / 15 min.
Supplemental Habilitation 2:1 - 15 min	$12.22 / 15 min.

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

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

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

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

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

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 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-3 Person-NG 4-Elig	$662.22 / 1 Day
Res Hab-3 Person-NG 4-Elig-w/Day Supports	$513.07 / 1 Day
Res Hab-Lic-1 Person-Inelig	$93.64 - $105.05 / 1 Day
Res Hab-Lic-2 Person-Inelig	$50.22 - $57.29 / 1 Day
Res Hab-Lic-3 Person-Inelig	$41.06 / 1 Day
Supplemental Habilitation 1:1 - 15 min	$6.12 / 15 min.
Supplemental Habilitation 2:1 - 15 min	$12.22 / 15 min.

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

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

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

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

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

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

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

CPS (1:1 to 1:5) Remote	$5.34 / 15 min.
CPS (1:1 to 1:5) Remote - ECS	Not Set
CPS (1:6 or >) Remote	$2.06 / 15 min.
CPS (1:6 or >) Remote - ECS	Not Set
CPS Community 1:1	$13.83 / 15 min.
CPS Community 1:1 ECS	Not Set
CPS Community 1:1 Enhanced	$19.26 / 15 min.
CPS Community 1:1 Enhcd LPN	$19.26 / 15 min.
CPS Community 1:1 Enhcd LPN ECS	Not Set
CPS Community 1:1 Enhcd RN	$19.26 / 15 min.
CPS Community 1:1 Enhcd RN ECS	Not Set
CPS Community 1:1 Enhcd-ESC	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 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	$93.64 / 1 Day
Res Hab-Lic-2 Person-Inelig	$50.22 / 1 Day
Respite Base-Emerg Lic 6400 24 Hrs Lvl 2 Enh-TD U2	Not Set
Respite Base-Emerg Lic 6400 24 Hrs Lvl 2 Enh-TE U2	Not Set
Respite Base-Emerg Lic 6400 24 Hrs Lvl 3 Enh-TD U2	Not Set
Respite Base-Emerg Lic 6400 24 Hrs Lvl 3 Enh-TE U2	Not Set
Respite, Base-Emerg Licen 6400 24 Hrs Basic-U2	Not Set
Respite, Base-Emerg Licen 6400 24 Hrs Lvl 1-U2	Not Set
Respite, Base-Emerg Licen 6400 24 Hrs Lvl 2 Enh-U2	Not Set
Respite, Base-Emerg Licen 6400 24 Hrs Lvl 2-U2	Not Set
Respite, Base-Emerg Licen 6400 24 Hrs Lvl 3 Enh-U2	Not Set
Respite, Base-Emerg Licen 6400 24 Hrs Lvl 3-U2	Not Set
Respite-Base Out-of-Home 24 Hours (Basic)-Day	Not Set
Respite-Base Out-of-Home 24 Hours (Level 1)-Day	Not Set
Respite-Base Out-of-Home 24 Hours (Level 2 Enh)	Not Set
Respite-Base Out-of-Home 24 Hours (Level 2 Enh)-TD	Not Set
Respite-Base Out-of-Home 24 Hours (Level 2 Enh)-TE	Not Set
Respite-Base Out-of-Home 24 Hours (Level 2)-Day	Not Set
Respite-Base Out-of-Home 24 Hours (Level 3 Enh)	Not Set
Respite-Base Out-of-Home 24 Hours (Level 3 Enh)-TD	Not Set
Respite-Base Out-of-Home 24 Hours (Level 3 Enh)-TE	Not Set
Respite-Base Out-of-Home 24 Hours (Level 3)	Not Set
Respite-Lic-Day-1 person-NG 3	$906.68 / 1 Day
Respite-Lic-Day-1 person-NG 3-ECS	Not Set
Respite-Lic-Day-1 person-NG 3-Emergency	$906.68 / 1 Day
Respite-Lic-Day-1 person-NG 3-Emergency-ECS	Not Set
Respite-Lic-Day-1 person-NG 4	$987.27 / 1 Day
Respite-Lic-Day-1 person-NG 4-ECS	Not Set
Respite-Lic-Day-1 person-NG 4-Emergency	$987.27 / 1 Day
Respite-Lic-Day-1 person-NG 4-Emergency-ECS	Not Set
Respite-Lic-Day-1 person-NG5	$987.25 / 1 Day
Respite-Lic-Day-1 person-NG5-ECS	Not Set
Respite-Lic-Day-1 person-NG5-Emergency	$987.25 / 1 Day
Respite-Lic-Day-1 person-NG5-Emergency-ECS	Not Set
Respite-Lic-Day-2 person-NG 1-Emergency	$503.18 / 1 Day
Respite-Lic-Day-2 person-NG 1-Emergency-ECS	Not Set
Respite-Lic-Day-2 person-NG 2	$616.04 / 1 Day
Respite-Lic-Day-2 person-NG 2-ECS	Not Set
Respite-Lic-Day-2 person-NG 2-Emergency	$616.04 / 1 Day
Respite-Lic-Day-2 person-NG 2-Emergency-ECS	Not Set
Respite-Lic-Day-2 person-NG 3	$738.67 / 1 Day
Respite-Lic-Day-2 person-NG 3-ECS	Not Set
Respite-Lic-Day-2 person-NG 3-Emergency	$738.67 / 1 Day
Respite-Lic-Day-2 person-NG 3-Emergency-ECS	Not Set
Respite-Lic-Day-2 person-NG 4	$800.99 / 1 Day
Respite-Lic-Day-2 person-NG 4-ECS	Not Set
Respite-Lic-Day-2 person-NG 4-Emergency	$800.99 / 1 Day
Respite-Lic-Day-2 person-NG 4-Emergency-ECS	Not Set
Respite-Lic-Day-2 person-NG1	$503.18 / 1 Day
Respite-Lic-Day-2 person-NG1-ECS	Not Set
Respite-Lic-Day-2 person-NG5	$800.99 / 1 Day
Respite-Lic-Day-2 person-NG5-ECS	Not Set
Respite-Lic-Day-2 person-NG5-Emergency	$800.99 / 1 Day
Respite-Lic-Day-2 person-NG5-Emergency-ECS	Not Set
Respite-Lic-Day-3 person-NG 2-ECS	Not Set
Respite-Lic-Day-3 person-NG 2-Emergency	$419.25 / 1 Day
Respite-Lic-Day-3 person-NG 2-Emergency-ECS	Not Set
Respite-Lic-Day-3 person-NG 3	$524.92 / 1 Day
Respite-Lic-Day-3 person-NG 3-ECS	Not Set
Respite-Lic-Day-3 person-NG 3-Emergency	$524.92 / 1 Day
Respite-Lic-Day-3 person-NG 3-Emergency-ECS	Not Set
Respite-Lic-Day-3 person-NG 4	$570.64 / 1 Day
Respite-Lic-Day-3 person-NG 4-ECS	Not Set
Respite-Lic-Day-3 person-NG 4-Emergency	$570.64 / 1 Day
Respite-Lic-Day-3 person-NG 4-Emergency-ECS	Not Set
Respite-Lic-Day-3 person-NG5	$570.64 / 1 Day
Respite-Lic-Day-3 person-NG5-ECS	Not Set
Respite-Lic-Day-3 person-NG5-Emergency	$570.64 / 1 Day
Respite-Lic-Day-3 person-NG5-Emergency-ECS	Not Set
Respite-Unlic,15-min(Level 3, 1:1 Enhcd)ECS	Not Set
Respite-Unlic,15-min(Level 3, 1:1 Enhcd)ECS - TD	Not Set
Respite-Unlic,15-min(Level 3, 1:1 Enhcd)ECS - TE	Not Set
Respite-Unlic- 15-min (Basic 1:4)	$2.44 / 15 min.
Respite-Unlic- 15-min (Basic 1:4) ECS	Not Set
Respite-Unlic- 15-min(Level 3, 1:1 Enhcd)	$13.28 / 15 min.
Respite-Unlic- 15-min(Level 3, 1:1 Enhcd) - TD	$13.28 / 15 min.
Respite-Unlic- 15-min(Level 3, 1:1 Enhcd) - TE	$13.28 / 15 min.
Respite-Unlic-Day (Level 3, 1:1 Enh) Out-of-Home	$531.24 / 1 Day
Respite-Unlic-Day (Level 3, 1:1 Enh)Out-of-Hme -TD	$531.24 / 1 Day
Respite-Unlic-Day (Level 3, 1:1 Enh)Out-of-Hme -TE	$531.24 / 1 Day
Supplemental Habilitation 1:1 - 15 min	$6.12 / 15 min.
Supplemental Habilitation 2:1 - 15 min	$12.22 / 15 min.

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

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

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

CPS (1:1 to 1:5) Remote	$5.34 / 15 min.
CPS (1:1 to 1:5) Remote - ECS	Not Set
CPS (1:6 or >) Remote	$2.06 / 15 min.
CPS (1:6 or >) Remote - ECS	Not Set
CPS Community 1:1	$13.83 / 15 min.
CPS Community 1:1 ECS	Not Set
CPS Community 1:1 Enhanced	$19.26 / 15 min.
CPS Community 1:1 Enhcd LPN	$19.26 / 15 min.
CPS Community 1:1 Enhcd LPN ECS	Not Set
CPS Community 1:1 Enhcd RN	$19.26 / 15 min.
CPS Community 1:1 Enhcd RN ECS	Not Set
CPS Community 1:1 Enhcd-ESC	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 3-Elig	$726.82 / 1 Day
Res Hab-2 Person-NG 3-Elig-w/Day Supports	$668.54 / 1 Day
Res Hab-2 Person-NG 4-Elig	$869.36 / 1 Day
Res Hab-2 Person-NG 4-Elig-w/Day Supports	$730.86 / 1 Day
Res Hab-2 Person-NG5-Elig	$1,312.57 / 1 Day
Res Hab-2 Person-NG5-Elig-w/Day Supports	$1,215.16 / 1 Day
Res Hab-3 Person-NG 4-Elig	$662.22 / 1 Day
Res Hab-3 Person-NG 4-Elig-w/Day Supports	$513.07 / 1 Day
Res Hab-Lic-1 Person-Inelig	$93.64 - $105.05 / 1 Day
Res Hab-Lic-2 Person-Inelig	$50.22 - $57.29 / 1 Day
Res Hab-Lic-3 Person-Inelig	$41.06 / 1 Day
Respite-Base Out-of-Home 24 Hours (Basic)-Day	Not Set
Respite-Base Out-of-Home 24 Hours (Level 1)-Day	Not Set
Respite-Base Out-of-Home 24 Hours (Level 2 Enh)	Not Set
Respite-Base Out-of-Home 24 Hours (Level 2 Enh)-TD	Not Set
Respite-Base Out-of-Home 24 Hours (Level 2 Enh)-TE	Not Set
Respite-Base Out-of-Home 24 Hours (Level 2)-Day	Not Set
Respite-Base Out-of-Home 24 Hours (Level 3 Enh)	Not Set
Respite-Base Out-of-Home 24 Hours (Level 3 Enh)-TD	Not Set
Respite-Base Out-of-Home 24 Hours (Level 3 Enh)-TE	Not Set
Respite-Base Out-of-Home 24 Hours (Level 3)	Not Set
Respite-Lic-Day-1 person-NG 3	$906.68 / 1 Day
Respite-Lic-Day-1 person-NG 3-ECS	Not Set
Respite-Lic-Day-1 person-NG 3-Emergency	$906.68 / 1 Day
Respite-Lic-Day-1 person-NG 3-Emergency-ECS	Not Set
Respite-Lic-Day-1 person-NG 4	$987.27 / 1 Day
Respite-Lic-Day-1 person-NG 4-ECS	Not Set
Respite-Lic-Day-1 person-NG 4-Emergency	$987.27 / 1 Day
Respite-Lic-Day-1 person-NG 4-Emergency-ECS	Not Set
Respite-Lic-Day-1 person-NG5	$987.25 / 1 Day
Respite-Lic-Day-2 person-NG 4	$800.99 / 1 Day
Respite-Lic-Day-2 person-NG 4-ECS	Not Set
Respite-Lic-Day-2 person-NG 4-Emergency	$800.99 / 1 Day
Respite-Lic-Day-2 person-NG 4-Emergency-ECS	Not Set
Respite-Lic-Day-2 person-NG5	$800.99 / 1 Day
Respite-Lic-Day-2 person-NG5-ECS	Not Set
Respite-Lic-Day-2 person-NG5-Emergency	$800.99 / 1 Day
Respite-Lic-Day-2 person-NG5-Emergency-ECS	Not Set
Respite-Lic-Day-3 person-NG 4	$570.64 / 1 Day
Respite-Lic-Day-3 person-NG 4-ECS	Not Set
Respite-Lic-Day-3 person-NG 4-Emergency	$570.64 / 1 Day
Respite-Lic-Day-3 person-NG 4-Emergency-ECS	Not Set
Respite-Lic-Day-3 person-NG5	$570.64 / 1 Day
Respite-Lic-Day-3 person-NG5-ECS	Not Set
Respite-Lic-Day-3 person-NG5-Emergency	$570.64 / 1 Day
Respite-Lic-Day-3 person-NG5-Emergency-ECS	Not Set
Respite-Unlic,15-min(Level 3, 1:1 Enhcd)ECS	Not Set
Respite-Unlic,15-min(Level 3, 1:1 Enhcd)ECS - TD	Not Set
Respite-Unlic,15-min(Level 3, 1:1 Enhcd)ECS - TE	Not Set
Respite-Unlic- 15-min (Basic 1:4)	$2.44 / 15 min.
Respite-Unlic- 15-min (Basic 1:4) ECS	Not Set
Respite-Unlic- 15-min(Level 3, 1:1 Enhcd)	$13.28 / 15 min.
Respite-Unlic- 15-min(Level 3, 1:1 Enhcd) - TD	$13.28 / 15 min.
Respite-Unlic- 15-min(Level 3, 1:1 Enhcd) - TE	$13.28 / 15 min.
Supplemental Habilitation 1:1 - 15 min	$6.12 / 15 min.
Supplemental Habilitation 2:1 - 15 min	$12.22 / 15 min.

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

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

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

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

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

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

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

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

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

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

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

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

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

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 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-3 Person-NG 4-Elig	$662.22 / 1 Day
Res Hab-3 Person-NG 4-Elig-w/Day Supports	$513.07 / 1 Day
Res Hab-Lic-1 Person-Inelig	$105.05 / 1 Day
Res Hab-Lic-2 Person-Inelig	$57.29 / 1 Day
Res Hab-Lic-3 Person-Inelig	$41.06 / 1 Day

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

CPS (1:1 to 1:5) Remote	$5.34 / 15 min.
CPS (1:1 to 1:5) Remote - ECS	Not Set
CPS (1:6 or >) Remote	$2.06 / 15 min.
CPS (1:6 or >) Remote - ECS	Not Set
CPS Community 1:1	$13.83 / 15 min.
CPS Community 1:1 ECS	Not Set
CPS Community 1:1 Enhanced	$19.26 / 15 min.
CPS Community 1:1 Enhcd LPN	$19.26 / 15 min.
CPS Community 1:1 Enhcd LPN ECS	Not Set
CPS Community 1:1 Enhcd RN	$19.26 / 15 min.
CPS Community 1:1 Enhcd RN ECS	Not Set
CPS Community 1:1 Enhcd-ESC	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 3-Elig	$726.82 / 1 Day
Res Hab-2 Person-NG 3-Elig-w/Day Supports	$668.54 / 1 Day
Res Hab-2 Person-NG 4-Elig	$869.36 / 1 Day
Res Hab-2 Person-NG 4-Elig-w/Day Supports	$730.86 / 1 Day
Res Hab-2 Person-NG5-Elig	$1,312.57 / 1 Day
Res Hab-2 Person-NG5-Elig-w/Day Supports	$1,215.16 / 1 Day
Res Hab-3 Person-NG 4-Elig	$662.22 / 1 Day
Res Hab-3 Person-NG 4-Elig-w/Day Supports	$513.07 / 1 Day
Res Hab-4 Person-NG 4-Elig-w/Day Supports	$398.69 / 1 Day
Res Hab-5-8 Person-NG5-Elig	$683.54 / 1 Day
Res Hab-5-8 Person-NG5-Elig-w/Day Supports	$579.75 / 1 Day
Res Hab-Lic-1 Person-Inelig	$93.64 - $105.05 / 1 Day
Res Hab-Lic-2 Person-Inelig	$50.22 - $57.29 / 1 Day
Res Hab-Lic-3 Person-Inelig	$41.06 / 1 Day
Res Hab-Lic-4 Person-Elig-NG 4	$510.56 / 1 Day
Res Hab-Lic-4 Person-Elig-NG5	$766.28 / 1 Day
Res Hab-Lic-4 Person-Inelig	$31.91 / 1 Day
Res Hab-Lic-5-8 Person-Inelig	$22.87 / 1 Day
Respite, Base-Emerg Licen 6400 24 Hrs Lvl 2-U2	Not Set
Respite, Non-Waiver Setting/PLF, NG 1	Not Set
Respite, Non-Waiver Setting/PLF, NG 1-ECS	Not Set
Respite, Non-Waiver Setting/PLF, NG 2	Not Set
Respite, Non-Waiver Setting/PLF, NG 2-ECS	Not Set
Respite, Non-Waiver Setting/PLF, NG 3	Not Set
Respite, Non-Waiver Setting/PLF, NG 3-ECS	Not Set
Respite, Non-Waiver Setting/PLF, NG 4	Not Set
Respite, Non-Waiver Setting/PLF, NG 4-ECS	Not Set
Respite, Non-Waiver Setting/PLF, NG5	Not Set
Respite, Non-Waiver Setting/PLF, NG5-ECS	Not Set
Respite-Base Out-of-Home 24 Hours (Basic)-Day	Not Set
Respite-Base Out-of-Home 24 Hours (Level 1)-Day	Not Set
Respite-Base Out-of-Home 24 Hours (Level 2 Enh)	Not Set
Respite-Base Out-of-Home 24 Hours (Level 2 Enh)-TD	Not Set
Respite-Base Out-of-Home 24 Hours (Level 2 Enh)-TE	Not Set
Respite-Base Out-of-Home 24 Hours (Level 2)-Day	Not Set
Respite-Base Out-of-Home 24 Hours (Level 3 Enh)	Not Set
Respite-Base Out-of-Home 24 Hours (Level 3 Enh)-TD	Not Set
Respite-Base Out-of-Home 24 Hours (Level 3 Enh)-TE	Not Set
Respite-Base Out-of-Home 24 Hours (Level 3)	Not Set
Respite-Lic-Day-1 person-NG 3	$906.68 / 1 Day
Respite-Lic-Day-1 person-NG 3-ECS	Not Set
Respite-Lic-Day-1 person-NG 3-Emergency	$906.68 / 1 Day
Respite-Lic-Day-1 person-NG 3-Emergency-ECS	Not Set
Respite-Lic-Day-1 person-NG 4	$987.27 / 1 Day
Respite-Lic-Day-1 person-NG 4-ECS	Not Set
Respite-Lic-Day-1 person-NG 4-Emergency	$987.27 / 1 Day
Respite-Lic-Day-1 person-NG 4-Emergency-ECS	Not Set
Respite-Lic-Day-1 person-NG5	$987.25 / 1 Day
Respite-Lic-Day-2 person-NG 4	$800.99 / 1 Day
Respite-Lic-Day-2 person-NG 4-ECS	Not Set
Respite-Lic-Day-2 person-NG 4-Emergency	$800.99 / 1 Day
Respite-Lic-Day-2 person-NG 4-Emergency-ECS	Not Set
Respite-Lic-Day-2 person-NG5	$800.99 / 1 Day
Respite-Lic-Day-2 person-NG5-ECS	Not Set
Respite-Lic-Day-2 person-NG5-Emergency	$800.99 / 1 Day
Respite-Lic-Day-2 person-NG5-Emergency-ECS	Not Set
Respite-Lic-Day-3 person-NG 4	$570.64 / 1 Day
Respite-Lic-Day-3 person-NG 4-ECS	Not Set
Respite-Lic-Day-3 person-NG 4-Emergency	$570.64 / 1 Day
Respite-Lic-Day-3 person-NG 4-Emergency-ECS	Not Set
Respite-Lic-Day-3 person-NG5	$570.64 / 1 Day
Respite-Lic-Day-3 person-NG5-ECS	Not Set
Respite-Lic-Day-3 person-NG5-Emergency	$570.64 / 1 Day
Respite-Lic-Day-3 person-NG5-Emergency-ECS	Not Set
Respite-Unlic,15-min(Level 3, 1:1 Enhcd)ECS	Not Set
Respite-Unlic,15-min(Level 3, 1:1 Enhcd)ECS - TD	Not Set
Respite-Unlic,15-min(Level 3, 1:1 Enhcd)ECS - TE	Not Set
Respite-Unlic- 15-min (Basic 1:4)	$2.44 / 15 min.
Respite-Unlic- 15-min (Basic 1:4) ECS	Not Set
Respite-Unlic- 15-min(Level 3, 1:1 Enhcd)	$13.28 / 15 min.
Respite-Unlic- 15-min(Level 3, 1:1 Enhcd) - TD	$13.28 / 15 min.
Respite-Unlic- 15-min(Level 3, 1:1 Enhcd) - TE	$13.28 / 15 min.
Respite-Unlic-Day (Level 3, 1:1 Enh) Out-of-Home	$531.24 / 1 Day
Respite-Unlic-Day (Level 3, 1:1 Enh)Out-of-Hme -TD	$531.24 / 1 Day
Respite-Unlic-Day (Level 3, 1:1 Enh)Out-of-Hme -TE	$531.24 / 1 Day
Supplemental Habilitation 1:1 - 15 min	$6.12 / 15 min.
Supplemental Habilitation 2:1 - 15 min	$12.22 / 15 min.

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

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

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

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

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

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

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

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

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

CPS (1:1 to 1:5) Remote	$5.34 / 15 min.
CPS (1:1 to 1:5) Remote - ECS	Not Set
CPS (1:6 or >) Remote	$2.06 / 15 min.
CPS (1:6 or >) Remote - ECS	Not Set
CPS Community 1:1	$13.83 / 15 min.
CPS Community 1:1 ECS	Not Set
CPS Community 1:1 Enhanced	$19.26 / 15 min.
CPS Community 1:1 Enhcd LPN	$19.26 / 15 min.
CPS Community 1:1 Enhcd LPN ECS	Not Set
CPS Community 1:1 Enhcd RN	$19.26 / 15 min.
CPS Community 1:1 Enhcd RN ECS	Not Set
CPS Community 1:1 Enhcd-ESC	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 3-Elig	$726.82 / 1 Day
Res Hab-2 Person-NG 3-Elig-w/Day Supports	$668.54 / 1 Day
Res Hab-2 Person-NG 4-Elig	$869.36 / 1 Day
Res Hab-2 Person-NG 4-Elig-w/Day Supports	$730.86 / 1 Day
Res Hab-2 Person-NG5-Elig	$1,312.57 / 1 Day
Res Hab-2 Person-NG5-Elig-w/Day Supports	$1,215.16 / 1 Day
Res Hab-3 Person-NG 4-Elig	$662.22 / 1 Day
Res Hab-3 Person-NG 4-Elig-w/Day Supports	$513.07 / 1 Day
Res Hab-4 Person-NG 3-Elig-w/Day Supports	$362.42 / 1 Day
Res Hab-4 Person-NG 4-Elig-w/Day Supports	$398.69 / 1 Day
Res Hab-5-8 Person-NG5-Elig	$683.54 / 1 Day
Res Hab-5-8 Person-NG5-Elig-w/Day Supports	$579.75 / 1 Day
Res Hab-Lic-1 Person-Inelig	$93.64 - $105.05 / 1 Day
Res Hab-Lic-2 Person-Inelig	$50.22 - $57.29 / 1 Day
Res Hab-Lic-3 Person-Inelig	$41.06 / 1 Day
Res Hab-Lic-4 Person-Elig-NG 3	$425.56 / 1 Day
Res Hab-Lic-4 Person-Elig-NG 4	$510.56 / 1 Day
Res Hab-Lic-4 Person-Elig-NG5	$766.28 / 1 Day
Res Hab-Lic-4 Person-Inelig	$31.91 / 1 Day
Res Hab-Lic-5-8 Person-Inelig	$22.87 / 1 Day
Respite-Base Out-of-Home 24 Hours (Basic)-Day	Not Set
Respite-Base Out-of-Home 24 Hours (Level 1)-Day	Not Set
Respite-Base Out-of-Home 24 Hours (Level 2 Enh)	Not Set
Respite-Base Out-of-Home 24 Hours (Level 2 Enh)-TD	Not Set
Respite-Base Out-of-Home 24 Hours (Level 2 Enh)-TE	Not Set
Respite-Base Out-of-Home 24 Hours (Level 2)-Day	Not Set
Respite-Base Out-of-Home 24 Hours (Level 3 Enh)	Not Set
Respite-Base Out-of-Home 24 Hours (Level 3 Enh)-TD	Not Set
Respite-Base Out-of-Home 24 Hours (Level 3 Enh)-TE	Not Set
Respite-Base Out-of-Home 24 Hours (Level 3)	Not Set
Respite-Lic-Day-1 person-NG 3	$906.68 / 1 Day
Respite-Lic-Day-1 person-NG 3-ECS	Not Set
Respite-Lic-Day-1 person-NG 3-Emergency	$906.68 / 1 Day
Respite-Lic-Day-1 person-NG 3-Emergency-ECS	Not Set
Respite-Lic-Day-1 person-NG 4	$987.27 / 1 Day
Respite-Lic-Day-1 person-NG 4-ECS	Not Set
Respite-Lic-Day-1 person-NG 4-Emergency	$987.27 / 1 Day
Respite-Lic-Day-1 person-NG 4-Emergency-ECS	Not Set
Respite-Lic-Day-1 person-NG5	$987.25 / 1 Day
Respite-Lic-Day-2 person-NG 4	$800.99 / 1 Day
Respite-Lic-Day-2 person-NG 4-ECS	Not Set
Respite-Lic-Day-2 person-NG 4-Emergency	$800.99 / 1 Day
Respite-Lic-Day-2 person-NG 4-Emergency-ECS	Not Set
Respite-Lic-Day-2 person-NG5	$800.99 / 1 Day
Respite-Lic-Day-2 person-NG5-ECS	Not Set
Respite-Lic-Day-2 person-NG5-Emergency	$800.99 / 1 Day
Respite-Lic-Day-2 person-NG5-Emergency-ECS	Not Set
Respite-Lic-Day-3 person-NG 1	$369.73 / 1 Day
Respite-Lic-Day-3 person-NG 1-Emergency	$369.73 / 1 Day
Respite-Lic-Day-3 person-NG 2	$419.25 / 1 Day
Respite-Lic-Day-3 person-NG 4	$570.64 / 1 Day
Respite-Lic-Day-3 person-NG 4-ECS	Not Set
Respite-Lic-Day-3 person-NG 4-Emergency	$570.64 / 1 Day
Respite-Lic-Day-3 person-NG 4-Emergency-ECS	Not Set
Respite-Lic-Day-3 person-NG5	$570.64 / 1 Day
Respite-Lic-Day-3 person-NG5-ECS	Not Set
Respite-Lic-Day-3 person-NG5-Emergency	$570.64 / 1 Day
Respite-Lic-Day-3 person-NG5-Emergency-ECS	Not Set
Respite-Unlic,15-min(Level 3, 1:1 Enhcd)ECS	Not Set
Respite-Unlic,15-min(Level 3, 1:1 Enhcd)ECS - TD	Not Set
Respite-Unlic,15-min(Level 3, 1:1 Enhcd)ECS - TE	Not Set
Respite-Unlic- 15-min (Basic 1:4)	$2.44 / 15 min.
Respite-Unlic- 15-min (Basic 1:4) ECS	Not Set
Respite-Unlic- 15-min(Level 3, 1:1 Enhcd)	$13.28 / 15 min.
Respite-Unlic- 15-min(Level 3, 1:1 Enhcd) - TD	$13.28 / 15 min.
Respite-Unlic- 15-min(Level 3, 1:1 Enhcd) - TE	$13.28 / 15 min.
Supplemental Habilitation 1:1 - 15 min	$6.12 / 15 min.
Supplemental Habilitation 2:1 - 15 min	$12.22 / 15 min.

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

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-Lic-1 Person-Inelig	$93.64 / 1 Day
Res Hab-Lic-2 Person-Inelig	$50.22 / 1 Day
Supplemental Habilitation 1:1 - 15 min	$6.12 / 15 min.
Supplemental Habilitation 2:1 - 15 min	$12.22 / 15 min.

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

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

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

CPS (1:1 to 1:5) Remote	$5.34 / 15 min.
CPS (1:1 to 1:5) Remote - ECS	Not Set
CPS (1:6 or >) Remote	$2.06 / 15 min.
CPS (1:6 or >) Remote - ECS	Not Set
CPS Community 1:1	$13.83 / 15 min.
CPS Community 1:1 ECS	Not Set
CPS Community 1:1 Enhanced	$19.26 / 15 min.
CPS Community 1:1 Enhcd LPN	$19.26 / 15 min.
CPS Community 1:1 Enhcd LPN ECS	Not Set
CPS Community 1:1 Enhcd RN	$19.26 / 15 min.
CPS Community 1:1 Enhcd RN ECS	Not Set
CPS Community 1:1 Enhcd-ESC	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-3 Person-NG 4-Elig	$662.22 / 1 Day
Res Hab-3 Person-NG 4-Elig-w/Day Supports	$513.07 / 1 Day
Res Hab-5-8 Person-NG5-Elig	$683.54 / 1 Day
Res Hab-5-8 Person-NG5-Elig-w/Day Supports	$579.75 / 1 Day
Res Hab-Lic-1 Person-Inelig	$93.64 - $105.05 / 1 Day
Res Hab-Lic-2 Person-Inelig	$50.22 - $57.29 / 1 Day
Res Hab-Lic-3 Person-Inelig	$41.06 / 1 Day
Res Hab-Lic-4 Person-Elig-NG5	$766.28 / 1 Day
Res Hab-Lic-5-8 Person-Inelig	$22.87 / 1 Day
Respite-Base Out-of-Home 24 Hours (Basic)-Day	Not Set
Respite-Base Out-of-Home 24 Hours (Level 1)-Day	Not Set
Respite-Base Out-of-Home 24 Hours (Level 2 Enh)	Not Set
Respite-Base Out-of-Home 24 Hours (Level 2 Enh)-TD	Not Set
Respite-Base Out-of-Home 24 Hours (Level 2 Enh)-TE	Not Set
Respite-Base Out-of-Home 24 Hours (Level 2)-Day	Not Set
Respite-Base Out-of-Home 24 Hours (Level 3 Enh)	Not Set
Respite-Base Out-of-Home 24 Hours (Level 3 Enh)-TD	Not Set
Respite-Base Out-of-Home 24 Hours (Level 3 Enh)-TE	Not Set
Respite-Base Out-of-Home 24 Hours (Level 3)	Not Set
Respite-Lic-Day-1 person-NG 3	$906.68 / 1 Day
Respite-Lic-Day-1 person-NG 3-ECS	Not Set
Respite-Lic-Day-1 person-NG 3-Emergency	$906.68 / 1 Day
Respite-Lic-Day-1 person-NG 3-Emergency-ECS	Not Set
Respite-Lic-Day-1 person-NG 4	$987.27 / 1 Day
Respite-Lic-Day-1 person-NG 4-ECS	Not Set
Respite-Lic-Day-1 person-NG 4-Emergency	$987.27 / 1 Day
Respite-Lic-Day-1 person-NG 4-Emergency-ECS	Not Set
Respite-Lic-Day-1 person-NG5	$987.25 / 1 Day
Respite-Unlic,15-min(Level 3, 1:1 Enhcd)ECS	Not Set
Respite-Unlic,15-min(Level 3, 1:1 Enhcd)ECS - TD	Not Set
Respite-Unlic,15-min(Level 3, 1:1 Enhcd)ECS - TE	Not Set
Respite-Unlic- 15-min (Basic 1:4)	$2.44 / 15 min.
Respite-Unlic- 15-min (Basic 1:4) ECS	Not Set
Respite-Unlic- 15-min(Level 3, 1:1 Enhcd)	$13.28 / 15 min.
Respite-Unlic- 15-min(Level 3, 1:1 Enhcd) - TD	$13.28 / 15 min.
Respite-Unlic- 15-min(Level 3, 1:1 Enhcd) - TE	$13.28 / 15 min.
Supplemental Habilitation 1:1 - 15 min	$6.12 / 15 min.
Supplemental Habilitation 2:1 - 15 min	$12.22 / 15 min.

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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