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Provider Demographic Information - ALPHA COMMUNITY LIVING ARRANGEMENTS

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PROVIDER DEMOGRAPHIC INFORMATION Supporting line for group header


Name:	ALPHA COMMUNITY LIVING ARRANGEMENTS
Address:	365 GOLDEN GATE DR VERONA, PA 15147-2609
Phone:	(412) 799-4082
Fax:	(770) 504-5470
E-mail:	nbailey@alphacommunityllc.com
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:	ALPHA COMMUNITY LIVING ARRANGEMENT LLC
Address:	365 GOLDEN GATE DR VERONA, PA 15147-2609
Phone:	(412) 799-4082
Fax:	(770) 504-5470

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PROVIDER SERVICES AND RATES Supporting line for group header


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

Companion Services (Level 1)	$4.77 / 15 min.
Companion Services (Level 2)	$8.33 / 15 min.
In-Home & Commnty Supprts (Basic)	$4.42 / 15 min.
In-Home & Commnty Supprts (Lvl 1)	$6.22 / 15 min.
In-Home & Commnty Supprts (Lvl 2 Enh)	$15.31 / 15 min.
In-Home & Commnty Supprts (Lvl 2 Enh) LPN	$15.31 / 15 min.
In-Home & Commnty Supprts (Lvl 2 Enh) RN	$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 Enh) LPN	$25.64 / 15 min.
In-Home & Commnty Supprts (Lvl 3 Enh) RN	$25.64 / 15 min.
In-Home & Commnty Supprts (Lvl 3)	$21.42 / 15 min.
Res Hab-2 Person-NG 1-Elig	$554.38 / 1 Day
Res Hab-2 Person-NG 1-Elig-w/Day Supports	$433.05 / 1 Day
Res Hab-2 Person-NG 2-Elig	$545.91 - $643.34 / 1 Day
Res Hab-2 Person-NG 2-Elig-w/Day Supports	$545.91 - $643.34 / 1 Day
Res Hab-2 Person-NG 3-Elig	$668.54 - $726.82 / 1 Day
Res Hab-2 Person-NG 3-Elig-w/Day Supports	$668.54 - $726.82 / 1 Day
Res Hab-2 Person-NG 4-Elig	$869.36 / 1 Day
Res Hab-2 Person-NG 4-Elig-w/Day Supports	$730.86 / 1 Day
Res Hab-2 Person-NG5-Elig	$1,312.57 / 1 Day
Res Hab-2 Person-NG5-Elig-w/Day Supports	$1,215.16 / 1 Day
Res Hab-3 Person-NG 1-Elig	$411.03 / 1 Day
Res Hab-3 Person-NG 1-Elig-w/Day Supports	$312.16 / 1 Day
Res Hab-3 Person-NG 2-Elig	$468.38 / 1 Day
Res Hab-3 Person-NG 2-Elig-w/Day Supports	$361.68 / 1 Day
Res Hab-3 Person-NG 3-Elig	$545.05 / 1 Day
Res Hab-3 Person-NG 3-Elig-w/Day Supports	$467.35 / 1 Day
Res Hab-3 Person-NG 4-Elig	$662.22 / 1 Day
Res Hab-3 Person-NG 4-Elig-w/Day Supports	$513.07 / 1 Day
Res Hab-3 Person-NG5-Elig	$1,004.32 / 1 Day
Res Hab-3 Person-NG5-Elig-w/Day Supports	$835.46 / 1 Day
Res Hab-Lic-2 Person-Inelig	$50.22 / 1 Day
Respite-Lic-Day-2 person-NG 1-Emergency	$503.18 / 1 Day
Respite-Lic-Day-2 person-NG 2	$616.04 / 1 Day
Respite-Lic-Day-2 person-NG 2-Emergency	$616.04 / 1 Day
Respite-Lic-Day-2 person-NG 3	$738.67 / 1 Day
Respite-Lic-Day-2 person-NG 3-Emergency	$738.67 / 1 Day
Respite-Lic-Day-2 person-NG 4	$800.99 / 1 Day
Respite-Lic-Day-2 person-NG 4-Emergency	$800.99 / 1 Day
Respite-Lic-Day-2 person-NG1	$503.18 / 1 Day
Respite-Lic-Day-2 person-NG5	$800.99 / 1 Day
Respite-Lic-Day-2 person-NG5-Emergency	$800.99 / 1 Day
Respite-Lic-Day-3 person-NG 1	$369.73 / 1 Day
Respite-Lic-Day-3 person-NG 1-Emergency	$369.73 / 1 Day
Respite-Lic-Day-3 person-NG 2	$419.25 / 1 Day
Respite-Lic-Day-3 person-NG 2-Emergency	$419.25 / 1 Day
Respite-Lic-Day-3 person-NG 3	$524.92 / 1 Day
Respite-Lic-Day-3 person-NG 3-Emergency	$524.92 / 1 Day
Respite-Lic-Day-3 person-NG 4	$570.64 / 1 Day
Respite-Lic-Day-3 person-NG 4-Emergency	$570.64 / 1 Day
Respite-Lic-Day-3 person-NG5	$570.64 / 1 Day
Respite-Lic-Day-3 person-NG5-Emergency	$570.64 / 1 Day
Respite-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-15-min(Level 2, 1:2)In-Home	$4.75 / 15 min.
Respite-Unlic-15-min(Level 2, 1:2)Out-of-Home	$4.75 / 15 min.
Respite-Unlic-15-min(Level 3, 1:1)In-Home	$8.59 / 15 min.
Respite-Unlic-15-min(Level 3, 1:1)Out-of-Home	$8.59 / 15 min.
Respite-Unlic-15-min(Level 4, 2:1 Enh) - TD	$21.74 / 15 min.
Respite-Unlic-15-min(Level 4, 2:1 Enh) - TE	$21.74 / 15 min.
Respite-Unlic-15-min(Level 4, 2:1 Enhanced)	$21.74 / 15 min.
Respite-Unlic-Day (Level 2, 1:2) In-Home	$190.26 / 1 Day
Respite-Unlic-Day (Level 2, 1:2) Out-of-Home	$190.26 / 1 Day
Respite-Unlic-Day (Level 3, 1:1 Enh) In-Home	$531.24 / 1 Day
Respite-Unlic-Day (Level 3, 1:1 Enh) In-Home - TD	$531.24 / 1 Day
Respite-Unlic-Day (Level 3, 1:1 Enh) In-Home - TE	$531.24 / 1 Day
Respite-Unlic-Day (Level 3, 1:1 Enh) Out-of-Home	$531.24 / 1 Day
Respite-Unlic-Day (Level 3, 1:1 Enh)Out-of-Hme -TD	$531.24 / 1 Day
Respite-Unlic-Day (Level 3, 1:1 Enh)Out-of-Hme -TE	$531.24 / 1 Day
Respite-Unlic-Day (Level 3, 1:1) In-Home	$343.22 / 1 Day
Respite-Unlic-Day (Level 3, 1:1) Out-of-Home	$343.22 / 1 Day
Respite-Unlic-Day (Level 4, 2:1 Enh) In-Home - TD	$869.48 / 1 Day
Respite-Unlic-Day (Level 4, 2:1 Enh) In-Home - TE	$869.48 / 1 Day
Respite-Unlic-Day (Level 4, 2:1 Enhcd) In-Home	$869.48 / 1 Day
Respite-Unlic-Day (Level 4, 2:1) In-Home	$681.46 / 1 Day
Respite-Unlic-Day (Level 4, 2:1) Out-of-Home	$681.46 / 1 Day
Respite-Unlic-Day(Level 4, 2:1 Enh) Out-of-Home-TD	$869.48 / 1 Day
Respite-Unlic-Day(Level 4, 2:1 Enh) Out-of-Home-TE	$869.48 / 1 Day
Respite-Unlic-Day(Level 4, 2:1 Enhcd) Out-of-Home	$869.48 / 1 Day
Supplemental Habilitation 1:1 - 15 min	$6.12 / 15 min.
Supplemental Habilitation 2:1 - 15 min	$12.22 / 15 min.

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

In-Home & Commnty Supprts (Basic)	$4.42 / 15 min.
In-Home & Commnty Supprts (Lvl 1)	$6.22 / 15 min.
In-Home & Commnty Supprts (Lvl 2 Enh)	$15.31 / 15 min.
In-Home & Commnty Supprts (Lvl 2 Enh) LPN	$15.31 / 15 min.
In-Home & Commnty Supprts (Lvl 2 Enh) RN	$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 Enh) LPN	$25.64 / 15 min.
In-Home & Commnty Supprts (Lvl 3 Enh) RN	$25.64 / 15 min.
In-Home & Commnty Supprts (Lvl 3)	$21.42 / 15 min.
Res Hab-2 Person-NG5-Elig	$1,312.57 / 1 Day
Res Hab-2 Person-NG5-Elig-w/Day Supports	$1,215.16 / 1 Day
Res Hab-3 Person-NG 1-Elig	$411.03 / 1 Day
Res Hab-3 Person-NG 1-Elig-w/Day Supports	$312.16 / 1 Day
Res Hab-3 Person-NG 2-Elig	$468.38 / 1 Day
Res Hab-3 Person-NG 2-Elig-w/Day Supports	$361.68 / 1 Day
Res Hab-3 Person-NG 3-Elig	$545.05 / 1 Day
Res Hab-3 Person-NG 3-Elig-w/Day Supports	$467.35 / 1 Day
Res Hab-3 Person-NG 4-Elig	$662.22 / 1 Day
Res Hab-3 Person-NG 4-Elig-w/Day Supports	$513.07 / 1 Day
Res Hab-3 Person-NG5-Elig	$1,004.32 / 1 Day
Res Hab-3 Person-NG5-Elig-w/Day Supports	$835.46 / 1 Day
Res Hab-Lic-2 Person-Inelig	$50.22 / 1 Day
Respite-Lic-Day-2 person-NG 1-Emergency	$503.18 / 1 Day
Respite-Lic-Day-2 person-NG 2	$616.04 / 1 Day
Respite-Lic-Day-2 person-NG 2-Emergency	$616.04 / 1 Day
Respite-Lic-Day-2 person-NG 3	$738.67 / 1 Day
Respite-Lic-Day-2 person-NG 3-Emergency	$738.67 / 1 Day
Respite-Lic-Day-2 person-NG 4	$800.99 / 1 Day
Respite-Lic-Day-2 person-NG 4-Emergency	$800.99 / 1 Day
Respite-Lic-Day-2 person-NG1	$503.18 / 1 Day
Respite-Lic-Day-2 person-NG5	$800.99 / 1 Day
Respite-Lic-Day-2 person-NG5-Emergency	$800.99 / 1 Day
Respite-Lic-Day-3 person-NG 1	$369.73 / 1 Day
Respite-Lic-Day-3 person-NG 1-Emergency	$369.73 / 1 Day
Respite-Lic-Day-3 person-NG 2	$419.25 / 1 Day
Respite-Lic-Day-3 person-NG 2-Emergency	$419.25 / 1 Day
Respite-Lic-Day-3 person-NG 3	$524.92 / 1 Day
Respite-Lic-Day-3 person-NG 3-Emergency	$524.92 / 1 Day
Respite-Lic-Day-3 person-NG 4	$570.64 / 1 Day
Respite-Lic-Day-3 person-NG 4-Emergency	$570.64 / 1 Day
Respite-Lic-Day-3 person-NG5	$570.64 / 1 Day
Respite-Lic-Day-3 person-NG5-Emergency	$570.64 / 1 Day

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

Companion Services (Level 1)	$4.77 / 15 min.
Companion Services (Level 2)	$8.33 / 15 min.
In-Home & Commnty Supprts (Basic)	$4.42 / 15 min.
In-Home & Commnty Supprts (Lvl 1)	$6.22 / 15 min.
In-Home & Commnty Supprts (Lvl 2 Enh)	$15.31 / 15 min.
In-Home & Commnty Supprts (Lvl 2 Enh) LPN	$15.31 / 15 min.
In-Home & Commnty Supprts (Lvl 2 Enh) RN	$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 Enh) LPN	$25.64 / 15 min.
In-Home & Commnty Supprts (Lvl 3 Enh) RN	$25.64 / 15 min.
In-Home & Commnty Supprts (Lvl 3)	$21.42 / 15 min.
Res Hab-2 Person-NG 3-Elig	$726.82 / 1 Day
Res Hab-2 Person-NG 3-Elig-w/Day Supports	$668.54 / 1 Day
Res Hab-2 Person-NG5-Elig	$1,312.57 / 1 Day
Res Hab-2 Person-NG5-Elig-w/Day Supports	$1,215.16 / 1 Day
Res Hab-3 Person-NG 1-Elig	$411.03 / 1 Day
Res Hab-3 Person-NG 1-Elig-w/Day Supports	$312.16 / 1 Day
Res Hab-3 Person-NG 2-Elig	$468.38 / 1 Day
Res Hab-3 Person-NG 2-Elig-w/Day Supports	$361.68 / 1 Day
Res Hab-3 Person-NG 3-Elig	$545.05 / 1 Day
Res Hab-3 Person-NG 3-Elig-w/Day Supports	$467.35 / 1 Day
Res Hab-3 Person-NG 4-Elig	$662.22 / 1 Day
Res Hab-3 Person-NG 4-Elig-w/Day Supports	$513.07 / 1 Day
Res Hab-3 Person-NG5-Elig	$1,004.32 / 1 Day
Res Hab-3 Person-NG5-Elig-w/Day Supports	$835.46 / 1 Day
Res Hab-Lic-2 Person-Inelig	$50.22 / 1 Day
Respite-Lic-Day-2 person-NG 1-Emergency	$503.18 / 1 Day
Respite-Lic-Day-2 person-NG 2	$616.04 / 1 Day
Respite-Lic-Day-2 person-NG 2-Emergency	$616.04 / 1 Day
Respite-Lic-Day-2 person-NG 3	$738.67 / 1 Day
Respite-Lic-Day-2 person-NG 3-Emergency	$738.67 / 1 Day
Respite-Lic-Day-2 person-NG 4	$800.99 / 1 Day
Respite-Lic-Day-2 person-NG 4-Emergency	$800.99 / 1 Day
Respite-Lic-Day-2 person-NG1	$503.18 / 1 Day
Respite-Lic-Day-2 person-NG5	$800.99 / 1 Day
Respite-Lic-Day-2 person-NG5-Emergency	$800.99 / 1 Day
Respite-Lic-Day-3 person-NG 1	$369.73 / 1 Day
Respite-Lic-Day-3 person-NG 1-Emergency	$369.73 / 1 Day
Respite-Lic-Day-3 person-NG 2	$419.25 / 1 Day
Respite-Lic-Day-3 person-NG 2-Emergency	$419.25 / 1 Day
Respite-Lic-Day-3 person-NG 3	$524.92 / 1 Day
Respite-Lic-Day-3 person-NG 3-Emergency	$524.92 / 1 Day
Respite-Lic-Day-3 person-NG 4	$570.64 / 1 Day
Respite-Lic-Day-3 person-NG 4-Emergency	$570.64 / 1 Day
Respite-Lic-Day-3 person-NG5	$570.64 / 1 Day
Respite-Lic-Day-3 person-NG5-Emergency	$570.64 / 1 Day
Respite-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-15-min(Level 2, 1:2)In-Home	$4.75 / 15 min.
Respite-Unlic-15-min(Level 2, 1:2)Out-of-Home	$4.75 / 15 min.
Respite-Unlic-15-min(Level 3, 1:1)In-Home	$8.59 / 15 min.
Respite-Unlic-15-min(Level 3, 1:1)Out-of-Home	$8.59 / 15 min.
Respite-Unlic-15-min(Level 4, 2:1 Enh) - TD	$21.74 / 15 min.
Respite-Unlic-15-min(Level 4, 2:1 Enh) - TE	$21.74 / 15 min.
Respite-Unlic-15-min(Level 4, 2:1 Enhanced)	$21.74 / 15 min.
Respite-Unlic-Day (Level 2, 1:2) In-Home	$190.26 / 1 Day
Respite-Unlic-Day (Level 2, 1:2) Out-of-Home	$190.26 / 1 Day
Respite-Unlic-Day (Level 3, 1:1 Enh) In-Home	$531.24 / 1 Day
Respite-Unlic-Day (Level 3, 1:1 Enh) In-Home - TD	$531.24 / 1 Day
Respite-Unlic-Day (Level 3, 1:1 Enh) In-Home - TE	$531.24 / 1 Day
Respite-Unlic-Day (Level 3, 1:1 Enh) Out-of-Home	$531.24 / 1 Day
Respite-Unlic-Day (Level 3, 1:1 Enh)Out-of-Hme -TD	$531.24 / 1 Day
Respite-Unlic-Day (Level 3, 1:1 Enh)Out-of-Hme -TE	$531.24 / 1 Day
Respite-Unlic-Day (Level 3, 1:1) In-Home	$343.22 / 1 Day
Respite-Unlic-Day (Level 3, 1:1) Out-of-Home	$343.22 / 1 Day
Respite-Unlic-Day (Level 4, 2:1 Enh) In-Home - TD	$869.48 / 1 Day
Respite-Unlic-Day (Level 4, 2:1 Enh) In-Home - TE	$869.48 / 1 Day
Respite-Unlic-Day (Level 4, 2:1 Enhcd) In-Home	$869.48 / 1 Day
Respite-Unlic-Day (Level 4, 2:1) In-Home	$681.46 / 1 Day
Respite-Unlic-Day (Level 4, 2:1) Out-of-Home	$681.46 / 1 Day
Respite-Unlic-Day(Level 4, 2:1 Enh) Out-of-Home-TD	$869.48 / 1 Day
Respite-Unlic-Day(Level 4, 2:1 Enh) Out-of-Home-TE	$869.48 / 1 Day
Respite-Unlic-Day(Level 4, 2:1 Enhcd) Out-of-Home	$869.48 / 1 Day

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

Res Hab-2 Person-NG5-Elig	$1,312.57 / 1 Day
Res Hab-2 Person-NG5-Elig-w/Day Supports	$1,215.16 / 1 Day
Res Hab-3 Person-NG 1-Elig	$411.03 / 1 Day
Res Hab-3 Person-NG 1-Elig-w/Day Supports	$312.16 / 1 Day
Res Hab-3 Person-NG 2-Elig	$468.38 / 1 Day
Res Hab-3 Person-NG 2-Elig-w/Day Supports	$361.68 / 1 Day
Res Hab-3 Person-NG 3-Elig	$545.05 / 1 Day
Res Hab-3 Person-NG 3-Elig-w/Day Supports	$467.35 / 1 Day
Res Hab-3 Person-NG 4-Elig	$662.22 / 1 Day
Res Hab-3 Person-NG 4-Elig-w/Day Supports	$513.07 / 1 Day
Res Hab-3 Person-NG5-Elig	$1,004.32 / 1 Day
Res Hab-3 Person-NG5-Elig-w/Day Supports	$835.46 / 1 Day
Res Hab-Lic-2 Person-Inelig	$50.22 / 1 Day
Respite-Lic-Day-2 person-NG 1-Emergency	$503.18 / 1 Day
Respite-Lic-Day-2 person-NG 2	$616.04 / 1 Day
Respite-Lic-Day-2 person-NG 2-Emergency	$616.04 / 1 Day
Respite-Lic-Day-2 person-NG 3	$738.67 / 1 Day
Respite-Lic-Day-2 person-NG 3-Emergency	$738.67 / 1 Day
Respite-Lic-Day-2 person-NG 4	$800.99 / 1 Day
Respite-Lic-Day-2 person-NG 4-Emergency	$800.99 / 1 Day
Respite-Lic-Day-2 person-NG1	$503.18 / 1 Day
Respite-Lic-Day-2 person-NG5	$800.99 / 1 Day
Respite-Lic-Day-2 person-NG5-Emergency	$800.99 / 1 Day
Respite-Lic-Day-3 person-NG 1	$369.73 / 1 Day
Respite-Lic-Day-3 person-NG 1-Emergency	$369.73 / 1 Day
Respite-Lic-Day-3 person-NG 2	$419.25 / 1 Day
Respite-Lic-Day-3 person-NG 2-Emergency	$419.25 / 1 Day
Respite-Lic-Day-3 person-NG 3	$524.92 / 1 Day
Respite-Lic-Day-3 person-NG 3-Emergency	$524.92 / 1 Day
Respite-Lic-Day-3 person-NG 4	$570.64 / 1 Day
Respite-Lic-Day-3 person-NG 4-Emergency	$570.64 / 1 Day
Respite-Lic-Day-3 person-NG5	$570.64 / 1 Day
Respite-Lic-Day-3 person-NG5-Emergency	$570.64 / 1 Day

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

Res Hab-2 Person-NG5-Elig	$1,312.57 / 1 Day
Res Hab-2 Person-NG5-Elig-w/Day Supports	$1,215.16 / 1 Day
Res Hab-3 Person-NG 1-Elig	$411.03 / 1 Day
Res Hab-3 Person-NG 1-Elig-w/Day Supports	$312.16 / 1 Day
Res Hab-3 Person-NG 2-Elig	$468.38 / 1 Day
Res Hab-3 Person-NG 2-Elig-w/Day Supports	$361.68 / 1 Day
Res Hab-3 Person-NG 3-Elig	$545.05 / 1 Day
Res Hab-3 Person-NG 3-Elig-w/Day Supports	$467.35 / 1 Day
Res Hab-3 Person-NG 4-Elig	$662.22 / 1 Day
Res Hab-3 Person-NG 4-Elig-w/Day Supports	$513.07 / 1 Day
Res Hab-3 Person-NG5-Elig	$1,004.32 / 1 Day
Res Hab-3 Person-NG5-Elig-w/Day Supports	$835.46 / 1 Day
Res Hab-Lic-2 Person-Inelig	$50.22 / 1 Day
Respite-Lic-Day-2 person-NG 1-Emergency	$503.18 / 1 Day
Respite-Lic-Day-2 person-NG 2	$616.04 / 1 Day
Respite-Lic-Day-2 person-NG 2-Emergency	$616.04 / 1 Day
Respite-Lic-Day-2 person-NG 3	$738.67 / 1 Day
Respite-Lic-Day-2 person-NG 3-Emergency	$738.67 / 1 Day
Respite-Lic-Day-2 person-NG 4	$800.99 / 1 Day
Respite-Lic-Day-2 person-NG 4-Emergency	$800.99 / 1 Day
Respite-Lic-Day-2 person-NG1	$503.18 / 1 Day
Respite-Lic-Day-2 person-NG5	$800.99 / 1 Day
Respite-Lic-Day-2 person-NG5-Emergency	$800.99 / 1 Day
Respite-Lic-Day-3 person-NG 1	$369.73 / 1 Day
Respite-Lic-Day-3 person-NG 1-Emergency	$369.73 / 1 Day
Respite-Lic-Day-3 person-NG 2	$419.25 / 1 Day
Respite-Lic-Day-3 person-NG 2-Emergency	$419.25 / 1 Day
Respite-Lic-Day-3 person-NG 3	$524.92 / 1 Day
Respite-Lic-Day-3 person-NG 3-Emergency	$524.92 / 1 Day
Respite-Lic-Day-3 person-NG 4	$570.64 / 1 Day
Respite-Lic-Day-3 person-NG 4-Emergency	$570.64 / 1 Day
Respite-Lic-Day-3 person-NG5	$570.64 / 1 Day
Respite-Lic-Day-3 person-NG5-Emergency	$570.64 / 1 Day

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

Res Hab-2 Person-NG5-Elig	$1,312.57 / 1 Day
Res Hab-2 Person-NG5-Elig-w/Day Supports	$1,215.16 / 1 Day
Res Hab-3 Person-NG 1-Elig	$411.03 / 1 Day
Res Hab-3 Person-NG 1-Elig-w/Day Supports	$312.16 / 1 Day
Res Hab-3 Person-NG 2-Elig	$468.38 / 1 Day
Res Hab-3 Person-NG 2-Elig-w/Day Supports	$361.68 / 1 Day
Res Hab-3 Person-NG 3-Elig	$545.05 / 1 Day
Res Hab-3 Person-NG 3-Elig-w/Day Supports	$467.35 / 1 Day
Res Hab-3 Person-NG 4-Elig	$662.22 / 1 Day
Res Hab-3 Person-NG 4-Elig-w/Day Supports	$513.07 / 1 Day
Res Hab-3 Person-NG5-Elig	$1,004.32 / 1 Day
Res Hab-3 Person-NG5-Elig-w/Day Supports	$835.46 / 1 Day
Res Hab-Lic-2 Person-Inelig	$50.22 / 1 Day
Respite-Lic-Day-2 person-NG 1-Emergency	$503.18 / 1 Day
Respite-Lic-Day-2 person-NG 2	$616.04 / 1 Day
Respite-Lic-Day-2 person-NG 2-Emergency	$616.04 / 1 Day
Respite-Lic-Day-2 person-NG 3	$738.67 / 1 Day
Respite-Lic-Day-2 person-NG 3-Emergency	$738.67 / 1 Day
Respite-Lic-Day-2 person-NG 4	$800.99 / 1 Day
Respite-Lic-Day-2 person-NG 4-Emergency	$800.99 / 1 Day
Respite-Lic-Day-2 person-NG1	$503.18 / 1 Day
Respite-Lic-Day-2 person-NG5	$800.99 / 1 Day
Respite-Lic-Day-2 person-NG5-Emergency	$800.99 / 1 Day
Respite-Lic-Day-3 person-NG 1	$369.73 / 1 Day
Respite-Lic-Day-3 person-NG 1-Emergency	$369.73 / 1 Day
Respite-Lic-Day-3 person-NG 2	$419.25 / 1 Day
Respite-Lic-Day-3 person-NG 2-Emergency	$419.25 / 1 Day
Respite-Lic-Day-3 person-NG 3	$524.92 / 1 Day
Respite-Lic-Day-3 person-NG 3-Emergency	$524.92 / 1 Day
Respite-Lic-Day-3 person-NG 4	$570.64 / 1 Day
Respite-Lic-Day-3 person-NG 4-Emergency	$570.64 / 1 Day
Respite-Lic-Day-3 person-NG5	$570.64 / 1 Day
Respite-Lic-Day-3 person-NG5-Emergency	$570.64 / 1 Day

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

Res Hab-2 Person-NG5-Elig	$1,312.57 / 1 Day
Res Hab-2 Person-NG5-Elig-w/Day Supports	$1,215.16 / 1 Day
Res Hab-3 Person-NG 1-Elig	$411.03 / 1 Day
Res Hab-3 Person-NG 1-Elig-w/Day Supports	$312.16 / 1 Day
Res Hab-3 Person-NG 2-Elig	$468.38 / 1 Day
Res Hab-3 Person-NG 2-Elig-w/Day Supports	$361.68 / 1 Day
Res Hab-3 Person-NG 3-Elig	$545.05 / 1 Day
Res Hab-3 Person-NG 3-Elig-w/Day Supports	$467.35 / 1 Day
Res Hab-3 Person-NG 4-Elig	$662.22 / 1 Day
Res Hab-3 Person-NG 4-Elig-w/Day Supports	$513.07 / 1 Day
Res Hab-3 Person-NG5-Elig	$1,004.32 / 1 Day
Res Hab-3 Person-NG5-Elig-w/Day Supports	$835.46 / 1 Day
Res Hab-Lic-2 Person-Inelig	$50.22 / 1 Day
Respite-Lic-Day-2 person-NG 1-Emergency	$503.18 / 1 Day
Respite-Lic-Day-2 person-NG 2	$616.04 / 1 Day
Respite-Lic-Day-2 person-NG 2-Emergency	$616.04 / 1 Day
Respite-Lic-Day-2 person-NG 3	$738.67 / 1 Day
Respite-Lic-Day-2 person-NG 3-Emergency	$738.67 / 1 Day
Respite-Lic-Day-2 person-NG 4	$800.99 / 1 Day
Respite-Lic-Day-2 person-NG 4-Emergency	$800.99 / 1 Day
Respite-Lic-Day-2 person-NG1	$503.18 / 1 Day
Respite-Lic-Day-2 person-NG5	$800.99 / 1 Day
Respite-Lic-Day-2 person-NG5-Emergency	$800.99 / 1 Day
Respite-Lic-Day-3 person-NG 1	$369.73 / 1 Day
Respite-Lic-Day-3 person-NG 1-Emergency	$369.73 / 1 Day
Respite-Lic-Day-3 person-NG 2	$419.25 / 1 Day
Respite-Lic-Day-3 person-NG 2-Emergency	$419.25 / 1 Day
Respite-Lic-Day-3 person-NG 3	$524.92 / 1 Day
Respite-Lic-Day-3 person-NG 3-Emergency	$524.92 / 1 Day
Respite-Lic-Day-3 person-NG 4	$570.64 / 1 Day
Respite-Lic-Day-3 person-NG 4-Emergency	$570.64 / 1 Day
Respite-Lic-Day-3 person-NG5	$570.64 / 1 Day
Respite-Lic-Day-3 person-NG5-Emergency	$570.64 / 1 Day

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

Res Hab-2 Person-NG5-Elig	$1,312.57 / 1 Day
Res Hab-2 Person-NG5-Elig-w/Day Supports	$1,215.16 / 1 Day
Res Hab-3 Person-NG 1-Elig	$411.03 / 1 Day
Res Hab-3 Person-NG 1-Elig-w/Day Supports	$312.16 / 1 Day
Res Hab-3 Person-NG 2-Elig	$468.38 / 1 Day
Res Hab-3 Person-NG 2-Elig-w/Day Supports	$361.68 / 1 Day
Res Hab-3 Person-NG 3-Elig	$545.05 / 1 Day
Res Hab-3 Person-NG 3-Elig-w/Day Supports	$467.35 / 1 Day
Res Hab-3 Person-NG 4-Elig	$662.22 / 1 Day
Res Hab-3 Person-NG 4-Elig-w/Day Supports	$513.07 / 1 Day
Res Hab-3 Person-NG5-Elig	$1,004.32 / 1 Day
Res Hab-3 Person-NG5-Elig-w/Day Supports	$835.46 / 1 Day
Res Hab-Lic-2 Person-Inelig	$50.22 / 1 Day
Respite-Lic-Day-2 person-NG 1-Emergency	$503.18 / 1 Day
Respite-Lic-Day-2 person-NG 2	$616.04 / 1 Day
Respite-Lic-Day-2 person-NG 2-Emergency	$616.04 / 1 Day
Respite-Lic-Day-2 person-NG 3	$738.67 / 1 Day
Respite-Lic-Day-2 person-NG 3-Emergency	$738.67 / 1 Day
Respite-Lic-Day-2 person-NG 4	$800.99 / 1 Day
Respite-Lic-Day-2 person-NG 4-Emergency	$800.99 / 1 Day
Respite-Lic-Day-2 person-NG1	$503.18 / 1 Day
Respite-Lic-Day-2 person-NG5	$800.99 / 1 Day
Respite-Lic-Day-2 person-NG5-Emergency	$800.99 / 1 Day
Respite-Lic-Day-3 person-NG 1	$369.73 / 1 Day
Respite-Lic-Day-3 person-NG 1-Emergency	$369.73 / 1 Day
Respite-Lic-Day-3 person-NG 2	$419.25 / 1 Day
Respite-Lic-Day-3 person-NG 2-Emergency	$419.25 / 1 Day
Respite-Lic-Day-3 person-NG 3	$524.92 / 1 Day
Respite-Lic-Day-3 person-NG 3-Emergency	$524.92 / 1 Day
Respite-Lic-Day-3 person-NG 4	$570.64 / 1 Day
Respite-Lic-Day-3 person-NG 4-Emergency	$570.64 / 1 Day
Respite-Lic-Day-3 person-NG5	$570.64 / 1 Day
Respite-Lic-Day-3 person-NG5-Emergency	$570.64 / 1 Day

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

Companion Services (Level 1)	$4.77 / 15 min.
Companion Services (Level 2)	$8.33 / 15 min.
In-Home & Commnty Supprts (Basic)	$4.42 / 15 min.
In-Home & Commnty Supprts (Lvl 1)	$6.22 / 15 min.
In-Home & Commnty Supprts (Lvl 2 Enh)	$15.31 / 15 min.
In-Home & Commnty Supprts (Lvl 2 Enh) LPN	$15.31 / 15 min.
In-Home & Commnty Supprts (Lvl 2 Enh) RN	$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.
Res Hab-2 Person-NG 1-Elig	$554.38 / 1 Day
Res Hab-2 Person-NG 1-Elig-w/Day Supports	$433.05 / 1 Day
Res Hab-2 Person-NG 2-Elig	$643.34 / 1 Day
Res Hab-2 Person-NG 2-Elig-w/Day Supports	$545.91 / 1 Day
Res Hab-2 Person-NG 3-Elig	$726.82 / 1 Day
Res Hab-2 Person-NG 3-Elig-w/Day Supports	$668.54 / 1 Day
Res Hab-2 Person-NG 4-Elig	$869.36 / 1 Day
Res Hab-2 Person-NG 4-Elig-w/Day Supports	$730.86 / 1 Day
Res Hab-2 Person-NG5-Elig	$1,312.57 / 1 Day
Res Hab-2 Person-NG5-Elig-w/Day Supports	$1,215.16 / 1 Day
Res Hab-3 Person-NG 1-Elig	$411.03 / 1 Day
Res Hab-3 Person-NG 1-Elig-w/Day Supports	$312.16 / 1 Day
Res Hab-3 Person-NG 2-Elig	$468.38 / 1 Day
Res Hab-3 Person-NG 2-Elig-w/Day Supports	$361.68 / 1 Day
Res Hab-3 Person-NG 3-Elig	$545.05 / 1 Day
Res Hab-3 Person-NG 3-Elig-w/Day Supports	$467.35 / 1 Day
Res Hab-3 Person-NG 4-Elig	$662.22 / 1 Day
Res Hab-3 Person-NG 4-Elig-w/Day Supports	$513.07 / 1 Day
Res Hab-3 Person-NG5-Elig	$1,004.32 / 1 Day
Res Hab-3 Person-NG5-Elig-w/Day Supports	$835.46 / 1 Day
Res Hab-Lic-2 Person-Inelig	$50.22 / 1 Day
Respite-Lic-Day-2 person-NG 1-Emergency	$503.18 / 1 Day
Respite-Lic-Day-2 person-NG 2	$616.04 / 1 Day
Respite-Lic-Day-2 person-NG 2-Emergency	$616.04 / 1 Day
Respite-Lic-Day-2 person-NG 3	$738.67 / 1 Day
Respite-Lic-Day-2 person-NG 3-Emergency	$738.67 / 1 Day
Respite-Lic-Day-2 person-NG 4	$800.99 / 1 Day
Respite-Lic-Day-2 person-NG 4-Emergency	$800.99 / 1 Day
Respite-Lic-Day-2 person-NG1	$503.18 / 1 Day
Respite-Lic-Day-2 person-NG5	$800.99 / 1 Day
Respite-Lic-Day-2 person-NG5-Emergency	$800.99 / 1 Day
Respite-Lic-Day-3 person-NG 1	$369.73 / 1 Day
Respite-Lic-Day-3 person-NG 1-Emergency	$369.73 / 1 Day
Respite-Lic-Day-3 person-NG 2	$419.25 / 1 Day
Respite-Lic-Day-3 person-NG 2-Emergency	$419.25 / 1 Day
Respite-Lic-Day-3 person-NG 3	$524.92 / 1 Day
Respite-Lic-Day-3 person-NG 3-Emergency	$524.92 / 1 Day
Respite-Lic-Day-3 person-NG 4	$570.64 / 1 Day
Respite-Lic-Day-3 person-NG 4-Emergency	$570.64 / 1 Day
Respite-Lic-Day-3 person-NG5	$570.64 / 1 Day
Respite-Lic-Day-3 person-NG5-Emergency	$570.64 / 1 Day
Respite-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-15-min(Level 2, 1:2)In-Home	$4.75 / 15 min.
Respite-Unlic-15-min(Level 2, 1:2)Out-of-Home	$4.75 / 15 min.
Respite-Unlic-15-min(Level 3, 1:1)In-Home	$8.59 / 15 min.
Respite-Unlic-15-min(Level 3, 1:1)Out-of-Home	$8.59 / 15 min.
Respite-Unlic-15-min(Level 4, 2:1 Enh) - TD	$21.74 / 15 min.
Respite-Unlic-15-min(Level 4, 2:1 Enh) - TE	$21.74 / 15 min.
Respite-Unlic-15-min(Level 4, 2:1 Enhanced)	$21.74 / 15 min.
Respite-Unlic-Day (Level 2, 1:2) In-Home	$190.26 / 1 Day
Respite-Unlic-Day (Level 2, 1:2) Out-of-Home	$190.26 / 1 Day
Respite-Unlic-Day (Level 3, 1:1 Enh) In-Home	$531.24 / 1 Day
Respite-Unlic-Day (Level 3, 1:1 Enh) In-Home - TD	$531.24 / 1 Day
Respite-Unlic-Day (Level 3, 1:1 Enh) In-Home - TE	$531.24 / 1 Day
Respite-Unlic-Day (Level 3, 1:1 Enh) Out-of-Home	$531.24 / 1 Day
Respite-Unlic-Day (Level 3, 1:1 Enh)Out-of-Hme -TD	$531.24 / 1 Day
Respite-Unlic-Day (Level 3, 1:1 Enh)Out-of-Hme -TE	$531.24 / 1 Day
Respite-Unlic-Day (Level 3, 1:1) In-Home	$343.22 / 1 Day
Respite-Unlic-Day (Level 3, 1:1) Out-of-Home	$343.22 / 1 Day
Respite-Unlic-Day (Level 4, 2:1 Enh) In-Home - TD	$869.48 / 1 Day
Respite-Unlic-Day (Level 4, 2:1 Enh) In-Home - TE	$869.48 / 1 Day
Respite-Unlic-Day (Level 4, 2:1 Enhcd) In-Home	$869.48 / 1 Day
Respite-Unlic-Day (Level 4, 2:1) In-Home	$681.46 / 1 Day
Respite-Unlic-Day (Level 4, 2:1) Out-of-Home	$681.46 / 1 Day
Respite-Unlic-Day(Level 4, 2:1 Enh) Out-of-Home-TD	$869.48 / 1 Day
Respite-Unlic-Day(Level 4, 2:1 Enh) Out-of-Home-TE	$869.48 / 1 Day
Respite-Unlic-Day(Level 4, 2:1 Enhcd) Out-of-Home	$869.48 / 1 Day
Supplemental Habilitation 1:1 - 15 min	$6.12 / 15 min.

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

Companion Services (Level 1)	$4.77 / 15 min.
Companion Services (Level 2)	$8.33 / 15 min.
In-Home & Commnty Supprts (Basic)	$4.42 / 15 min.
In-Home & Commnty Supprts (Lvl 1)	$6.22 / 15 min.
In-Home & Commnty Supprts (Lvl 2 Enh)	$15.31 / 15 min.
In-Home & Commnty Supprts (Lvl 2 Enh) LPN	$15.31 / 15 min.
In-Home & Commnty Supprts (Lvl 2 Enh) RN	$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.
Res Hab-2 Person-NG 1-Elig	$554.38 / 1 Day
Res Hab-2 Person-NG 1-Elig-w/Day Supports	$433.05 / 1 Day
Res Hab-2 Person-NG 2-Elig	$643.34 / 1 Day
Res Hab-2 Person-NG 2-Elig-w/Day Supports	$545.91 / 1 Day
Res Hab-2 Person-NG 3-Elig	$726.82 / 1 Day
Res Hab-2 Person-NG 3-Elig-w/Day Supports	$668.54 / 1 Day
Res Hab-2 Person-NG 4-Elig	$869.36 / 1 Day
Res Hab-2 Person-NG 4-Elig-w/Day Supports	$730.86 / 1 Day
Res Hab-Lic-2 Person-Inelig	$50.22 / 1 Day
Respite-Lic-Day-2 person-NG 1-Emergency	$503.18 / 1 Day
Respite-Lic-Day-2 person-NG 3	$738.67 / 1 Day
Respite-Lic-Day-2 person-NG 3-Emergency	$738.67 / 1 Day
Respite-Lic-Day-2 person-NG 4	$800.99 / 1 Day
Respite-Lic-Day-2 person-NG 4-Emergency	$800.99 / 1 Day
Respite-Lic-Day-2 person-NG1	$503.18 / 1 Day
Respite-Lic-Day-2 person-NG5	$800.99 / 1 Day
Respite-Lic-Day-2 person-NG5-Emergency	$800.99 / 1 Day
Respite-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-15-min(Level 2, 1:2)In-Home	$4.75 / 15 min.
Respite-Unlic-15-min(Level 2, 1:2)Out-of-Home	$4.75 / 15 min.
Respite-Unlic-15-min(Level 3, 1:1)In-Home	$8.59 / 15 min.
Respite-Unlic-15-min(Level 3, 1:1)Out-of-Home	$8.59 / 15 min.
Respite-Unlic-15-min(Level 4, 2:1 Enh) - TD	$21.74 / 15 min.
Respite-Unlic-15-min(Level 4, 2:1 Enh) - TE	$21.74 / 15 min.
Respite-Unlic-15-min(Level 4, 2:1 Enhanced)	$21.74 / 15 min.
Respite-Unlic-Day (Level 2, 1:2) In-Home	$190.26 / 1 Day
Respite-Unlic-Day (Level 2, 1:2) Out-of-Home	$190.26 / 1 Day
Respite-Unlic-Day (Level 3, 1:1 Enh) In-Home	$531.24 / 1 Day
Respite-Unlic-Day (Level 3, 1:1 Enh) In-Home - TD	$531.24 / 1 Day
Respite-Unlic-Day (Level 3, 1:1 Enh) In-Home - TE	$531.24 / 1 Day
Respite-Unlic-Day (Level 3, 1:1 Enh) Out-of-Home	$531.24 / 1 Day
Respite-Unlic-Day (Level 3, 1:1 Enh)Out-of-Hme -TD	$531.24 / 1 Day
Respite-Unlic-Day (Level 3, 1:1 Enh)Out-of-Hme -TE	$531.24 / 1 Day
Respite-Unlic-Day (Level 3, 1:1) In-Home	$343.22 / 1 Day
Respite-Unlic-Day (Level 3, 1:1) Out-of-Home	$343.22 / 1 Day
Respite-Unlic-Day (Level 4, 2:1 Enh) In-Home - TD	$869.48 / 1 Day
Respite-Unlic-Day (Level 4, 2:1 Enh) In-Home - TE	$869.48 / 1 Day
Respite-Unlic-Day (Level 4, 2:1 Enhcd) In-Home	$869.48 / 1 Day
Respite-Unlic-Day (Level 4, 2:1) In-Home	$681.46 / 1 Day
Respite-Unlic-Day (Level 4, 2:1) Out-of-Home	$681.46 / 1 Day
Respite-Unlic-Day(Level 4, 2:1 Enh) Out-of-Home-TD	$869.48 / 1 Day
Respite-Unlic-Day(Level 4, 2:1 Enh) Out-of-Home-TE	$869.48 / 1 Day
Respite-Unlic-Day(Level 4, 2:1 Enhcd) Out-of-Home	$869.48 / 1 Day
Supplemental Habilitation 1:1 - 15 min	$6.12 / 15 min.

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

Res Hab-Lic-2 Person-Inelig	$50.22 / 1 Day

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

Res Hab-Lic-2 Person-Inelig	$50.22 / 1 Day

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

Res Hab-Lic-2 Person-Inelig	$50.22 / 1 Day

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

Res Hab-Lic-2 Person-Inelig	$50.22 / 1 Day

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

Res Hab-Lic-2 Person-Inelig	$50.22 / 1 Day

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

Res Hab-Lic-2 Person-Inelig	$50.22 / 1 Day

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

Res Hab-Lic-2 Person-Inelig	$50.22 / 1 Day

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

Res Hab-Lic-2 Person-Inelig	$50.22 / 1 Day

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

Res Hab-Lic-2 Person-Inelig	$50.22 / 1 Day

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

Res Hab-Lic-2 Person-Inelig	$50.22 / 1 Day

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

Res Hab-Lic-2 Person-Inelig	$50.22 / 1 Day

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

Res Hab-Lic-2 Person-Inelig	$50.22 / 1 Day

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

Res Hab-Lic-2 Person-Inelig	$50.22 / 1 Day

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

Res Hab-Lic-2 Person-Inelig	$50.22 / 1 Day

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

Res Hab-Lic-2 Person-Inelig	$50.22 / 1 Day

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

Res Hab-Lic-2 Person-Inelig	$50.22 / 1 Day

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

Res Hab-Lic-2 Person-Inelig	$50.22 / 1 Day

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

Res Hab-Lic-2 Person-Inelig	$50.22 / 1 Day

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

Res Hab-Lic-2 Person-Inelig	$50.22 / 1 Day

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

Res Hab-Lic-2 Person-Inelig	$50.22 / 1 Day

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

Res Hab-Lic-2 Person-Inelig	$50.22 / 1 Day

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

Res Hab-Lic-2 Person-Inelig	$50.22 / 1 Day

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

Res Hab-Lic-2 Person-Inelig	$50.22 / 1 Day

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

Res Hab-Lic-2 Person-Inelig	$50.22 / 1 Day

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

Res Hab-Lic-2 Person-Inelig	$50.22 / 1 Day

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

Res Hab-Lic-2 Person-Inelig	$50.22 / 1 Day

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

Res Hab-Lic-2 Person-Inelig	$50.22 / 1 Day

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

Res Hab-Lic-2 Person-Inelig	$50.22 / 1 Day

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

Res Hab-Lic-2 Person-Inelig	$50.22 / 1 Day

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

Res Hab-Lic-2 Person-Inelig	$50.22 / 1 Day

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

Res Hab-Lic-2 Person-Inelig	$50.22 / 1 Day

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

Res Hab-Lic-2 Person-Inelig	$50.22 / 1 Day

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

Res Hab-Lic-2 Person-Inelig	$50.22 / 1 Day

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

Res Hab-Lic-2 Person-Inelig	$50.22 / 1 Day

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

Companion Services (Level 1)	$4.77 / 15 min.
Companion Services (Level 2)	$8.33 / 15 min.
In-Home & Commnty Supprts (Basic)	$4.42 / 15 min.
In-Home & Commnty Supprts (Lvl 1)	$6.22 / 15 min.
In-Home & Commnty Supprts (Lvl 2 Enh)	$15.31 / 15 min.
In-Home & Commnty Supprts (Lvl 2 Enh) LPN	$15.31 / 15 min.
In-Home & Commnty Supprts (Lvl 2 Enh) RN	$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.
Res Hab-2 Person-NG 1-Elig	$554.38 / 1 Day
Res Hab-2 Person-NG 1-Elig-w/Day Supports	$433.05 / 1 Day
Res Hab-2 Person-NG 2-Elig	$643.34 / 1 Day
Res Hab-2 Person-NG 2-Elig-w/Day Supports	$545.91 / 1 Day
Res Hab-2 Person-NG 3-Elig	$726.82 / 1 Day
Res Hab-2 Person-NG 3-Elig-w/Day Supports	$668.54 / 1 Day
Res Hab-2 Person-NG 4-Elig	$869.36 / 1 Day
Res Hab-2 Person-NG 4-Elig-w/Day Supports	$730.86 / 1 Day
Res Hab-Lic-2 Person-Inelig	$50.22 / 1 Day
Respite-Lic-Day-2 person-NG 2	$616.04 / 1 Day
Respite-Lic-Day-2 person-NG 2-Emergency	$616.04 / 1 Day
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-15-min(Level 2, 1:2)In-Home	$4.75 / 15 min.
Respite-Unlic-15-min(Level 2, 1:2)Out-of-Home	$4.75 / 15 min.
Respite-Unlic-15-min(Level 3, 1:1)In-Home	$8.59 / 15 min.
Respite-Unlic-15-min(Level 3, 1:1)Out-of-Home	$8.59 / 15 min.
Respite-Unlic-15-min(Level 4, 2:1 Enh) - TD	$21.74 / 15 min.
Respite-Unlic-15-min(Level 4, 2:1 Enh) - TE	$21.74 / 15 min.
Respite-Unlic-15-min(Level 4, 2:1 Enhanced)	$21.74 / 15 min.
Respite-Unlic-Day (Level 2, 1:2) In-Home	$190.26 / 1 Day
Respite-Unlic-Day (Level 2, 1:2) Out-of-Home	$190.26 / 1 Day
Respite-Unlic-Day (Level 3, 1:1 Enh) In-Home	$531.24 / 1 Day
Respite-Unlic-Day (Level 3, 1:1 Enh) In-Home - TD	$531.24 / 1 Day
Respite-Unlic-Day (Level 3, 1:1 Enh) In-Home - TE	$531.24 / 1 Day
Respite-Unlic-Day (Level 3, 1:1 Enh) Out-of-Home	$531.24 / 1 Day
Respite-Unlic-Day (Level 3, 1:1 Enh)Out-of-Hme -TD	$531.24 / 1 Day
Respite-Unlic-Day (Level 3, 1:1 Enh)Out-of-Hme -TE	$531.24 / 1 Day
Respite-Unlic-Day (Level 3, 1:1) In-Home	$343.22 / 1 Day
Respite-Unlic-Day (Level 3, 1:1) Out-of-Home	$343.22 / 1 Day
Respite-Unlic-Day (Level 4, 2:1 Enh) In-Home - TD	$869.48 / 1 Day
Respite-Unlic-Day (Level 4, 2:1 Enh) In-Home - TE	$869.48 / 1 Day
Respite-Unlic-Day (Level 4, 2:1 Enhcd) In-Home	$869.48 / 1 Day
Respite-Unlic-Day (Level 4, 2:1) In-Home	$681.46 / 1 Day
Respite-Unlic-Day (Level 4, 2:1) Out-of-Home	$681.46 / 1 Day
Respite-Unlic-Day(Level 4, 2:1 Enh) Out-of-Home-TD	$869.48 / 1 Day
Respite-Unlic-Day(Level 4, 2:1 Enh) Out-of-Home-TE	$869.48 / 1 Day
Respite-Unlic-Day(Level 4, 2:1 Enhcd) Out-of-Home	$869.48 / 1 Day
Supplemental Habilitation 1:1 - 15 min	$6.12 / 15 min.

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

Res Hab-Lic-2 Person-Inelig	$50.22 / 1 Day

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

Companion Services (Level 1)	$4.77 / 15 min.
Companion Services (Level 2)	$8.33 / 15 min.
In-Home & Commnty Supprts (Basic)	$4.42 / 15 min.
In-Home & Commnty Supprts (Lvl 1)	$6.22 / 15 min.
In-Home & Commnty Supprts (Lvl 2 Enh)	$15.31 / 15 min.
In-Home & Commnty Supprts (Lvl 2 Enh) LPN	$15.31 / 15 min.
In-Home & Commnty Supprts (Lvl 2 Enh) RN	$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.
Res Hab-2 Person-NG 1-Elig	$554.38 / 1 Day
Res Hab-2 Person-NG 1-Elig-w/Day Supports	$433.05 / 1 Day
Res Hab-2 Person-NG 2-Elig	$643.34 / 1 Day
Res Hab-2 Person-NG 2-Elig-w/Day Supports	$545.91 / 1 Day
Res Hab-2 Person-NG 3-Elig	$726.82 / 1 Day
Res Hab-2 Person-NG 3-Elig-w/Day Supports	$668.54 / 1 Day
Res Hab-2 Person-NG 4-Elig	$869.36 / 1 Day
Res Hab-2 Person-NG 4-Elig-w/Day Supports	$730.86 / 1 Day
Res Hab-Lic-2 Person-Inelig	$50.22 / 1 Day
Respite-Lic-Day-2 person-NG 2	$616.04 / 1 Day
Respite-Lic-Day-2 person-NG 2-Emergency	$616.04 / 1 Day
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-15-min(Level 2, 1:2)In-Home	$4.75 / 15 min.
Respite-Unlic-15-min(Level 2, 1:2)Out-of-Home	$4.75 / 15 min.
Respite-Unlic-15-min(Level 3, 1:1)In-Home	$8.59 / 15 min.
Respite-Unlic-15-min(Level 3, 1:1)Out-of-Home	$8.59 / 15 min.
Respite-Unlic-15-min(Level 4, 2:1 Enh) - TD	$21.74 / 15 min.
Respite-Unlic-15-min(Level 4, 2:1 Enh) - TE	$21.74 / 15 min.
Respite-Unlic-15-min(Level 4, 2:1 Enhanced)	$21.74 / 15 min.
Respite-Unlic-Day (Level 2, 1:2) In-Home	$190.26 / 1 Day
Respite-Unlic-Day (Level 2, 1:2) Out-of-Home	$190.26 / 1 Day
Respite-Unlic-Day (Level 3, 1:1 Enh) In-Home	$531.24 / 1 Day
Respite-Unlic-Day (Level 3, 1:1 Enh) In-Home - TD	$531.24 / 1 Day
Respite-Unlic-Day (Level 3, 1:1 Enh) In-Home - TE	$531.24 / 1 Day
Respite-Unlic-Day (Level 3, 1:1 Enh) Out-of-Home	$531.24 / 1 Day
Respite-Unlic-Day (Level 3, 1:1 Enh)Out-of-Hme -TD	$531.24 / 1 Day
Respite-Unlic-Day (Level 3, 1:1 Enh)Out-of-Hme -TE	$531.24 / 1 Day
Respite-Unlic-Day (Level 3, 1:1) In-Home	$343.22 / 1 Day
Respite-Unlic-Day (Level 3, 1:1) Out-of-Home	$343.22 / 1 Day
Respite-Unlic-Day (Level 4, 2:1 Enh) In-Home - TD	$869.48 / 1 Day
Respite-Unlic-Day (Level 4, 2:1 Enh) In-Home - TE	$869.48 / 1 Day
Respite-Unlic-Day (Level 4, 2:1 Enhcd) In-Home	$869.48 / 1 Day
Respite-Unlic-Day (Level 4, 2:1) In-Home	$681.46 / 1 Day
Respite-Unlic-Day (Level 4, 2:1) Out-of-Home	$681.46 / 1 Day
Respite-Unlic-Day(Level 4, 2:1 Enh) Out-of-Home-TD	$869.48 / 1 Day
Respite-Unlic-Day(Level 4, 2:1 Enh) Out-of-Home-TE	$869.48 / 1 Day
Respite-Unlic-Day(Level 4, 2:1 Enhcd) Out-of-Home	$869.48 / 1 Day
Supplemental Habilitation 1:1 - 15 min	$6.12 / 15 min.
Supplemental Habilitation 2:1 - 15 min	$12.22 / 15 min.

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

Res Hab-Lic-2 Person-Inelig	$50.22 / 1 Day

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