Rates

On Jan. 1, 1996, the Department of Human Services implemented 55 PA.Code Chapter 1187, the Nursing Facilities Services Case-Mix Reimbursement System. Case mix rates for all Medical Assistance (MA) nursing facilities’ were determined in accordance with the conditions and limitations specified in 55 PA.Code Chapter 1187 and the Commonwealth’s Title XIX State Plan. Beginning, Fiscal Year 2006-07, the Department changed the rate setting methodology for MA county nursing facilities and reimbursed the facilities in accordance with 55 PA.Code Chapter 1189, for County Nursing Facilities, which was adopted June 23, 2006 and became effective July 1, 2006.

Long Term Care/Case Mix Rates

This section includes the most recent proposed case mix rates as well as final rates beginning January 1996. Click on the appropriate link below to initiate steps to view the rate information you are interested in. This information is updated as notification of the proposed and final rates is published in the Pennsylvania Bulletin.

Rate Files

The rate files are Excel spreadsheets and Microsoft Excel is needed to access these files. Some of these pages are large and contain a great deal of information - please be aware that they may require several minutes to load.

Proposed Rates - These are the most recent proposed case mix rates.

Condensed Final Rates - These are the condensed versions of final case mix rates. These documents consist of Provider Names, MA CMI Averages, and Final Rates.

Detailed Final Rates - These are the full Excel spreadsheets for final case mix rates. These spreadsheets consist of Provider Name, MA CMI Averages, Final Rates, Average Per Diems, Peer Group Prices, Limited Prices, Cost Center Rates, etc.

Crosswalk to Column Headings of Rate Spreadsheets

2018-2019 Detailed Final Rates

2017-2018 Detailed Final Rates

2016-2017 Detailed Final Rates

2015-2016 Detailed Final Rates

2014-2015 Detailed Final Rates

2013-2014 Detailed Final Rates

2012-2013 Detailed Final Rates

2011-2012 Detailed Final Rates

Criteria for Reversals 7/1/01

 

 

 

 
                                                            
County Final Rates:

Rate Year

County Detailed Rates

2018-2019View 2018-2019 County Detailed Rates
2017-2018View 2017-2018 County Detailed Rates
2016-2017View 2016-2017 County Detailed Rates
2015-2016View 2015-2016 County Detailed Rates
2014-2015View 2014-2015 County Detailed Rates
2013-2014View 2013-2014 County Detailed Rates
2012-2013View 2012-2013 County Detailed Rates
2011-2012View 2011-2012 County Detailed Rates
2010-2011View 2010-2011 County Detailed Rates
2009-2010View 2009-2010 County Detailed Rates
2008-2009View 2008-2009 County Detailed Rates
2007-2008View 2007-2008 County Detailed Rates
2006-2007View 2006-2007 County Detailed Rates

 

Nursing Facility Final Rates:

Month/Year

Condensed Rates

Detailed Rates

Crosswalk

April 2019View April, 2019 Condensed RatesView April, 2019 Detailed Rates 
January 2019View Jan, 2019 Condensed RatesView Jan, 2019 Detailed Rates 
October 2018View Oct. 2018 Condensed RatesView Oct. 2018 Detailed Rates 
July 2018View July 2018 Condensed RatesView July 2018 Detailed RatesView July 2018 Crosswalk
April 2018View April 2018 Condensed RatesView April 2018 Detailed Rates 
January 2018View Jan. 2018 Condensed RatesView Jan. 2018 Detailed Rates 
October 2017View Oct. 2017 Condensed RatesView 
July 2017View July 2017 Condensed RatesViewView 
April 2017View April 2017 Condensed RatesView 
January 2017View Jan. 2017 Condensed RatesView 
October 2016View Oct. 2016 Condensed RatesView 
July 2016 View July 2016 Condensed RatesViewView
April 2016View April 2016 Condensed RatesView 
January 2016View Jan. 2016 Condensed RatesView 

October 2015

View Oct. 2015 Condensed RatesView 

July 2015 

View July 2015 Condensed Rates

View 

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April 2015

View April 2015 Condensed Rates

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January 2015

View Jan. 2015 Condensed Rates

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October 2014

View Oct. 2014 Condensed Rates

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July 2014 

View July 2014 Condensed Rates

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April 2014

View April 2014 Condensed Rates

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January 2014 

View Jan. 2014 Condensed Rates

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October 2013 

View Oct. 2013 Condensed Rates

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July 2013 

View July 2013 Condensed Rates

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April 2013 

View April 2013 Condensed Rates

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January 2013 

View Jan. 2013 Condensed Rates

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October 2012

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July 2012

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April 2012

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January 2012

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October 2011

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July 2011

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April 2011

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January 2011

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October 2010

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July 2010

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April 2010

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January 2010

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October 2009

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July 2009

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April 2009

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January 2009

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October 2008

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July 2008

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April 2008

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January 2008

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October 2007

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July 2007

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April 2007

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January 2007

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October 2006

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July 2006

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April 2006

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January 2006

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October 2005

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July 2005

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April 2005

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January 2005

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October 2004

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July 2004

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April 2004

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January 2004

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October 2003

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July 2003

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April 2003

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January 2003

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October 2002

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July 2002

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October 2001

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July 2001

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January 2001

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October 2000

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July 2000

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April 2000

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January 2000

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October 1999

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July 1999

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April 1999

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January 1999

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October 1998

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July 1998

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April 1998

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January 1998

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October 1997

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July 1997

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April 1997

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January 1997

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October 1996

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July 1996

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April 1996

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January 1996

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                                                                 Special Rehab Facility Final Rates:

Month/Year

Condensed Rates

Detailed Rates

April 2012

View

View

January 2012ViewView

November 2011

ViewView