Rates

On January 1, 1996, the Department of Human Services (Department) 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 2006-2007, 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 preposed 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

2016-2017

2015-2016

2014-2015

2013-2014

2012-2013

2011-2012

Criteria for Reversals 7/1/01

Proposed Rates:

Rate YearCounty Proposed Rates
2017-2018View

 

 Month/Year    Nursing Facility Proposed Condensed RatesNursing Facility Proposed Detailed Rates
July 2017ViewView
October 2017ViewView
January 2018ViewView
April 2018ViewView

 
                                                         
County Final Rates:

Rate Year

County Detailed Rates

2016-2017View
2015-2016View
2014-2015View
2013-2014View
2012-2013View
2011-2012View
2010-2011View
2009-2010View
2008-2009View
2007-2008View
2006-2007View

 

Nursing Facility Final Rates:

Month/Year

Condensed Rates

Detailed Rates

Crosswalk

April 2017ViewView 
January 2017ViewView 
October 2016ViewView 
July 2016 ViewViewView
April 2016ViewView 
January 2016ViewView 

October 2015

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July 2015 

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April 2015

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January 2015

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October 2014

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July 2014 

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April 2014

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January 2014 

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October 2013 

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July 2013 

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April 2013 

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January 2013 

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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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April 2002

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January 2002

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October 2001

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July 2001

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April 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

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January 2012ViewView

November 2011

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