Attachment B PASRR Rates.xlsx

	A	B	C	D
1	Attachment B: Rate Table
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3	Letter Name	Code	Rate	Rural Rate*
4	Assessment Update	AU	$138.00	$188.00
5	Convalescent	CONV	$440.00	$490.00
6	Denial A	D	$138.00	$188.00
7	Denial A Reassessment	DR	$138.00	$188.00
8	Denial B	D	$138.00	$188.00
9	Denial B Reassessment	DR	$138.00	$188.00
10	Denial C	D	$440.00	$490.00
11	Denial C Reassessment	DR	$138.00	$188.00
12	Diagnosis of Dementia	DEM	$250.00	$280.00
13	Initial Significant Change	ISC	$440.00	$490.00
14	LTC	LTC	$440.00	$490.00
15	LTCI	LTC	$440.00	$490.00
16	No Significant Change	NSC	$0.00	$0.00
17	No Significant Change Not Approved	NSCNA	$0.00	$0.00
18	No Significant Change Not Needed	NSCNN	$0.00	$0.00
19	NSMI	NSMI	$250.00	$280.00
20	NSMI - Significant Change	NSMISC	$250.00	$280.00
21	Provisional	P	$440.00	$490.00
22	Reassessment - Active Discharge	RES	$138.00	$188.00
23	Reassessment - End of Convalescent Stay	RES	$138.00	$188.00
24	Reassessment Short Term Stay	RES	$138.00	$188.00
25	Reassessment Significant Change	RES	$440.00	$490.00
26	Requires Active Discharge Once Medically Stabilize	LTC	$440.00	$490.00
27	Resident Left Facility Deceased	U	$75.00	$75.00
28	Resident Left Facility Early	U	$75.00	$75.00
29	Short Term Stay	SS	$440.00	$490.00
30	Short Term Stay I	SS	$440.00	$490.00
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32	*Rural Rates apply when a PASRR Level II Evaluation requires the Contractor to travel at least 50 miles one-way from their home base.
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