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Provider Demographic Information - KELSCH ASSOCIATES INC

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PROVIDER DEMOGRAPHIC INFORMATION Supporting line for group header


Name:	KELSCH ASSOCIATES INC
Address:	319 N POTTSTOWN PIKE STE 305 EXTON, PA 19341-2218
Phone:	(610) 363-0920
Fax:	(610) 363-7865
E-mail:	INFO@KELSCHASSOCIATES.ORG
Web Site:	www.kelschassociates.org

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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:	KELSCH ASSOCIATES
Address:	319 POTTSTOWN PIKE STE 305 EXTON, PA 19341-
Phone:	(610) 363-0920
Fax:	(610) 363-7865

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PROVIDER SERVICES AND RATES Supporting line for group header


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

Life Sharing-1 person-Elig-NG 1 > 30 Hrs	$171.35 / 1 Day
Life Sharing-1 person-Elig-NG 2 > 30 Hrs	$204.29 / 1 Day
Life Sharing-1 person-Elig-NG 3 > 30 Hrs	$279.58 / 1 Day
Life Sharing-1 person-Elig-NG 4 > 30 Hrs	$355.61 / 1 Day
Life Sharing-2 person-Elig-NG 1 > 30 Hrs	$120.79 / 1 Day
Life Sharing-2 person-Elig-NG 2 > 30 Hrs	$144.84 / 1 Day
Life Sharing-2 person-Elig-NG 3 > 30 Hrs	$197.06 / 1 Day
Life Sharing-2 person-Elig-NG 4 > 30 Hrs	$237.16 / 1 Day

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

Life Sharing-1 person-Elig-NG 1 > 30 Hrs	$171.35 / 1 Day
Life Sharing-1 person-Elig-NG 2 > 30 Hrs	$204.29 / 1 Day
Life Sharing-1 person-Elig-NG 3 > 30 Hrs	$279.58 / 1 Day
Life Sharing-1 person-Elig-NG 4 > 30 Hrs	$355.61 / 1 Day
Life Sharing-2 person-Elig-NG 1 > 30 Hrs	$120.79 / 1 Day
Life Sharing-2 person-Elig-NG 2 > 30 Hrs	$144.84 / 1 Day
Life Sharing-2 person-Elig-NG 3 > 30 Hrs	$197.06 / 1 Day
Life Sharing-2 person-Elig-NG 4 > 30 Hrs	$237.16 / 1 Day

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

Life Sharing-1 person-Elig-NG 1 > 30 Hrs	$171.35 / 1 Day
Life Sharing-1 person-Elig-NG 2 > 30 Hrs	$204.29 / 1 Day
Life Sharing-1 person-Elig-NG 3 > 30 Hrs	$279.58 / 1 Day
Life Sharing-1 person-Elig-NG 4 > 30 Hrs	$355.61 / 1 Day
Life Sharing-2 person-Elig-NG 1 > 30 Hrs	$120.79 / 1 Day
Life Sharing-2 person-Elig-NG 2 > 30 Hrs	$144.84 / 1 Day
Life Sharing-2 person-Elig-NG 3 > 30 Hrs	$197.06 / 1 Day
Life Sharing-2 person-Elig-NG 4 > 30 Hrs	$237.16 / 1 Day

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

Life Sharing-1 person-Elig-NG 1 > 30 Hrs	$171.35 / 1 Day
Life Sharing-1 person-Elig-NG 2 > 30 Hrs	$204.29 / 1 Day
Life Sharing-1 person-Elig-NG 3 > 30 Hrs	$279.58 / 1 Day
Life Sharing-1 person-Elig-NG 4 > 30 Hrs	$355.61 / 1 Day
Life Sharing-2 person-Elig-NG 1 > 30 Hrs	$120.79 / 1 Day
Life Sharing-2 person-Elig-NG 2 > 30 Hrs	$144.84 / 1 Day
Life Sharing-2 person-Elig-NG 3 > 30 Hrs	$197.06 / 1 Day
Life Sharing-2 person-Elig-NG 4 > 30 Hrs	$237.16 / 1 Day

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

Life Sharing-1 person-Elig-NG 1 > 30 Hrs	$171.35 / 1 Day
Life Sharing-1 person-Elig-NG 2 > 30 Hrs	$204.29 / 1 Day
Life Sharing-1 person-Elig-NG 3 > 30 Hrs	$279.58 / 1 Day
Life Sharing-1 person-Elig-NG 4 > 30 Hrs	$355.61 / 1 Day
Life Sharing-2 person-Elig-NG 1 > 30 Hrs	$120.79 / 1 Day
Life Sharing-2 person-Elig-NG 2 > 30 Hrs	$144.84 / 1 Day
Life Sharing-2 person-Elig-NG 3 > 30 Hrs	$197.06 / 1 Day
Life Sharing-2 person-Elig-NG 4 > 30 Hrs	$237.16 / 1 Day
Res Hab-1 Person-NG 1-Elig	$523.00 / 1 Day
Res Hab-1 Person-NG 1-Elig-w/Day Supports	$408.54 / 1 Day
Res Hab-1 Person-NG 2-Elig	$606.92 / 1 Day
Res Hab-1 Person-NG 2-Elig-w/Day Supports	$515.01 / 1 Day
Res Hab-1 Person-NG 3-Elig	$924.89 / 1 Day
Res Hab-1 Person-NG 3-Elig-w/Day Supports	$746.22 / 1 Day
Res Hab-1 Person-NG 4-Elig	$1,118.74 / 1 Day
Res Hab-1 Person-NG 4-Elig-w/Day Supports	$822.23 / 1 Day
Res Hab-2 Person-NG 1-Elig	$523.00 / 1 Day
Res Hab-2 Person-NG 1-Elig-w/Day Supports	$408.54 / 1 Day
Res Hab-2 Person-NG 2-Elig	$606.92 / 1 Day
Res Hab-2 Person-NG 2-Elig-w/Day Supports	$515.01 / 1 Day
Res Hab-2 Person-NG 3-Elig	$685.68 / 1 Day
Res Hab-2 Person-NG 3-Elig-w/Day Supports	$630.70 / 1 Day
Res Hab-2 Person-NG 4-Elig	$820.15 / 1 Day
Res Hab-2 Person-NG 4-Elig-w/Day Supports	$689.49 / 1 Day
Res Hab-3 Person-NG 1-Elig	$387.76 / 1 Day
Res Hab-3 Person-NG 1-Elig-w/Day Supports	$294.49 / 1 Day
Res Hab-3 Person-NG 2-Elig	$441.87 / 1 Day
Res Hab-3 Person-NG 2-Elig-w/Day Supports	$341.21 / 1 Day
Res Hab-3 Person-NG 3-Elig	$514.20 / 1 Day
Res Hab-3 Person-NG 3-Elig-w/Day Supports	$440.90 / 1 Day
Res Hab-3 Person-NG 4-Elig	$624.74 / 1 Day
Res Hab-3 Person-NG 4-Elig-w/Day Supports	$484.03 / 1 Day
Res Hab-Lic-1 Person-Inelig	$99.10 / 1 Day
Res Hab-Lic-2 Person-Inelig	$54.05 / 1 Day
Res Hab-Lic-3 Person-Inelig	$38.74 / 1 Day
Supplemental Habilitation 1:1 - 15 min	$5.77 / 15 min.
Supplemental Habilitation 2:1 - 15 min	$11.53 / 15 min.

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

Life Sharing-1 person-Elig-NG 1 > 30 Hrs	$171.35 / 1 Day
Life Sharing-1 person-Elig-NG 2 > 30 Hrs	$204.29 / 1 Day
Life Sharing-1 person-Elig-NG 3 > 30 Hrs	$279.58 / 1 Day
Life Sharing-1 person-Elig-NG 4 > 30 Hrs	$355.61 / 1 Day
Life Sharing-2 person-Elig-NG 1 > 30 Hrs	$120.79 / 1 Day
Life Sharing-2 person-Elig-NG 2 > 30 Hrs	$144.84 / 1 Day
Life Sharing-2 person-Elig-NG 3 > 30 Hrs	$197.06 / 1 Day
Life Sharing-2 person-Elig-NG 4 > 30 Hrs	$237.16 / 1 Day

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

Life Sharing-1 person-Elig-NG 1 > 30 Hrs	$171.35 / 1 Day
Life Sharing-1 person-Elig-NG 2 > 30 Hrs	$204.29 / 1 Day
Life Sharing-1 person-Elig-NG 3 > 30 Hrs	$279.58 / 1 Day
Life Sharing-1 person-Elig-NG 4 > 30 Hrs	$355.61 / 1 Day
Life Sharing-2 person-Elig-NG 1 > 30 Hrs	$120.79 / 1 Day
Life Sharing-2 person-Elig-NG 2 > 30 Hrs	$144.84 / 1 Day
Life Sharing-2 person-Elig-NG 3 > 30 Hrs	$197.06 / 1 Day
Life Sharing-2 person-Elig-NG 4 > 30 Hrs	$237.16 / 1 Day

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

Life Sharing-1 person-Elig-NG 1 > 30 Hrs	$171.35 / 1 Day
Life Sharing-1 person-Elig-NG 2 > 30 Hrs	$204.29 / 1 Day
Life Sharing-1 person-Elig-NG 3 > 30 Hrs	$279.58 / 1 Day
Life Sharing-1 person-Elig-NG 4 > 30 Hrs	$355.61 / 1 Day
Life Sharing-2 person-Elig-NG 1 > 30 Hrs	$120.79 / 1 Day
Life Sharing-2 person-Elig-NG 2 > 30 Hrs	$144.84 / 1 Day
Life Sharing-2 person-Elig-NG 3 > 30 Hrs	$197.06 / 1 Day
Life Sharing-2 person-Elig-NG 4 > 30 Hrs	$237.16 / 1 Day
Res Hab-1 Person-NG 1-Elig	$523.00 / 1 Day
Res Hab-1 Person-NG 1-Elig-w/Day Supports	$408.54 / 1 Day
Res Hab-1 Person-NG 2-Elig	$606.92 / 1 Day
Res Hab-1 Person-NG 2-Elig-w/Day Supports	$515.01 / 1 Day
Res Hab-1 Person-NG 3-Elig	$924.89 / 1 Day
Res Hab-1 Person-NG 3-Elig-w/Day Supports	$746.22 / 1 Day
Res Hab-1 Person-NG 4-Elig	$1,118.74 / 1 Day
Res Hab-1 Person-NG 4-Elig-w/Day Supports	$822.23 / 1 Day
Res Hab-2 Person-NG 1-Elig	$523.00 / 1 Day
Res Hab-2 Person-NG 1-Elig-w/Day Supports	$408.54 / 1 Day
Res Hab-2 Person-NG 2-Elig	$606.92 / 1 Day
Res Hab-2 Person-NG 2-Elig-w/Day Supports	$515.01 / 1 Day
Res Hab-2 Person-NG 3-Elig	$685.68 / 1 Day
Res Hab-2 Person-NG 3-Elig-w/Day Supports	$630.70 / 1 Day
Res Hab-2 Person-NG 4-Elig	$820.15 / 1 Day
Res Hab-2 Person-NG 4-Elig-w/Day Supports	$689.49 / 1 Day
Res Hab-3 Person-NG 1-Elig	$387.76 / 1 Day
Res Hab-3 Person-NG 1-Elig-w/Day Supports	$294.49 / 1 Day
Res Hab-3 Person-NG 2-Elig	$441.87 / 1 Day
Res Hab-3 Person-NG 2-Elig-w/Day Supports	$341.21 / 1 Day
Res Hab-3 Person-NG 3-Elig	$514.20 / 1 Day
Res Hab-3 Person-NG 3-Elig-w/Day Supports	$440.90 / 1 Day
Res Hab-3 Person-NG 4-Elig	$624.74 / 1 Day
Res Hab-3 Person-NG 4-Elig-w/Day Supports	$484.03 / 1 Day
Res Hab-Lic-1 Person-Inelig	$99.10 / 1 Day
Res Hab-Lic-2 Person-Inelig	$54.05 / 1 Day
Res Hab-Lic-3 Person-Inelig	$38.74 / 1 Day
Supplemental Habilitation 1:1 - 15 min	$5.77 / 15 min.
Supplemental Habilitation 2:1 - 15 min	$11.53 / 15 min.

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

Life Sharing-1 person-Elig-NG 1 > 30 Hrs	$171.35 / 1 Day
Life Sharing-1 person-Elig-NG 2 > 30 Hrs	$204.29 / 1 Day
Life Sharing-1 person-Elig-NG 3 > 30 Hrs	$279.58 / 1 Day
Life Sharing-1 person-Elig-NG 4 > 30 Hrs	$355.61 / 1 Day
Life Sharing-2 person-Elig-NG 1 > 30 Hrs	$120.79 / 1 Day
Life Sharing-2 person-Elig-NG 2 > 30 Hrs	$144.84 / 1 Day
Life Sharing-2 person-Elig-NG 3 > 30 Hrs	$197.06 / 1 Day
Life Sharing-2 person-Elig-NG 4 > 30 Hrs	$237.16 / 1 Day

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

Life Sharing-1 person-Elig-NG 1 > 30 Hrs	$171.35 / 1 Day
Life Sharing-1 person-Elig-NG 2 > 30 Hrs	$204.29 / 1 Day
Life Sharing-1 person-Elig-NG 3 > 30 Hrs	$279.58 / 1 Day
Life Sharing-1 person-Elig-NG 4 > 30 Hrs	$355.61 / 1 Day
Life Sharing-2 person-Elig-NG 1 > 30 Hrs	$120.79 / 1 Day
Life Sharing-2 person-Elig-NG 2 > 30 Hrs	$144.84 / 1 Day
Life Sharing-2 person-Elig-NG 3 > 30 Hrs	$197.06 / 1 Day
Life Sharing-2 person-Elig-NG 4 > 30 Hrs	$237.16 / 1 Day

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

Life Sharing-1 person-Elig-NG 1 > 30 Hrs	$171.35 / 1 Day
Life Sharing-1 person-Elig-NG 2 > 30 Hrs	$204.29 / 1 Day
Life Sharing-1 person-Elig-NG 3 > 30 Hrs	$279.58 / 1 Day
Life Sharing-1 person-Elig-NG 4 > 30 Hrs	$355.61 / 1 Day
Life Sharing-2 person-Elig-NG 1 > 30 Hrs	$120.79 / 1 Day
Life Sharing-2 person-Elig-NG 2 > 30 Hrs	$144.84 / 1 Day
Life Sharing-2 person-Elig-NG 3 > 30 Hrs	$197.06 / 1 Day
Life Sharing-2 person-Elig-NG 4 > 30 Hrs	$237.16 / 1 Day

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

Life Sharing-1 person-Elig-NG 1 > 30 Hrs	$171.35 / 1 Day
Life Sharing-1 person-Elig-NG 2 > 30 Hrs	$204.29 / 1 Day
Life Sharing-1 person-Elig-NG 3 > 30 Hrs	$279.58 / 1 Day
Life Sharing-1 person-Elig-NG 4 > 30 Hrs	$355.61 / 1 Day
Life Sharing-2 person-Elig-NG 1 > 30 Hrs	$120.79 / 1 Day
Life Sharing-2 person-Elig-NG 2 > 30 Hrs	$144.84 / 1 Day
Life Sharing-2 person-Elig-NG 3 > 30 Hrs	$197.06 / 1 Day
Life Sharing-2 person-Elig-NG 4 > 30 Hrs	$237.16 / 1 Day

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

Life Sharing-1 person-Elig-NG 1 > 30 Hrs	$171.35 / 1 Day
Life Sharing-1 person-Elig-NG 2 > 30 Hrs	$204.29 / 1 Day
Life Sharing-1 person-Elig-NG 3 > 30 Hrs	$279.58 / 1 Day
Life Sharing-1 person-Elig-NG 4 > 30 Hrs	$355.61 / 1 Day
Life Sharing-2 person-Elig-NG 1 > 30 Hrs	$120.79 / 1 Day
Life Sharing-2 person-Elig-NG 2 > 30 Hrs	$144.84 / 1 Day
Life Sharing-2 person-Elig-NG 3 > 30 Hrs	$197.06 / 1 Day
Life Sharing-2 person-Elig-NG 4 > 30 Hrs	$237.16 / 1 Day

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

CPS Community 1:1	$12.81 / 15 min.
CPS Community 1:2 or 1:3	$6.98 / 15 min.
CPS Community 2:1	$24.62 / 15 min.
CPS Community 2:3	$10.43 / 15 min.
CPS Facility 1:1	$12.40 / 15 min.
CPS Facility 1:1 Enhanced	$17.27 / 15 min.
CPS Facility 1:1 Enhcd LPN	$17.27 / 15 min.
CPS Facility 1:1 Enhcd RN	$17.27 / 15 min.
CPS Facility 1:11 to 1:15	$2.96 / 15 min.
CPS Facility 1:2 to 1:3	$6.84 / 15 min.
CPS Facility 1:4 to 1:6	$5.23 / 15 min.
CPS Facility 1:7 to 1:10	$3.18 / 15 min.
CPS Facility 2:1	$23.77 / 15 min.
CPS Facility 2:1 Enhcd	$28.65 / 15 min.
CPS Facility 2:1 Enhcd LPN	$28.65 / 15 min.
CPS Facility 2:1 Enhcd RN	$28.65 / 15 min.
CPS:Community OnCall/Remote Support	$1.64 / 15 min.
In-Home & Commnty Supprts (Lvl 2)	$10.28 / 15 min.
Life Sharing (Base Only)	Not Set
Life Sharing-1 Person-Elig-NG 1-by Relative >30Hrs	$171.35 / 1 Day
Life Sharing-1 per-Elig-NG 2-by Relative > 30 Hrs	$204.29 / 1 Day
Life Sharing-1 per-Elig-NG 3-By Relative > 30 Hrs	$279.58 / 1 Day
Life Sharing-1 per-Elig-NG 4-by Relative > 30 Hrs	$355.61 / 1 Day
Life Sharing-1 per-Elig-Unlic by Relative < 30Hrs	$147.63 / 1 Day
Life Sharing-1 person-Elig-NG 1 > 30 Hrs	$171.35 / 1 Day
Life Sharing-1 person-Elig-NG 2 > 30 Hrs	$204.29 / 1 Day
Life Sharing-1 person-Elig-NG 3 > 30 Hrs	$279.58 / 1 Day
Life Sharing-1 person-Elig-NG 4 > 30 Hrs	$355.61 / 1 Day
Life Sharing-2 person-Elig-NG 1 > 30 Hrs	$120.79 / 1 Day
Life Sharing-2 person-Elig-NG 2 > 30 Hrs	$144.84 / 1 Day
Life Sharing-2 person-Elig-NG 3 > 30 Hrs	$197.06 / 1 Day
Life Sharing-2 person-Elig-NG 4 > 30 Hrs	$237.16 / 1 Day
Needs Exception Allowance (NEA)-Adult Res (6400)	$752.29 - $868.90 / 1 Day
Needs Excptn Allowance (NEA)-Adult Res (6400)-521	$0.01 - $999.56 / 1 Day
Res Hab-1 Person-NG 1-Elig	$523.00 / 1 Day
Res Hab-1 Person-NG 1-Elig-w/Day Supports	$408.54 / 1 Day
Res Hab-1 Person-NG 2-Elig	$606.92 / 1 Day
Res Hab-1 Person-NG 2-Elig-w/Day Supports	$515.01 / 1 Day
Res Hab-1 Person-NG 3-Elig	$924.89 / 1 Day
Res Hab-1 Person-NG 3-Elig-w/Day Supports	$746.22 / 1 Day
Res Hab-1 Person-NG 4-Elig	$1,118.74 / 1 Day
Res Hab-1 Person-NG 4-Elig-w/Day Supports	$822.23 / 1 Day
Res Hab-2 Person-NG 1-Elig	$523.00 / 1 Day
Res Hab-2 Person-NG 1-Elig-w/Day Supports	$408.54 / 1 Day
Res Hab-2 Person-NG 2-Elig	$606.92 / 1 Day
Res Hab-2 Person-NG 2-Elig-w/Day Supports	$515.01 / 1 Day
Res Hab-2 Person-NG 3-Elig	$685.68 / 1 Day
Res Hab-2 Person-NG 3-Elig-w/Day Supports	$630.70 / 1 Day
Res Hab-2 Person-NG 4-Elig	$820.15 / 1 Day
Res Hab-2 Person-NG 4-Elig-w/Day Supports	$689.49 / 1 Day
Res Hab-3 Person-NG 1-Elig	$387.76 / 1 Day
Res Hab-3 Person-NG 1-Elig-w/Day Supports	$294.49 / 1 Day
Res Hab-3 Person-NG 2-Elig	$441.87 / 1 Day
Res Hab-3 Person-NG 2-Elig-w/Day Supports	$341.21 / 1 Day
Res Hab-3 Person-NG 3-Elig	$514.20 / 1 Day
Res Hab-3 Person-NG 3-Elig-w/Day Supports	$440.90 / 1 Day
Res Hab-3 Person-NG 4-Elig	$624.74 / 1 Day
Res Hab-3 Person-NG 4-Elig-w/Day Supports	$484.03 / 1 Day
Res Hab-4 Person-NG 1-Elig-w/Day Supports	$232.07 / 1 Day
Res Hab-4 Person-NG 2-Elig-w/Day Supports	$268.22 / 1 Day
Res Hab-4 Person-NG 3-Elig-w/Day Supports	$341.91 / 1 Day
Res Hab-4 Person-NG 4-Elig-w/Day Supports	$376.12 / 1 Day
Res Hab-5-8 Person-NG 1-Elig	$267.15 / 1 Day
Res Hab-5-8 Person-NG 1-Elig-w/Day Supports	$212.03 / 1 Day
Res Hab-5-8 Person-NG 2-Elig	$311.99 / 1 Day
Res Hab-5-8 Person-NG 2-Elig-w/Day Supports	$250.71 / 1 Day
Res Hab-5-8 Person-NG 3-Elig	$360.24 / 1 Day
Res Hab-5-8 Person-NG 3-Elig-w/Day Supports	$314.42 / 1 Day
Res Hab-5-8 Person-NG 4-Elig	$429.04 / 1 Day
Res Hab-5-8 Person-NG 4-Elig-w/Day Supports	$338.58 / 1 Day
Res Hab-Lic-1 Person-Inelig	$99.10 / 1 Day
Res Hab-Lic-2 Person-Inelig	$54.05 / 1 Day
Res Hab-Lic-3 Person-Inelig	$38.74 / 1 Day
Res Hab-Lic-4 Person-Elig-NG 1	$304.14 / 1 Day
Res Hab-Lic-4 Person-Elig-NG 2	$347.00 / 1 Day
Res Hab-Lic-4 Person-Elig-NG 3	$401.47 / 1 Day
Res Hab-Lic-4 Person-Elig-NG 4	$481.66 / 1 Day
Res Hab-Lic-4 Person-Inelig	$30.10 / 1 Day
Res Hab-Lic-5-8 Person-Inelig	$21.58 / 1 Day
Resid Hab-Unlic 1-Indiv Home (Eligible)	$132.49 / 1 Day
Resid Hab-Unlic 1-Indiv Home (Inelig)	$26.69 / 1 Day
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-Base Out-of-Home 24 Hours (Basic)-Day	Not Set
Respite-Lic-Day-2 person-NG 3	$696.86 / 1 Day
Respite-Lic-Day-2 person-NG 3-Emergency	$696.86 / 1 Day
Respite-Lic-Day-2 person-NG 4	$755.65 / 1 Day
Respite-Lic-Day-2 person-NG 4-Emergency	$755.65 / 1 Day
Respite-Lic-Day-3 person-NG 1	$348.80 / 1 Day
Respite-Lic-Day-3 person-NG 1-Emergency	$348.80 / 1 Day
Respite-Lic-Day-3 person-NG 2	$395.52 / 1 Day
Respite-Lic-Day-3 person-NG 2-Emergency	$395.52 / 1 Day
Respite-Lic-Day-3 person-NG 3	$495.21 / 1 Day
Respite-Lic-Day-3 person-NG 3-Emergency	$495.21 / 1 Day
Respite-Lic-Day-3 person-NG 4	$538.34 / 1 Day
Respite-Lic-Day-3 person-NG 4-Emergency	$538.34 / 1 Day
Respite-Lic-Day-4 person-NG 1	$278.56 / 1 Day
Respite-Lic-Day-4 person-NG 2	$314.71 / 1 Day
Respite-Lic-Day-4 person-NG 2-Emergency	$314.71 / 1 Day
Respite-Lic-Day-4 person-NG 3	$388.40 / 1 Day
Respite-Lic-Day-4 person-NG 4	$422.61 / 1 Day
Supplemental Habilitation 1:1 - 15 min	$5.77 / 15 min.
Supplemental Habilitation 2:1 - 15 min	$11.53 / 15 min.

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

Life Sharing-1 person-Elig-NG 1 > 30 Hrs	$171.35 / 1 Day
Life Sharing-1 person-Elig-NG 2 > 30 Hrs	$204.29 / 1 Day
Life Sharing-1 person-Elig-NG 3 > 30 Hrs	$279.58 / 1 Day
Life Sharing-1 person-Elig-NG 4 > 30 Hrs	$355.61 / 1 Day
Life Sharing-2 person-Elig-NG 1 > 30 Hrs	$120.79 / 1 Day
Life Sharing-2 person-Elig-NG 2 > 30 Hrs	$144.84 / 1 Day
Life Sharing-2 person-Elig-NG 3 > 30 Hrs	$197.06 / 1 Day
Life Sharing-2 person-Elig-NG 4 > 30 Hrs	$237.16 / 1 Day

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

Life Sharing-1 person-Elig-NG 1 > 30 Hrs	$171.35 / 1 Day
Life Sharing-1 person-Elig-NG 2 > 30 Hrs	$204.29 / 1 Day
Life Sharing-1 person-Elig-NG 3 > 30 Hrs	$279.58 / 1 Day
Life Sharing-1 person-Elig-NG 4 > 30 Hrs	$355.61 / 1 Day
Life Sharing-2 person-Elig-NG 1 > 30 Hrs	$120.79 / 1 Day
Life Sharing-2 person-Elig-NG 2 > 30 Hrs	$144.84 / 1 Day
Life Sharing-2 person-Elig-NG 3 > 30 Hrs	$197.06 / 1 Day
Life Sharing-2 person-Elig-NG 4 > 30 Hrs	$237.16 / 1 Day

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

Life Sharing-1 person-Elig-NG 1 > 30 Hrs	$171.35 / 1 Day
Life Sharing-1 person-Elig-NG 2 > 30 Hrs	$204.29 / 1 Day
Life Sharing-1 person-Elig-NG 3 > 30 Hrs	$279.58 / 1 Day
Life Sharing-1 person-Elig-NG 4 > 30 Hrs	$355.61 / 1 Day
Life Sharing-2 person-Elig-NG 1 > 30 Hrs	$120.79 / 1 Day
Life Sharing-2 person-Elig-NG 2 > 30 Hrs	$144.84 / 1 Day
Life Sharing-2 person-Elig-NG 3 > 30 Hrs	$197.06 / 1 Day
Life Sharing-2 person-Elig-NG 4 > 30 Hrs	$237.16 / 1 Day

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

Life Sharing-1 person-Elig-NG 1 > 30 Hrs	$171.35 / 1 Day
Life Sharing-1 person-Elig-NG 2 > 30 Hrs	$204.29 / 1 Day
Life Sharing-1 person-Elig-NG 3 > 30 Hrs	$279.58 / 1 Day
Life Sharing-1 person-Elig-NG 4 > 30 Hrs	$355.61 / 1 Day
Life Sharing-2 person-Elig-NG 1 > 30 Hrs	$120.79 / 1 Day
Life Sharing-2 person-Elig-NG 2 > 30 Hrs	$144.84 / 1 Day
Life Sharing-2 person-Elig-NG 3 > 30 Hrs	$197.06 / 1 Day
Life Sharing-2 person-Elig-NG 4 > 30 Hrs	$237.16 / 1 Day

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

Life Sharing-1 person-Elig-NG 1 > 30 Hrs	$171.35 / 1 Day
Life Sharing-1 person-Elig-NG 2 > 30 Hrs	$204.29 / 1 Day
Life Sharing-1 person-Elig-NG 3 > 30 Hrs	$279.58 / 1 Day
Life Sharing-1 person-Elig-NG 4 > 30 Hrs	$355.61 / 1 Day
Life Sharing-2 person-Elig-NG 1 > 30 Hrs	$120.79 / 1 Day
Life Sharing-2 person-Elig-NG 2 > 30 Hrs	$144.84 / 1 Day
Life Sharing-2 person-Elig-NG 3 > 30 Hrs	$197.06 / 1 Day
Life Sharing-2 person-Elig-NG 4 > 30 Hrs	$237.16 / 1 Day

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

Life Sharing-1 person-Elig-NG 1 > 30 Hrs	$171.35 / 1 Day
Life Sharing-1 person-Elig-NG 2 > 30 Hrs	$204.29 / 1 Day
Life Sharing-1 person-Elig-NG 3 > 30 Hrs	$279.58 / 1 Day
Life Sharing-1 person-Elig-NG 4 > 30 Hrs	$355.61 / 1 Day
Life Sharing-2 person-Elig-NG 1 > 30 Hrs	$120.79 / 1 Day
Life Sharing-2 person-Elig-NG 2 > 30 Hrs	$144.84 / 1 Day
Life Sharing-2 person-Elig-NG 3 > 30 Hrs	$197.06 / 1 Day
Life Sharing-2 person-Elig-NG 4 > 30 Hrs	$237.16 / 1 Day

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

CPS Community 1:1	$12.81 / 15 min.
CPS Community 1:2 or 1:3	$6.98 / 15 min.
CPS Community 2:1	$24.62 / 15 min.
CPS Community 2:3	$10.43 / 15 min.
CPS Facility 1:1	$12.40 / 15 min.
CPS Facility 1:1 Enhanced	$17.27 / 15 min.
CPS Facility 1:1 Enhcd LPN	$17.27 / 15 min.
CPS Facility 1:1 Enhcd RN	$17.27 / 15 min.
CPS Facility 1:11 to 1:15	$2.96 / 15 min.
CPS Facility 1:2 to 1:3	$6.84 / 15 min.
CPS Facility 1:4 to 1:6	$5.23 / 15 min.
CPS Facility 1:7 to 1:10	$3.18 / 15 min.
CPS Facility 2:1	$23.77 / 15 min.
CPS Facility 2:1 Enhcd	$28.65 / 15 min.
CPS Facility 2:1 Enhcd LPN	$28.65 / 15 min.
CPS Facility 2:1 Enhcd RN	$28.65 / 15 min.
CPS:Community OnCall/Remote Support	$1.64 / 15 min.
Life Sharing-1 person-Elig-NG 1 > 30 Hrs	$171.35 / 1 Day
Life Sharing-1 person-Elig-NG 2 > 30 Hrs	$204.29 / 1 Day
Life Sharing-1 person-Elig-NG 3 > 30 Hrs	$279.58 / 1 Day
Life Sharing-1 person-Elig-NG 4 > 30 Hrs	$355.61 / 1 Day
Life Sharing-2 person-Elig-NG 1 > 30 Hrs	$120.79 / 1 Day
Life Sharing-2 person-Elig-NG 2 > 30 Hrs	$144.84 / 1 Day
Life Sharing-2 person-Elig-NG 3 > 30 Hrs	$197.06 / 1 Day
Life Sharing-2 person-Elig-NG 4 > 30 Hrs	$237.16 / 1 Day
Needs Exception Allowance (NEA)-Adult Res (6400)	$868.90 / 1 Day
Res Hab-1 Person-NG 1-Elig	$523.00 / 1 Day
Res Hab-1 Person-NG 1-Elig-w/Day Supports	$408.54 / 1 Day
Res Hab-1 Person-NG 2-Elig	$606.92 / 1 Day
Res Hab-1 Person-NG 2-Elig-w/Day Supports	$515.01 / 1 Day
Res Hab-1 Person-NG 3-Elig	$924.89 / 1 Day
Res Hab-1 Person-NG 3-Elig-w/Day Supports	$746.22 / 1 Day
Res Hab-1 Person-NG 4-Elig	$1,118.74 / 1 Day
Res Hab-1 Person-NG 4-Elig-w/Day Supports	$822.23 / 1 Day
Res Hab-2 Person-NG 1-Elig	$523.00 / 1 Day
Res Hab-2 Person-NG 1-Elig-w/Day Supports	$408.54 / 1 Day
Res Hab-2 Person-NG 2-Elig	$606.92 / 1 Day
Res Hab-2 Person-NG 2-Elig-w/Day Supports	$515.01 / 1 Day
Res Hab-2 Person-NG 3-Elig	$685.68 / 1 Day
Res Hab-2 Person-NG 3-Elig-w/Day Supports	$630.70 / 1 Day
Res Hab-2 Person-NG 4-Elig	$820.15 / 1 Day
Res Hab-2 Person-NG 4-Elig-w/Day Supports	$689.49 / 1 Day
Res Hab-3 Person-NG 1-Elig	$387.76 / 1 Day
Res Hab-3 Person-NG 1-Elig-w/Day Supports	$294.49 / 1 Day
Res Hab-3 Person-NG 2-Elig	$441.87 / 1 Day
Res Hab-3 Person-NG 2-Elig-w/Day Supports	$341.21 / 1 Day
Res Hab-3 Person-NG 3-Elig	$514.20 / 1 Day
Res Hab-3 Person-NG 3-Elig-w/Day Supports	$440.90 / 1 Day
Res Hab-3 Person-NG 4-Elig	$624.74 / 1 Day
Res Hab-3 Person-NG 4-Elig-w/Day Supports	$484.03 / 1 Day
Res Hab-4 Person-NG 1-Elig-w/Day Supports	$232.07 / 1 Day
Res Hab-4 Person-NG 2-Elig-w/Day Supports	$268.22 / 1 Day
Res Hab-4 Person-NG 3-Elig-w/Day Supports	$341.91 / 1 Day
Res Hab-4 Person-NG 4-Elig-w/Day Supports	$376.12 / 1 Day
Res Hab-Lic-1 Person-Inelig	$99.10 / 1 Day
Res Hab-Lic-2 Person-Inelig	$54.05 / 1 Day
Res Hab-Lic-3 Person-Inelig	$38.74 / 1 Day
Res Hab-Lic-4 Person-Elig-NG 1	$304.14 / 1 Day
Res Hab-Lic-4 Person-Elig-NG 2	$347.00 / 1 Day
Res Hab-Lic-4 Person-Elig-NG 3	$401.47 / 1 Day
Res Hab-Lic-4 Person-Elig-NG 4	$481.66 / 1 Day
Res Hab-Lic-4 Person-Inelig	$30.10 / 1 Day
Resid Hab-Unlic 1-Indiv Home (Eligible)	$132.49 / 1 Day
Resid Hab-Unlic 1-Indiv Home (Inelig)	$26.69 / 1 Day
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
Supplemental Habilitation 1:1 - 15 min	$5.77 / 15 min.
Supplemental Habilitation 2:1 - 15 min	$11.53 / 15 min.

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

Life Sharing-1 person-Elig-NG 1 > 30 Hrs	$171.35 / 1 Day
Life Sharing-1 person-Elig-NG 2 > 30 Hrs	$204.29 / 1 Day
Life Sharing-1 person-Elig-NG 3 > 30 Hrs	$279.58 / 1 Day
Life Sharing-1 person-Elig-NG 4 > 30 Hrs	$355.61 / 1 Day
Life Sharing-2 person-Elig-NG 1 > 30 Hrs	$120.79 / 1 Day
Life Sharing-2 person-Elig-NG 2 > 30 Hrs	$144.84 / 1 Day
Life Sharing-2 person-Elig-NG 3 > 30 Hrs	$197.06 / 1 Day
Life Sharing-2 person-Elig-NG 4 > 30 Hrs	$237.16 / 1 Day

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

Life Sharing-1 person-Elig-NG 1 > 30 Hrs	$171.35 / 1 Day
Life Sharing-1 person-Elig-NG 2 > 30 Hrs	$204.29 / 1 Day
Life Sharing-1 person-Elig-NG 3 > 30 Hrs	$279.58 / 1 Day
Life Sharing-1 person-Elig-NG 4 > 30 Hrs	$355.61 / 1 Day
Life Sharing-2 person-Elig-NG 1 > 30 Hrs	$120.79 / 1 Day
Life Sharing-2 person-Elig-NG 2 > 30 Hrs	$144.84 / 1 Day
Life Sharing-2 person-Elig-NG 3 > 30 Hrs	$197.06 / 1 Day
Life Sharing-2 person-Elig-NG 4 > 30 Hrs	$237.16 / 1 Day

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

Life Sharing-1 person-Elig-NG 1 > 30 Hrs	$171.35 / 1 Day
Life Sharing-1 person-Elig-NG 2 > 30 Hrs	$204.29 / 1 Day
Life Sharing-1 person-Elig-NG 3 > 30 Hrs	$279.58 / 1 Day
Life Sharing-1 person-Elig-NG 4 > 30 Hrs	$355.61 / 1 Day
Life Sharing-2 person-Elig-NG 1 > 30 Hrs	$120.79 / 1 Day
Life Sharing-2 person-Elig-NG 2 > 30 Hrs	$144.84 / 1 Day
Life Sharing-2 person-Elig-NG 3 > 30 Hrs	$197.06 / 1 Day
Life Sharing-2 person-Elig-NG 4 > 30 Hrs	$237.16 / 1 Day

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

Life Sharing-1 person-Elig-NG 1 > 30 Hrs	$171.35 / 1 Day
Life Sharing-1 person-Elig-NG 2 > 30 Hrs	$204.29 / 1 Day
Life Sharing-1 person-Elig-NG 3 > 30 Hrs	$279.58 / 1 Day
Life Sharing-1 person-Elig-NG 4 > 30 Hrs	$355.61 / 1 Day
Life Sharing-2 person-Elig-NG 1 > 30 Hrs	$120.79 / 1 Day
Life Sharing-2 person-Elig-NG 2 > 30 Hrs	$144.84 / 1 Day
Life Sharing-2 person-Elig-NG 3 > 30 Hrs	$197.06 / 1 Day
Life Sharing-2 person-Elig-NG 4 > 30 Hrs	$237.16 / 1 Day

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

Life Sharing-1 person-Elig-NG 1 > 30 Hrs	$171.35 / 1 Day
Life Sharing-1 person-Elig-NG 2 > 30 Hrs	$204.29 / 1 Day
Life Sharing-1 person-Elig-NG 3 > 30 Hrs	$279.58 / 1 Day
Life Sharing-1 person-Elig-NG 4 > 30 Hrs	$355.61 / 1 Day
Life Sharing-2 person-Elig-NG 1 > 30 Hrs	$120.79 / 1 Day
Life Sharing-2 person-Elig-NG 2 > 30 Hrs	$144.84 / 1 Day
Life Sharing-2 person-Elig-NG 3 > 30 Hrs	$197.06 / 1 Day
Life Sharing-2 person-Elig-NG 4 > 30 Hrs	$237.16 / 1 Day

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

Life Sharing-1 person-Elig-NG 1 > 30 Hrs	$171.35 / 1 Day
Life Sharing-1 person-Elig-NG 2 > 30 Hrs	$204.29 / 1 Day
Life Sharing-1 person-Elig-NG 3 > 30 Hrs	$279.58 / 1 Day
Life Sharing-1 person-Elig-NG 4 > 30 Hrs	$355.61 / 1 Day
Life Sharing-2 person-Elig-NG 1 > 30 Hrs	$120.79 / 1 Day
Life Sharing-2 person-Elig-NG 2 > 30 Hrs	$144.84 / 1 Day
Life Sharing-2 person-Elig-NG 3 > 30 Hrs	$197.06 / 1 Day
Life Sharing-2 person-Elig-NG 4 > 30 Hrs	$237.16 / 1 Day

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

Life Sharing-1 person-Elig-NG 1 > 30 Hrs	$171.35 / 1 Day
Life Sharing-1 person-Elig-NG 2 > 30 Hrs	$204.29 / 1 Day
Life Sharing-1 person-Elig-NG 3 > 30 Hrs	$279.58 / 1 Day
Life Sharing-1 person-Elig-NG 4 > 30 Hrs	$355.61 / 1 Day
Life Sharing-2 person-Elig-NG 1 > 30 Hrs	$120.79 / 1 Day
Life Sharing-2 person-Elig-NG 2 > 30 Hrs	$144.84 / 1 Day
Life Sharing-2 person-Elig-NG 3 > 30 Hrs	$197.06 / 1 Day
Life Sharing-2 person-Elig-NG 4 > 30 Hrs	$237.16 / 1 Day

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

Life Sharing-1 person-Elig-NG 1 > 30 Hrs	$171.35 / 1 Day
Life Sharing-1 person-Elig-NG 2 > 30 Hrs	$204.29 / 1 Day
Life Sharing-1 person-Elig-NG 3 > 30 Hrs	$279.58 / 1 Day
Life Sharing-1 person-Elig-NG 4 > 30 Hrs	$355.61 / 1 Day
Life Sharing-2 person-Elig-NG 1 > 30 Hrs	$120.79 / 1 Day
Life Sharing-2 person-Elig-NG 2 > 30 Hrs	$144.84 / 1 Day
Life Sharing-2 person-Elig-NG 3 > 30 Hrs	$197.06 / 1 Day
Life Sharing-2 person-Elig-NG 4 > 30 Hrs	$237.16 / 1 Day
Res Hab-1 Person-NG 1-Elig	$523.00 / 1 Day
Res Hab-1 Person-NG 1-Elig-w/Day Supports	$408.54 / 1 Day
Res Hab-1 Person-NG 2-Elig	$606.92 / 1 Day
Res Hab-1 Person-NG 2-Elig-w/Day Supports	$515.01 / 1 Day
Res Hab-1 Person-NG 3-Elig	$924.89 / 1 Day
Res Hab-1 Person-NG 3-Elig-w/Day Supports	$746.22 / 1 Day
Res Hab-1 Person-NG 4-Elig	$1,118.74 / 1 Day
Res Hab-1 Person-NG 4-Elig-w/Day Supports	$822.23 / 1 Day
Res Hab-2 Person-NG 1-Elig	$523.00 / 1 Day
Res Hab-2 Person-NG 1-Elig-w/Day Supports	$408.54 / 1 Day
Res Hab-2 Person-NG 2-Elig	$606.92 / 1 Day
Res Hab-2 Person-NG 2-Elig-w/Day Supports	$515.01 / 1 Day
Res Hab-2 Person-NG 3-Elig	$685.68 / 1 Day
Res Hab-2 Person-NG 3-Elig-w/Day Supports	$630.70 / 1 Day
Res Hab-2 Person-NG 4-Elig	$820.15 / 1 Day
Res Hab-2 Person-NG 4-Elig-w/Day Supports	$689.49 / 1 Day
Res Hab-3 Person-NG 1-Elig	$387.76 / 1 Day
Res Hab-3 Person-NG 1-Elig-w/Day Supports	$294.49 / 1 Day
Res Hab-3 Person-NG 2-Elig	$441.87 / 1 Day
Res Hab-3 Person-NG 2-Elig-w/Day Supports	$341.21 / 1 Day
Res Hab-3 Person-NG 3-Elig	$514.20 / 1 Day
Res Hab-3 Person-NG 3-Elig-w/Day Supports	$440.90 / 1 Day
Res Hab-3 Person-NG 4-Elig	$624.74 / 1 Day
Res Hab-3 Person-NG 4-Elig-w/Day Supports	$484.03 / 1 Day
Res Hab-Lic-1 Person-Inelig	$99.10 / 1 Day
Res Hab-Lic-2 Person-Inelig	$54.05 / 1 Day
Res Hab-Lic-3 Person-Inelig	$38.74 / 1 Day
Supplemental Habilitation 1:1 - 15 min	$5.77 / 15 min.
Supplemental Habilitation 2:1 - 15 min	$11.53 / 15 min.

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

Life Sharing-1 person-Elig-NG 1 > 30 Hrs	$171.35 / 1 Day
Life Sharing-1 person-Elig-NG 2 > 30 Hrs	$204.29 / 1 Day
Life Sharing-1 person-Elig-NG 3 > 30 Hrs	$279.58 / 1 Day
Life Sharing-1 person-Elig-NG 4 > 30 Hrs	$355.61 / 1 Day
Life Sharing-2 person-Elig-NG 1 > 30 Hrs	$120.79 / 1 Day
Life Sharing-2 person-Elig-NG 2 > 30 Hrs	$144.84 / 1 Day
Life Sharing-2 person-Elig-NG 3 > 30 Hrs	$197.06 / 1 Day
Life Sharing-2 person-Elig-NG 4 > 30 Hrs	$237.16 / 1 Day

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

Life Sharing-1 person-Elig-NG 1 > 30 Hrs	$171.35 / 1 Day
Life Sharing-1 person-Elig-NG 2 > 30 Hrs	$204.29 / 1 Day
Life Sharing-1 person-Elig-NG 3 > 30 Hrs	$279.58 / 1 Day
Life Sharing-1 person-Elig-NG 4 > 30 Hrs	$355.61 / 1 Day
Life Sharing-2 person-Elig-NG 1 > 30 Hrs	$120.79 / 1 Day
Life Sharing-2 person-Elig-NG 2 > 30 Hrs	$144.84 / 1 Day
Life Sharing-2 person-Elig-NG 3 > 30 Hrs	$197.06 / 1 Day
Life Sharing-2 person-Elig-NG 4 > 30 Hrs	$237.16 / 1 Day

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

Life Sharing-1 person-Elig-NG 1 > 30 Hrs	$171.35 / 1 Day
Life Sharing-1 person-Elig-NG 2 > 30 Hrs	$204.29 / 1 Day
Life Sharing-1 person-Elig-NG 3 > 30 Hrs	$279.58 / 1 Day
Life Sharing-1 person-Elig-NG 4 > 30 Hrs	$355.61 / 1 Day
Life Sharing-2 person-Elig-NG 1 > 30 Hrs	$120.79 / 1 Day
Life Sharing-2 person-Elig-NG 2 > 30 Hrs	$144.84 / 1 Day
Life Sharing-2 person-Elig-NG 3 > 30 Hrs	$197.06 / 1 Day
Life Sharing-2 person-Elig-NG 4 > 30 Hrs	$237.16 / 1 Day

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

Life Sharing-1 person-Elig-NG 1 > 30 Hrs	$171.35 / 1 Day
Life Sharing-1 person-Elig-NG 2 > 30 Hrs	$204.29 / 1 Day
Life Sharing-1 person-Elig-NG 3 > 30 Hrs	$279.58 / 1 Day
Life Sharing-1 person-Elig-NG 4 > 30 Hrs	$355.61 / 1 Day
Life Sharing-2 person-Elig-NG 1 > 30 Hrs	$120.79 / 1 Day
Life Sharing-2 person-Elig-NG 2 > 30 Hrs	$144.84 / 1 Day
Life Sharing-2 person-Elig-NG 3 > 30 Hrs	$197.06 / 1 Day
Life Sharing-2 person-Elig-NG 4 > 30 Hrs	$237.16 / 1 Day

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

Life Sharing-1 person-Elig-NG 1 > 30 Hrs	$171.35 / 1 Day
Life Sharing-1 person-Elig-NG 2 > 30 Hrs	$204.29 / 1 Day
Life Sharing-1 person-Elig-NG 3 > 30 Hrs	$279.58 / 1 Day
Life Sharing-1 person-Elig-NG 4 > 30 Hrs	$355.61 / 1 Day
Life Sharing-2 person-Elig-NG 1 > 30 Hrs	$120.79 / 1 Day
Life Sharing-2 person-Elig-NG 2 > 30 Hrs	$144.84 / 1 Day
Life Sharing-2 person-Elig-NG 3 > 30 Hrs	$197.06 / 1 Day
Life Sharing-2 person-Elig-NG 4 > 30 Hrs	$237.16 / 1 Day

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

Life Sharing-1 person-Elig-NG 1 > 30 Hrs	$171.35 / 1 Day
Life Sharing-1 person-Elig-NG 2 > 30 Hrs	$204.29 / 1 Day
Life Sharing-1 person-Elig-NG 3 > 30 Hrs	$279.58 / 1 Day
Life Sharing-1 person-Elig-NG 4 > 30 Hrs	$355.61 / 1 Day
Life Sharing-2 person-Elig-NG 1 > 30 Hrs	$120.79 / 1 Day
Life Sharing-2 person-Elig-NG 2 > 30 Hrs	$144.84 / 1 Day
Life Sharing-2 person-Elig-NG 3 > 30 Hrs	$197.06 / 1 Day
Life Sharing-2 person-Elig-NG 4 > 30 Hrs	$237.16 / 1 Day

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

Life Sharing-1 person-Elig-NG 1 > 30 Hrs	$171.35 / 1 Day
Life Sharing-1 person-Elig-NG 2 > 30 Hrs	$204.29 / 1 Day
Life Sharing-1 person-Elig-NG 3 > 30 Hrs	$279.58 / 1 Day
Life Sharing-1 person-Elig-NG 4 > 30 Hrs	$355.61 / 1 Day
Life Sharing-2 person-Elig-NG 1 > 30 Hrs	$120.79 / 1 Day
Life Sharing-2 person-Elig-NG 2 > 30 Hrs	$144.84 / 1 Day
Life Sharing-2 person-Elig-NG 3 > 30 Hrs	$197.06 / 1 Day
Life Sharing-2 person-Elig-NG 4 > 30 Hrs	$237.16 / 1 Day

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

Life Sharing-1 person-Elig-NG 1 > 30 Hrs	$171.35 / 1 Day
Life Sharing-1 person-Elig-NG 2 > 30 Hrs	$204.29 / 1 Day
Life Sharing-1 person-Elig-NG 3 > 30 Hrs	$279.58 / 1 Day
Life Sharing-1 person-Elig-NG 4 > 30 Hrs	$355.61 / 1 Day
Life Sharing-2 person-Elig-NG 1 > 30 Hrs	$120.79 / 1 Day
Life Sharing-2 person-Elig-NG 2 > 30 Hrs	$144.84 / 1 Day
Life Sharing-2 person-Elig-NG 3 > 30 Hrs	$197.06 / 1 Day
Life Sharing-2 person-Elig-NG 4 > 30 Hrs	$237.16 / 1 Day
Res Hab-1 Person-NG 1-Elig	$523.00 / 1 Day
Res Hab-1 Person-NG 1-Elig-w/Day Supports	$408.54 / 1 Day
Res Hab-1 Person-NG 2-Elig	$606.92 / 1 Day
Res Hab-1 Person-NG 2-Elig-w/Day Supports	$515.01 / 1 Day
Res Hab-1 Person-NG 3-Elig	$924.89 / 1 Day
Res Hab-1 Person-NG 3-Elig-w/Day Supports	$746.22 / 1 Day
Res Hab-1 Person-NG 4-Elig	$1,118.74 / 1 Day
Res Hab-1 Person-NG 4-Elig-w/Day Supports	$822.23 / 1 Day
Res Hab-2 Person-NG 1-Elig	$523.00 / 1 Day
Res Hab-2 Person-NG 1-Elig-w/Day Supports	$408.54 / 1 Day
Res Hab-2 Person-NG 2-Elig	$606.92 / 1 Day
Res Hab-2 Person-NG 2-Elig-w/Day Supports	$515.01 / 1 Day
Res Hab-2 Person-NG 3-Elig	$685.68 / 1 Day
Res Hab-2 Person-NG 3-Elig-w/Day Supports	$630.70 / 1 Day
Res Hab-2 Person-NG 4-Elig	$820.15 / 1 Day
Res Hab-2 Person-NG 4-Elig-w/Day Supports	$689.49 / 1 Day
Res Hab-3 Person-NG 1-Elig	$387.76 / 1 Day
Res Hab-3 Person-NG 1-Elig-w/Day Supports	$294.49 / 1 Day
Res Hab-3 Person-NG 2-Elig	$441.87 / 1 Day
Res Hab-3 Person-NG 2-Elig-w/Day Supports	$341.21 / 1 Day
Res Hab-3 Person-NG 3-Elig	$514.20 / 1 Day
Res Hab-3 Person-NG 3-Elig-w/Day Supports	$440.90 / 1 Day
Res Hab-3 Person-NG 4-Elig	$624.74 / 1 Day
Res Hab-3 Person-NG 4-Elig-w/Day Supports	$484.03 / 1 Day
Res Hab-Lic-1 Person-Inelig	$99.10 / 1 Day
Res Hab-Lic-2 Person-Inelig	$54.05 / 1 Day
Res Hab-Lic-3 Person-Inelig	$38.74 / 1 Day
Supplemental Habilitation 1:1 - 15 min	$5.77 / 15 min.
Supplemental Habilitation 2:1 - 15 min	$11.53 / 15 min.

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

Life Sharing-1 person-Elig-NG 1 > 30 Hrs	$171.35 / 1 Day
Life Sharing-1 person-Elig-NG 2 > 30 Hrs	$204.29 / 1 Day
Life Sharing-1 person-Elig-NG 3 > 30 Hrs	$279.58 / 1 Day
Life Sharing-1 person-Elig-NG 4 > 30 Hrs	$355.61 / 1 Day
Life Sharing-2 person-Elig-NG 1 > 30 Hrs	$120.79 / 1 Day
Life Sharing-2 person-Elig-NG 2 > 30 Hrs	$144.84 / 1 Day
Life Sharing-2 person-Elig-NG 3 > 30 Hrs	$197.06 / 1 Day
Life Sharing-2 person-Elig-NG 4 > 30 Hrs	$237.16 / 1 Day

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

Life Sharing-1 person-Elig-NG 1 > 30 Hrs	$171.35 / 1 Day
Life Sharing-1 person-Elig-NG 2 > 30 Hrs	$204.29 / 1 Day
Life Sharing-1 person-Elig-NG 3 > 30 Hrs	$279.58 / 1 Day
Life Sharing-1 person-Elig-NG 4 > 30 Hrs	$355.61 / 1 Day
Life Sharing-2 person-Elig-NG 1 > 30 Hrs	$120.79 / 1 Day
Life Sharing-2 person-Elig-NG 2 > 30 Hrs	$144.84 / 1 Day
Life Sharing-2 person-Elig-NG 3 > 30 Hrs	$197.06 / 1 Day
Life Sharing-2 person-Elig-NG 4 > 30 Hrs	$237.16 / 1 Day

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

CPS Community 1:1	$12.81 / 15 min.
CPS Community 1:2 or 1:3	$6.98 / 15 min.
CPS Community 2:1	$24.62 / 15 min.
CPS Community 2:3	$10.43 / 15 min.
CPS Facility 1:1	$12.40 / 15 min.
CPS Facility 1:11 to 1:15	$2.96 / 15 min.
CPS Facility 1:2 to 1:3	$6.84 / 15 min.
CPS Facility 1:4 to 1:6	$5.23 / 15 min.
CPS Facility 1:7 to 1:10	$3.18 / 15 min.
CPS Facility 2:1	$23.77 / 15 min.
CPS:Community OnCall/Remote Support	$1.64 / 15 min.
Life Sharing-1 person-Elig-NG 1 > 30 Hrs	$171.35 / 1 Day
Life Sharing-1 person-Elig-NG 2 > 30 Hrs	$204.29 / 1 Day
Life Sharing-1 person-Elig-NG 3 > 30 Hrs	$279.58 / 1 Day
Life Sharing-1 person-Elig-NG 4 > 30 Hrs	$355.61 / 1 Day
Life Sharing-2 person-Elig-NG 1 > 30 Hrs	$120.79 / 1 Day
Life Sharing-2 person-Elig-NG 2 > 30 Hrs	$144.84 / 1 Day
Life Sharing-2 person-Elig-NG 3 > 30 Hrs	$197.06 / 1 Day
Life Sharing-2 person-Elig-NG 4 > 30 Hrs	$237.16 / 1 Day
Res Hab-1 Person-NG 1-Elig	$523.00 / 1 Day
Res Hab-1 Person-NG 1-Elig-w/Day Supports	$408.54 / 1 Day
Res Hab-1 Person-NG 2-Elig	$606.92 / 1 Day
Res Hab-1 Person-NG 2-Elig-w/Day Supports	$515.01 / 1 Day
Res Hab-1 Person-NG 3-Elig	$924.89 / 1 Day
Res Hab-1 Person-NG 3-Elig-w/Day Supports	$746.22 / 1 Day
Res Hab-1 Person-NG 4-Elig	$1,118.74 / 1 Day
Res Hab-1 Person-NG 4-Elig-w/Day Supports	$822.23 / 1 Day
Res Hab-2 Person-NG 1-Elig	$523.00 / 1 Day
Res Hab-2 Person-NG 1-Elig-w/Day Supports	$408.54 / 1 Day
Res Hab-2 Person-NG 2-Elig	$606.92 / 1 Day
Res Hab-2 Person-NG 2-Elig-w/Day Supports	$515.01 / 1 Day
Res Hab-2 Person-NG 3-Elig	$685.68 / 1 Day
Res Hab-2 Person-NG 3-Elig-w/Day Supports	$630.70 / 1 Day
Res Hab-2 Person-NG 4-Elig	$820.15 / 1 Day
Res Hab-2 Person-NG 4-Elig-w/Day Supports	$689.49 / 1 Day
Res Hab-3 Person-NG 1-Elig	$387.76 / 1 Day
Res Hab-3 Person-NG 1-Elig-w/Day Supports	$294.49 / 1 Day
Res Hab-3 Person-NG 2-Elig	$441.87 / 1 Day
Res Hab-3 Person-NG 2-Elig-w/Day Supports	$341.21 / 1 Day
Res Hab-3 Person-NG 3-Elig	$514.20 / 1 Day
Res Hab-3 Person-NG 3-Elig-w/Day Supports	$440.90 / 1 Day
Res Hab-3 Person-NG 4-Elig	$624.74 / 1 Day
Res Hab-3 Person-NG 4-Elig-w/Day Supports	$484.03 / 1 Day
Res Hab-5-8 Person-NG 1-Elig	$267.15 / 1 Day
Res Hab-5-8 Person-NG 1-Elig-w/Day Supports	$212.03 / 1 Day
Res Hab-5-8 Person-NG 2-Elig	$311.99 / 1 Day
Res Hab-5-8 Person-NG 2-Elig-w/Day Supports	$250.71 / 1 Day
Res Hab-5-8 Person-NG 3-Elig	$360.24 / 1 Day
Res Hab-5-8 Person-NG 3-Elig-w/Day Supports	$314.42 / 1 Day
Res Hab-5-8 Person-NG 4-Elig	$429.04 / 1 Day
Res Hab-5-8 Person-NG 4-Elig-w/Day Supports	$338.58 / 1 Day
Res Hab-Lic-1 Person-Inelig	$99.10 / 1 Day
Res Hab-Lic-2 Person-Inelig	$54.05 / 1 Day
Res Hab-Lic-3 Person-Inelig	$38.74 / 1 Day
Res Hab-Lic-5-8 Person-Inelig	$21.58 / 1 Day
Supplemental Habilitation 1:1 - 15 min	$5.77 / 15 min.
Supplemental Habilitation 2:1 - 15 min	$11.53 / 15 min.

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

Life Sharing-1 person-Elig-NG 1 > 30 Hrs	$171.35 / 1 Day
Life Sharing-1 person-Elig-NG 2 > 30 Hrs	$204.29 / 1 Day
Life Sharing-1 person-Elig-NG 3 > 30 Hrs	$279.58 / 1 Day
Life Sharing-1 person-Elig-NG 4 > 30 Hrs	$355.61 / 1 Day
Life Sharing-2 person-Elig-NG 1 > 30 Hrs	$120.79 / 1 Day
Life Sharing-2 person-Elig-NG 2 > 30 Hrs	$144.84 / 1 Day
Life Sharing-2 person-Elig-NG 3 > 30 Hrs	$197.06 / 1 Day
Life Sharing-2 person-Elig-NG 4 > 30 Hrs	$237.16 / 1 Day

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

Life Sharing-1 person-Elig-NG 1 > 30 Hrs	$171.35 / 1 Day
Life Sharing-1 person-Elig-NG 2 > 30 Hrs	$204.29 / 1 Day
Life Sharing-1 person-Elig-NG 3 > 30 Hrs	$279.58 / 1 Day
Life Sharing-1 person-Elig-NG 4 > 30 Hrs	$355.61 / 1 Day
Life Sharing-2 person-Elig-NG 1 > 30 Hrs	$120.79 / 1 Day
Life Sharing-2 person-Elig-NG 2 > 30 Hrs	$144.84 / 1 Day
Life Sharing-2 person-Elig-NG 3 > 30 Hrs	$197.06 / 1 Day
Life Sharing-2 person-Elig-NG 4 > 30 Hrs	$237.16 / 1 Day

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

Life Sharing-1 person-Elig-NG 1 > 30 Hrs	$171.35 / 1 Day
Life Sharing-1 person-Elig-NG 2 > 30 Hrs	$204.29 / 1 Day
Life Sharing-1 person-Elig-NG 3 > 30 Hrs	$279.58 / 1 Day
Life Sharing-1 person-Elig-NG 4 > 30 Hrs	$355.61 / 1 Day
Life Sharing-2 person-Elig-NG 1 > 30 Hrs	$120.79 / 1 Day
Life Sharing-2 person-Elig-NG 2 > 30 Hrs	$144.84 / 1 Day
Life Sharing-2 person-Elig-NG 3 > 30 Hrs	$197.06 / 1 Day
Life Sharing-2 person-Elig-NG 4 > 30 Hrs	$237.16 / 1 Day

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

Life Sharing-1 person-Elig-NG 1 > 30 Hrs	$171.35 / 1 Day
Life Sharing-1 person-Elig-NG 2 > 30 Hrs	$204.29 / 1 Day
Life Sharing-1 person-Elig-NG 3 > 30 Hrs	$279.58 / 1 Day
Life Sharing-1 person-Elig-NG 4 > 30 Hrs	$355.61 / 1 Day
Life Sharing-2 person-Elig-NG 1 > 30 Hrs	$120.79 / 1 Day
Life Sharing-2 person-Elig-NG 2 > 30 Hrs	$144.84 / 1 Day
Life Sharing-2 person-Elig-NG 3 > 30 Hrs	$197.06 / 1 Day
Life Sharing-2 person-Elig-NG 4 > 30 Hrs	$237.16 / 1 Day

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

Life Sharing-1 person-Elig-NG 1 > 30 Hrs	$171.35 / 1 Day
Life Sharing-1 person-Elig-NG 2 > 30 Hrs	$204.29 / 1 Day
Life Sharing-1 person-Elig-NG 3 > 30 Hrs	$279.58 / 1 Day
Life Sharing-1 person-Elig-NG 4 > 30 Hrs	$355.61 / 1 Day
Life Sharing-2 person-Elig-NG 1 > 30 Hrs	$120.79 / 1 Day
Life Sharing-2 person-Elig-NG 2 > 30 Hrs	$144.84 / 1 Day
Life Sharing-2 person-Elig-NG 3 > 30 Hrs	$197.06 / 1 Day
Life Sharing-2 person-Elig-NG 4 > 30 Hrs	$237.16 / 1 Day

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

Life Sharing-1 person-Elig-NG 1 > 30 Hrs	$171.35 / 1 Day
Life Sharing-1 person-Elig-NG 2 > 30 Hrs	$204.29 / 1 Day
Life Sharing-1 person-Elig-NG 3 > 30 Hrs	$279.58 / 1 Day
Life Sharing-1 person-Elig-NG 4 > 30 Hrs	$355.61 / 1 Day
Life Sharing-2 person-Elig-NG 1 > 30 Hrs	$120.79 / 1 Day
Life Sharing-2 person-Elig-NG 2 > 30 Hrs	$144.84 / 1 Day
Life Sharing-2 person-Elig-NG 3 > 30 Hrs	$197.06 / 1 Day
Life Sharing-2 person-Elig-NG 4 > 30 Hrs	$237.16 / 1 Day
Res Hab-3 Person-NG 1-Elig	$387.76 / 1 Day
Res Hab-Lic-1 Person-Inelig	$99.10 / 1 Day
Res Hab-Lic-3 Person-Inelig	$38.74 / 1 Day

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

Life Sharing-1 person-Elig-NG 1 > 30 Hrs	$171.35 / 1 Day
Life Sharing-1 person-Elig-NG 2 > 30 Hrs	$204.29 / 1 Day
Life Sharing-1 person-Elig-NG 3 > 30 Hrs	$279.58 / 1 Day
Life Sharing-1 person-Elig-NG 4 > 30 Hrs	$355.61 / 1 Day
Life Sharing-2 person-Elig-NG 1 > 30 Hrs	$120.79 / 1 Day
Life Sharing-2 person-Elig-NG 2 > 30 Hrs	$144.84 / 1 Day
Life Sharing-2 person-Elig-NG 3 > 30 Hrs	$197.06 / 1 Day
Life Sharing-2 person-Elig-NG 4 > 30 Hrs	$237.16 / 1 Day

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

Life Sharing-1 person-Elig-NG 1 > 30 Hrs	$171.35 / 1 Day
Life Sharing-1 person-Elig-NG 2 > 30 Hrs	$204.29 / 1 Day
Life Sharing-1 person-Elig-NG 3 > 30 Hrs	$279.58 / 1 Day
Life Sharing-1 person-Elig-NG 4 > 30 Hrs	$355.61 / 1 Day
Life Sharing-2 person-Elig-NG 1 > 30 Hrs	$120.79 / 1 Day
Life Sharing-2 person-Elig-NG 2 > 30 Hrs	$144.84 / 1 Day
Life Sharing-2 person-Elig-NG 3 > 30 Hrs	$197.06 / 1 Day
Life Sharing-2 person-Elig-NG 4 > 30 Hrs	$237.16 / 1 Day
Needs Exception Allowance (NEA)-Adult Res (6400)	$868.90 / 1 Day
Needs Excptn Allowance (NEA)-Adult Res (6400)-521	$999.56 / 1 Day
Res Hab-1 Person-NG 1-Elig	$523.00 / 1 Day
Res Hab-1 Person-NG 1-Elig-w/Day Supports	$408.54 / 1 Day
Res Hab-1 Person-NG 2-Elig	$606.92 / 1 Day
Res Hab-1 Person-NG 2-Elig-w/Day Supports	$515.01 / 1 Day
Res Hab-1 Person-NG 3-Elig	$924.89 / 1 Day
Res Hab-1 Person-NG 3-Elig-w/Day Supports	$746.22 / 1 Day
Res Hab-1 Person-NG 4-Elig	$1,118.74 / 1 Day
Res Hab-1 Person-NG 4-Elig-w/Day Supports	$822.23 / 1 Day
Res Hab-2 Person-NG 1-Elig	$523.00 / 1 Day
Res Hab-2 Person-NG 1-Elig-w/Day Supports	$408.54 / 1 Day
Res Hab-2 Person-NG 2-Elig	$606.92 / 1 Day
Res Hab-2 Person-NG 2-Elig-w/Day Supports	$515.01 / 1 Day
Res Hab-2 Person-NG 3-Elig	$685.68 / 1 Day
Res Hab-2 Person-NG 3-Elig-w/Day Supports	$630.70 / 1 Day
Res Hab-2 Person-NG 4-Elig	$820.15 / 1 Day
Res Hab-2 Person-NG 4-Elig-w/Day Supports	$689.49 / 1 Day
Res Hab-3 Person-NG 1-Elig	$387.76 / 1 Day
Res Hab-3 Person-NG 1-Elig-w/Day Supports	$294.49 / 1 Day
Res Hab-3 Person-NG 2-Elig	$441.87 / 1 Day
Res Hab-3 Person-NG 2-Elig-w/Day Supports	$341.21 / 1 Day
Res Hab-3 Person-NG 3-Elig	$514.20 / 1 Day
Res Hab-3 Person-NG 3-Elig-w/Day Supports	$440.90 / 1 Day
Res Hab-3 Person-NG 4-Elig	$624.74 / 1 Day
Res Hab-3 Person-NG 4-Elig-w/Day Supports	$484.03 / 1 Day
Res Hab-Lic-1 Person-Inelig	$99.10 / 1 Day
Res Hab-Lic-2 Person-Inelig	$54.05 / 1 Day
Res Hab-Lic-3 Person-Inelig	$38.74 / 1 Day
Supplemental Habilitation 1:1 - 15 min	$5.77 / 15 min.
Supplemental Habilitation 2:1 - 15 min	$11.53 / 15 min.

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