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Provider Demographic Information - PATHWAYS OF SOUTHWESTERN PENNSYLVANIA INC

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PROVIDER DEMOGRAPHIC INFORMATION Supporting line for group header


Name:	PATHWAYS OF SOUTHWESTERN PENNSYLVANIA INC
Address:	95 W BEAU ST STE 420 WASHINGTON, PA 15301-6800
Phone:	(724) 225-8145
Fax:	(724) 225-4934
E-mail:	jward@yourpathways.org
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:	Regional/Field Office	Counties Served:	Fayette, Greene, Washington
Name:	UCP OF SOUTHWESTERN PENNSYLVANIA
Address:	655 JEFFERSON AVE WASHINGTON, PA 15301-4118
Phone:	(724) 225-8145
Fax:	(724) 229-0851


Type:	Regional/Field Office	Counties Served:	Fayette, Greene, Washington
Name:	PATHWAYS OF SOUTHWESTERN PENNSYLVANIA
Address:	95 W BEAU ST STE 420 WASHINGTON, PA 15301-6800
Phone:	(724) 229-0851
Fax:	(724) 229-9252

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PROVIDER SERVICES AND RATES Supporting line for group header


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

Behavioral Supports-Level 1-Initial/Ongoing	$23.85 / 15 min.
CPS Community 1:1	$13.83 / 15 min.
CPS Community 1:2 or 1:3	$7.54 / 15 min.
CPS Community 2:1	$26.59 / 15 min.
CPS Community 2:3	$11.26 / 15 min.
CPS Facility 1:1	$13.39 / 15 min.
CPS Facility 1:1 Enhanced	$18.65 / 15 min.
CPS Facility 1:1 Enhcd LPN	$18.65 / 15 min.
CPS Facility 1:1 Enhcd RN	$18.65 / 15 min.
CPS Facility 1:11 to 1:15	$3.20 / 15 min.
CPS Facility 1:2 to 1:3	$7.39 / 15 min.
CPS Facility 1:4 to 1:6	$5.65 / 15 min.
CPS Facility 1:7 to 1:10	$3.43 / 15 min.
CPS Facility 2:1	$25.67 / 15 min.
CPS Facility 2:1 Enhcd	$30.94 / 15 min.
CPS Facility 2:1 Enhcd LPN	$30.94 / 15 min.
CPS Facility 2:1 Enhcd RN	$30.94 / 15 min.
CPS:Community OnCall/Remote Support	$1.77 / 15 min.
Licen Day Hab., Older Adult Daily Living Centers	$4.02 / 15 min.
Music Therapy (1:1)	$18.81 / 15 min.
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-4 Person-NG 1-Elig-w/Day Supports	$245.99 / 1 Day
Res Hab-4 Person-NG 2-Elig-w/Day Supports	$284.31 / 1 Day
Res Hab-4 Person-NG 3-Elig-w/Day Supports	$362.42 / 1 Day
Res Hab-4 Person-NG 4-Elig-w/Day Supports	$398.69 / 1 Day
Res Hab-Lic-3 Person-Inelig	$35.47 / 1 Day
Res Hab-Lic-4 Person-Elig-NG 1	$322.49 / 1 Day
Res Hab-Lic-4 Person-Elig-NG 2	$367.82 / 1 Day
Res Hab-Lic-4 Person-Elig-NG 3	$425.56 / 1 Day
Res Hab-Lic-4 Person-Elig-NG 4	$510.56 / 1 Day
Res Hab-Lic-4 Person-Inelig	$27.15 / 1 Day
Supplemental Habilitation 1:1 - 15 min	$6.12 / 15 min.
Supplemental Habilitation 2:1 - 15 min	$12.22 / 15 min.
Supported Living-2 Person-NG1	$112.14 / 1 Day
Supported Living-2 Person-NG2	$214.77 / 1 Day
Supported Living-2 Person-NG3	$358.94 / 1 Day
Supported Living-2 Person-NG4	$576.34 / 1 Day
Supported Living-2 Person-NG5	$576.34 / 1 Day
Supported Living-3 Person-NG1	$80.09 / 1 Day
Supported Living-3 Person-NG2	$142.24 / 1 Day
Supported Living-3 Person-NG3	$249.17 / 1 Day
Supported Living-3 Person-NG4	$401.19 / 1 Day
Supported Living-3 Person-NG5	$401.19 / 1 Day
Transportation(Zone 1)-Trip	$36.54 / Trip
Transportation(Zone 2)-Trip	$65.78 / Trip
Transportation(Zone 3)-Trip	$74.73 / Trip

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

Behavioral Supports-Level 1-Initial/Ongoing	$23.85 / 15 min.
Supported Living-2 Person-NG1	$112.14 / 1 Day
Supported Living-2 Person-NG2	$214.77 / 1 Day
Supported Living-2 Person-NG3	$358.94 / 1 Day
Supported Living-2 Person-NG4	$576.34 / 1 Day
Supported Living-2 Person-NG5	$576.34 / 1 Day
Supported Living-3 Person-NG1	$80.09 / 1 Day
Supported Living-3 Person-NG2	$142.24 / 1 Day
Supported Living-3 Person-NG3	$249.17 / 1 Day
Supported Living-3 Person-NG4	$401.19 / 1 Day
Supported Living-3 Person-NG5	$401.19 / 1 Day
Transportation(Zone 1)-Trip	$36.54 / Trip
Transportation(Zone 2)-Trip	$65.78 / Trip
Transportation(Zone 3)-Trip	$74.73 / Trip

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

Behavioral Supports-Level 1-Initial/Ongoing	$23.85 / 15 min.
CPS Community 1:1	$13.83 / 15 min.
CPS Community 1:2 or 1:3	$7.54 / 15 min.
CPS Community 2:1	$26.59 / 15 min.
CPS Community 2:3	$11.26 / 15 min.
CPS Facility 1:1	$13.39 / 15 min.
CPS Facility 1:1 Enhanced	$18.65 / 15 min.
CPS Facility 1:1 Enhcd LPN	$18.65 / 15 min.
CPS Facility 1:1 Enhcd RN	$18.65 / 15 min.
CPS Facility 1:11 to 1:15	$3.20 / 15 min.
CPS Facility 1:2 to 1:3	$7.39 / 15 min.
CPS Facility 1:4 to 1:6	$5.65 / 15 min.
CPS Facility 1:7 to 1:10	$3.43 / 15 min.
CPS Facility 2:1	$25.67 / 15 min.
CPS Facility 2:1 Enhcd	$30.94 / 15 min.
CPS Facility 2:1 Enhcd LPN	$30.94 / 15 min.
CPS Facility 2:1 Enhcd RN	$30.94 / 15 min.
CPS:Community OnCall/Remote Support	$1.77 / 15 min.
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-Lic-3 Person-Inelig	$35.47 / 1 Day
Supported Living-2 Person-NG1	$112.14 / 1 Day
Supported Living-2 Person-NG2	$214.77 / 1 Day
Supported Living-2 Person-NG3	$358.94 / 1 Day
Supported Living-2 Person-NG4	$576.34 / 1 Day
Supported Living-2 Person-NG5	$576.34 / 1 Day
Supported Living-3 Person-NG1	$80.09 / 1 Day
Supported Living-3 Person-NG2	$142.24 / 1 Day
Supported Living-3 Person-NG3	$249.17 / 1 Day
Supported Living-3 Person-NG4	$401.19 / 1 Day
Supported Living-3 Person-NG5	$401.19 / 1 Day
Transportation(Zone 1)-Trip	$36.54 / Trip
Transportation(Zone 2)-Trip	$65.78 / Trip
Transportation(Zone 3)-Trip	$74.73 / Trip

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

Behavioral Supports-Level 1-Initial/Ongoing	$23.85 / 15 min.
Supported Living-2 Person-NG1	$112.14 / 1 Day
Supported Living-2 Person-NG2	$214.77 / 1 Day
Supported Living-2 Person-NG3	$358.94 / 1 Day
Supported Living-2 Person-NG4	$576.34 / 1 Day
Supported Living-2 Person-NG5	$576.34 / 1 Day
Supported Living-3 Person-NG1	$80.09 / 1 Day
Supported Living-3 Person-NG2	$142.24 / 1 Day
Supported Living-3 Person-NG3	$249.17 / 1 Day
Supported Living-3 Person-NG4	$401.19 / 1 Day
Supported Living-3 Person-NG5	$401.19 / 1 Day
Transportation(Zone 1)-Trip	$36.54 / Trip
Transportation(Zone 2)-Trip	$65.78 / Trip
Transportation(Zone 3)-Trip	$74.73 / Trip

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

Behavioral Supports-Level 1-Initial/Ongoing	$23.85 / 15 min.
Supported Living-2 Person-NG1	$112.14 / 1 Day
Supported Living-2 Person-NG2	$214.77 / 1 Day
Supported Living-2 Person-NG3	$358.94 / 1 Day
Supported Living-2 Person-NG4	$576.34 / 1 Day
Supported Living-2 Person-NG5	$576.34 / 1 Day
Supported Living-3 Person-NG1	$80.09 / 1 Day
Supported Living-3 Person-NG2	$142.24 / 1 Day
Supported Living-3 Person-NG3	$249.17 / 1 Day
Supported Living-3 Person-NG4	$401.19 / 1 Day
Supported Living-3 Person-NG5	$401.19 / 1 Day
Transportation(Zone 1)-Trip	$36.54 / Trip
Transportation(Zone 2)-Trip	$65.78 / Trip
Transportation(Zone 3)-Trip	$74.73 / Trip

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

Behavioral Supports-Level 1-Initial/Ongoing	$23.85 / 15 min.
Supported Living-2 Person-NG1	$112.14 / 1 Day
Supported Living-2 Person-NG2	$214.77 / 1 Day
Supported Living-2 Person-NG3	$358.94 / 1 Day
Supported Living-2 Person-NG4	$576.34 / 1 Day
Supported Living-2 Person-NG5	$576.34 / 1 Day
Supported Living-3 Person-NG1	$80.09 / 1 Day
Supported Living-3 Person-NG2	$142.24 / 1 Day
Supported Living-3 Person-NG3	$249.17 / 1 Day
Supported Living-3 Person-NG4	$401.19 / 1 Day
Supported Living-3 Person-NG5	$401.19 / 1 Day
Transportation(Zone 1)-Trip	$36.54 / Trip
Transportation(Zone 2)-Trip	$65.78 / Trip
Transportation(Zone 3)-Trip	$74.73 / Trip

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

Behavioral Supports-Level 1-Initial/Ongoing	$23.85 / 15 min.
Supported Living-2 Person-NG1	$112.14 / 1 Day
Supported Living-2 Person-NG2	$214.77 / 1 Day
Supported Living-2 Person-NG3	$358.94 / 1 Day
Supported Living-2 Person-NG4	$576.34 / 1 Day
Supported Living-2 Person-NG5	$576.34 / 1 Day
Supported Living-3 Person-NG1	$80.09 / 1 Day
Supported Living-3 Person-NG2	$142.24 / 1 Day
Supported Living-3 Person-NG3	$249.17 / 1 Day
Supported Living-3 Person-NG4	$401.19 / 1 Day
Supported Living-3 Person-NG5	$401.19 / 1 Day
Transportation(Zone 1)-Trip	$36.54 / Trip
Transportation(Zone 2)-Trip	$65.78 / Trip
Transportation(Zone 3)-Trip	$74.73 / Trip

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

Behavioral Supports-Level 1-Initial/Ongoing	$23.85 / 15 min.
Supported Living-2 Person-NG1	$112.14 / 1 Day
Supported Living-2 Person-NG2	$214.77 / 1 Day
Supported Living-2 Person-NG3	$358.94 / 1 Day
Supported Living-2 Person-NG4	$576.34 / 1 Day
Supported Living-2 Person-NG5	$576.34 / 1 Day
Supported Living-3 Person-NG1	$80.09 / 1 Day
Supported Living-3 Person-NG2	$142.24 / 1 Day
Supported Living-3 Person-NG3	$249.17 / 1 Day
Supported Living-3 Person-NG4	$401.19 / 1 Day
Supported Living-3 Person-NG5	$401.19 / 1 Day
Transportation(Zone 1)-Trip	$36.54 / Trip
Transportation(Zone 2)-Trip	$65.78 / Trip
Transportation(Zone 3)-Trip	$74.73 / Trip

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

Behavioral Supports-Level 1-Initial/Ongoing	$23.85 / 15 min.
Supported Living-2 Person-NG1	$112.14 / 1 Day
Supported Living-2 Person-NG2	$214.77 / 1 Day
Supported Living-2 Person-NG3	$358.94 / 1 Day
Supported Living-2 Person-NG4	$576.34 / 1 Day
Supported Living-2 Person-NG5	$576.34 / 1 Day
Supported Living-3 Person-NG1	$80.09 / 1 Day
Supported Living-3 Person-NG2	$142.24 / 1 Day
Supported Living-3 Person-NG3	$249.17 / 1 Day
Supported Living-3 Person-NG4	$401.19 / 1 Day
Supported Living-3 Person-NG5	$401.19 / 1 Day
Transportation(Zone 1)-Trip	$36.54 / Trip
Transportation(Zone 2)-Trip	$65.78 / Trip
Transportation(Zone 3)-Trip	$74.73 / Trip

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

Behavioral Supports-Level 1-Initial/Ongoing	$23.85 / 15 min.
Supported Living-2 Person-NG1	$112.14 / 1 Day
Supported Living-2 Person-NG2	$214.77 / 1 Day
Supported Living-2 Person-NG3	$358.94 / 1 Day
Supported Living-2 Person-NG4	$576.34 / 1 Day
Supported Living-2 Person-NG5	$576.34 / 1 Day
Supported Living-3 Person-NG1	$80.09 / 1 Day
Supported Living-3 Person-NG2	$142.24 / 1 Day
Supported Living-3 Person-NG3	$249.17 / 1 Day
Supported Living-3 Person-NG4	$401.19 / 1 Day
Supported Living-3 Person-NG5	$401.19 / 1 Day
Transportation(Zone 1)-Trip	$36.54 / Trip
Transportation(Zone 2)-Trip	$65.78 / Trip
Transportation(Zone 3)-Trip	$74.73 / Trip

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

Behavioral Supports-Level 1-Initial/Ongoing	$23.85 / 15 min.
Supported Living-2 Person-NG1	$112.14 / 1 Day
Supported Living-2 Person-NG2	$214.77 / 1 Day
Supported Living-2 Person-NG3	$358.94 / 1 Day
Supported Living-2 Person-NG4	$576.34 / 1 Day
Supported Living-2 Person-NG5	$576.34 / 1 Day
Supported Living-3 Person-NG1	$80.09 / 1 Day
Supported Living-3 Person-NG2	$142.24 / 1 Day
Supported Living-3 Person-NG3	$249.17 / 1 Day
Supported Living-3 Person-NG4	$401.19 / 1 Day
Supported Living-3 Person-NG5	$401.19 / 1 Day
Transportation(Zone 1)-Trip	$36.54 / Trip
Transportation(Zone 2)-Trip	$65.78 / Trip
Transportation(Zone 3)-Trip	$74.73 / Trip

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

Behavioral Supports-Level 1-Initial/Ongoing	$23.85 / 15 min.
Supported Living-2 Person-NG1	$112.14 / 1 Day
Supported Living-2 Person-NG2	$214.77 / 1 Day
Supported Living-2 Person-NG3	$358.94 / 1 Day
Supported Living-2 Person-NG4	$576.34 / 1 Day
Supported Living-2 Person-NG5	$576.34 / 1 Day
Supported Living-3 Person-NG1	$80.09 / 1 Day
Supported Living-3 Person-NG2	$142.24 / 1 Day
Supported Living-3 Person-NG3	$249.17 / 1 Day
Supported Living-3 Person-NG4	$401.19 / 1 Day
Supported Living-3 Person-NG5	$401.19 / 1 Day
Transportation(Zone 1)-Trip	$36.54 / Trip
Transportation(Zone 2)-Trip	$65.78 / Trip
Transportation(Zone 3)-Trip	$74.73 / Trip

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

Behavioral Supports-Level 1-Initial/Ongoing	$23.85 / 15 min.
Supported Living-2 Person-NG1	$112.14 / 1 Day
Supported Living-2 Person-NG2	$214.77 / 1 Day
Supported Living-2 Person-NG3	$358.94 / 1 Day
Supported Living-2 Person-NG4	$576.34 / 1 Day
Supported Living-2 Person-NG5	$576.34 / 1 Day
Supported Living-3 Person-NG1	$80.09 / 1 Day
Supported Living-3 Person-NG2	$142.24 / 1 Day
Supported Living-3 Person-NG3	$249.17 / 1 Day
Supported Living-3 Person-NG4	$401.19 / 1 Day
Supported Living-3 Person-NG5	$401.19 / 1 Day
Transportation(Zone 1)-Trip	$36.54 / Trip
Transportation(Zone 2)-Trip	$65.78 / Trip
Transportation(Zone 3)-Trip	$74.73 / Trip

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

Behavioral Supports-Level 1-Initial/Ongoing	$23.85 / 15 min.
Supported Living-2 Person-NG1	$112.14 / 1 Day
Supported Living-2 Person-NG2	$214.77 / 1 Day
Supported Living-2 Person-NG3	$358.94 / 1 Day
Supported Living-2 Person-NG4	$576.34 / 1 Day
Supported Living-2 Person-NG5	$576.34 / 1 Day
Supported Living-3 Person-NG1	$80.09 / 1 Day
Supported Living-3 Person-NG2	$142.24 / 1 Day
Supported Living-3 Person-NG3	$249.17 / 1 Day
Supported Living-3 Person-NG4	$401.19 / 1 Day
Supported Living-3 Person-NG5	$401.19 / 1 Day
Transportation(Zone 1)-Trip	$36.54 / Trip
Transportation(Zone 2)-Trip	$65.78 / Trip
Transportation(Zone 3)-Trip	$74.73 / Trip

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

Behavioral Supports-Level 1-Initial/Ongoing	$23.85 / 15 min.
Supported Living-2 Person-NG1	$112.14 / 1 Day
Supported Living-2 Person-NG2	$214.77 / 1 Day
Supported Living-2 Person-NG3	$358.94 / 1 Day
Supported Living-2 Person-NG4	$576.34 / 1 Day
Supported Living-2 Person-NG5	$576.34 / 1 Day
Supported Living-3 Person-NG1	$80.09 / 1 Day
Supported Living-3 Person-NG2	$142.24 / 1 Day
Supported Living-3 Person-NG3	$249.17 / 1 Day
Supported Living-3 Person-NG4	$401.19 / 1 Day
Supported Living-3 Person-NG5	$401.19 / 1 Day
Transportation(Zone 1)-Trip	$36.54 / Trip
Transportation(Zone 2)-Trip	$65.78 / Trip
Transportation(Zone 3)-Trip	$74.73 / Trip

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

Behavioral Supports-Level 1-Initial/Ongoing	$23.85 / 15 min.
Supported Living-2 Person-NG1	$112.14 / 1 Day
Supported Living-2 Person-NG2	$214.77 / 1 Day
Supported Living-2 Person-NG3	$358.94 / 1 Day
Supported Living-2 Person-NG4	$576.34 / 1 Day
Supported Living-2 Person-NG5	$576.34 / 1 Day
Supported Living-3 Person-NG1	$80.09 / 1 Day
Supported Living-3 Person-NG2	$142.24 / 1 Day
Supported Living-3 Person-NG3	$249.17 / 1 Day
Supported Living-3 Person-NG4	$401.19 / 1 Day
Supported Living-3 Person-NG5	$401.19 / 1 Day
Transportation(Zone 1)-Trip	$36.54 / Trip
Transportation(Zone 2)-Trip	$65.78 / Trip
Transportation(Zone 3)-Trip	$74.73 / Trip

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

Behavioral Supports-Level 1-Initial/Ongoing	$23.85 / 15 min.
Supported Living-2 Person-NG1	$112.14 / 1 Day
Supported Living-2 Person-NG2	$214.77 / 1 Day
Supported Living-2 Person-NG3	$358.94 / 1 Day
Supported Living-2 Person-NG4	$576.34 / 1 Day
Supported Living-2 Person-NG5	$576.34 / 1 Day
Supported Living-3 Person-NG1	$80.09 / 1 Day
Supported Living-3 Person-NG2	$142.24 / 1 Day
Supported Living-3 Person-NG3	$249.17 / 1 Day
Supported Living-3 Person-NG4	$401.19 / 1 Day
Supported Living-3 Person-NG5	$401.19 / 1 Day
Transportation(Zone 1)-Trip	$36.54 / Trip
Transportation(Zone 2)-Trip	$65.78 / Trip
Transportation(Zone 3)-Trip	$74.73 / Trip

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

Behavioral Supports-Level 1-Initial/Ongoing	$23.85 / 15 min.
Supported Living-2 Person-NG1	$112.14 / 1 Day
Supported Living-2 Person-NG2	$214.77 / 1 Day
Supported Living-2 Person-NG3	$358.94 / 1 Day
Supported Living-2 Person-NG4	$576.34 / 1 Day
Supported Living-2 Person-NG5	$576.34 / 1 Day
Supported Living-3 Person-NG1	$80.09 / 1 Day
Supported Living-3 Person-NG2	$142.24 / 1 Day
Supported Living-3 Person-NG3	$249.17 / 1 Day
Supported Living-3 Person-NG4	$401.19 / 1 Day
Supported Living-3 Person-NG5	$401.19 / 1 Day
Transportation(Zone 1)-Trip	$36.54 / Trip
Transportation(Zone 2)-Trip	$65.78 / Trip
Transportation(Zone 3)-Trip	$74.73 / Trip

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

Behavioral Supports-Level 1-Initial/Ongoing	$23.85 / 15 min.
Supported Living-2 Person-NG1	$112.14 / 1 Day
Supported Living-2 Person-NG2	$214.77 / 1 Day
Supported Living-2 Person-NG3	$358.94 / 1 Day
Supported Living-2 Person-NG4	$576.34 / 1 Day
Supported Living-2 Person-NG5	$576.34 / 1 Day
Supported Living-3 Person-NG1	$80.09 / 1 Day
Supported Living-3 Person-NG2	$142.24 / 1 Day
Supported Living-3 Person-NG3	$249.17 / 1 Day
Supported Living-3 Person-NG4	$401.19 / 1 Day
Supported Living-3 Person-NG5	$401.19 / 1 Day
Transportation(Zone 1)-Trip	$36.54 / Trip
Transportation(Zone 2)-Trip	$65.78 / Trip
Transportation(Zone 3)-Trip	$74.73 / Trip

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

Behavioral Supports-Level 1-Initial/Ongoing	$23.85 / 15 min.
Supported Living-2 Person-NG1	$112.14 / 1 Day
Supported Living-2 Person-NG2	$214.77 / 1 Day
Supported Living-2 Person-NG3	$358.94 / 1 Day
Supported Living-2 Person-NG4	$576.34 / 1 Day
Supported Living-2 Person-NG5	$576.34 / 1 Day
Supported Living-3 Person-NG1	$80.09 / 1 Day
Supported Living-3 Person-NG2	$142.24 / 1 Day
Supported Living-3 Person-NG3	$249.17 / 1 Day
Supported Living-3 Person-NG4	$401.19 / 1 Day
Supported Living-3 Person-NG5	$401.19 / 1 Day
Transportation(Zone 1)-Trip	$36.54 / Trip
Transportation(Zone 2)-Trip	$65.78 / Trip
Transportation(Zone 3)-Trip	$74.73 / Trip

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

Behavioral Supports-Level 1-Initial/Ongoing	$23.85 / 15 min.
Supported Living-2 Person-NG1	$112.14 / 1 Day
Supported Living-2 Person-NG2	$214.77 / 1 Day
Supported Living-2 Person-NG3	$358.94 / 1 Day
Supported Living-2 Person-NG4	$576.34 / 1 Day
Supported Living-2 Person-NG5	$576.34 / 1 Day
Supported Living-3 Person-NG1	$80.09 / 1 Day
Supported Living-3 Person-NG2	$142.24 / 1 Day
Supported Living-3 Person-NG3	$249.17 / 1 Day
Supported Living-3 Person-NG4	$401.19 / 1 Day
Supported Living-3 Person-NG5	$401.19 / 1 Day
Transportation(Zone 1)-Trip	$36.54 / Trip
Transportation(Zone 2)-Trip	$65.78 / Trip
Transportation(Zone 3)-Trip	$74.73 / Trip

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

Behavioral Supports-Level 1-Initial/Ongoing	$23.85 / 15 min.
Supported Living-2 Person-NG1	$112.14 / 1 Day
Supported Living-2 Person-NG2	$214.77 / 1 Day
Supported Living-2 Person-NG3	$358.94 / 1 Day
Supported Living-2 Person-NG4	$576.34 / 1 Day
Supported Living-2 Person-NG5	$576.34 / 1 Day
Supported Living-3 Person-NG1	$80.09 / 1 Day
Supported Living-3 Person-NG2	$142.24 / 1 Day
Supported Living-3 Person-NG3	$249.17 / 1 Day
Supported Living-3 Person-NG4	$401.19 / 1 Day
Supported Living-3 Person-NG5	$401.19 / 1 Day
Transportation(Zone 1)-Trip	$36.54 / Trip
Transportation(Zone 2)-Trip	$65.78 / Trip
Transportation(Zone 3)-Trip	$74.73 / Trip

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

Behavioral Supports-Level 1-Initial/Ongoing	$23.85 / 15 min.
CPS Community 1:1	$13.83 / 15 min.
CPS Community 1:1 Enhanced	$19.26 / 15 min.
CPS Community 1:1 Enhcd LPN	$19.26 / 15 min.
CPS Community 1:1 Enhcd RN	$19.26 / 15 min.
CPS Community 1:2 or 1:3	$7.54 / 15 min.
CPS Community 2:1	$26.59 / 15 min.
CPS Community 2:1 Enhanced	$32.08 / 15 min.
CPS Community 2:1 Enhcd RN	$32.08 / 15 min.
CPS Community 2:3	$11.26 / 15 min.
CPS Community Enhcd LPN	$32.08 / 15 min.
CPS Facility 1:1	$13.39 / 15 min.
CPS Facility 1:1 Enhanced	$18.65 / 15 min.
CPS Facility 1:1 Enhcd LPN	$18.65 / 15 min.
CPS Facility 1:1 Enhcd RN	$18.65 / 15 min.
CPS Facility 1:11 to 1:15	$3.20 / 15 min.
CPS Facility 1:2 to 1:3	$7.39 / 15 min.
CPS Facility 1:4 to 1:6	$5.65 / 15 min.
CPS Facility 1:7 to 1:10	$3.43 / 15 min.
CPS Facility 2:1	$25.67 / 15 min.
CPS Facility 2:1 Enhcd	$30.94 / 15 min.
CPS Facility 2:1 Enhcd LPN	$30.94 / 15 min.
CPS Facility 2:1 Enhcd RN	$30.94 / 15 min.
CPS:Community OnCall/Remote Support	$1.77 / 15 min.
Music Therapy (1:1)	$18.81 / 15 min.
Supported Living-2 Person-NG1	$112.14 / 1 Day
Supported Living-2 Person-NG2	$214.77 / 1 Day
Supported Living-2 Person-NG3	$358.94 / 1 Day
Supported Living-2 Person-NG4	$576.34 / 1 Day
Supported Living-2 Person-NG5	$576.34 / 1 Day
Supported Living-3 Person-NG1	$80.09 / 1 Day
Supported Living-3 Person-NG2	$142.24 / 1 Day
Supported Living-3 Person-NG3	$249.17 / 1 Day
Supported Living-3 Person-NG4	$401.19 / 1 Day
Supported Living-3 Person-NG5	$401.19 / 1 Day
Transportation(Zone 1)-Trip	$36.54 / Trip
Transportation(Zone 2)-Trip	$65.78 / Trip
Transportation(Zone 3)-Trip	$74.73 / Trip

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

Behavioral Supports-Level 1-Initial/Ongoing	$23.85 / 15 min.
Supported Living-2 Person-NG1	$112.14 / 1 Day
Supported Living-2 Person-NG2	$214.77 / 1 Day
Supported Living-2 Person-NG3	$358.94 / 1 Day
Supported Living-2 Person-NG4	$576.34 / 1 Day
Supported Living-2 Person-NG5	$576.34 / 1 Day
Supported Living-3 Person-NG1	$80.09 / 1 Day
Supported Living-3 Person-NG2	$142.24 / 1 Day
Supported Living-3 Person-NG3	$249.17 / 1 Day
Supported Living-3 Person-NG4	$401.19 / 1 Day
Supported Living-3 Person-NG5	$401.19 / 1 Day
Transportation(Zone 1)-Trip	$36.54 / Trip
Transportation(Zone 2)-Trip	$65.78 / Trip
Transportation(Zone 3)-Trip	$74.73 / Trip

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

Behavioral Supports-Level 1-Initial/Ongoing	$23.85 / 15 min.
Supported Living-2 Person-NG1	$112.14 / 1 Day
Supported Living-2 Person-NG2	$214.77 / 1 Day
Supported Living-2 Person-NG3	$358.94 / 1 Day
Supported Living-2 Person-NG4	$576.34 / 1 Day
Supported Living-2 Person-NG5	$576.34 / 1 Day
Supported Living-3 Person-NG1	$80.09 / 1 Day
Supported Living-3 Person-NG2	$142.24 / 1 Day
Supported Living-3 Person-NG3	$249.17 / 1 Day
Supported Living-3 Person-NG4	$401.19 / 1 Day
Supported Living-3 Person-NG5	$401.19 / 1 Day
Transportation(Zone 1)-Trip	$36.54 / Trip
Transportation(Zone 2)-Trip	$65.78 / Trip
Transportation(Zone 3)-Trip	$74.73 / Trip

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

Behavioral Supports-Level 1-Initial/Ongoing	$23.85 / 15 min.
CPS Community 1:1	$13.83 / 15 min.
CPS Community 1:2 or 1:3	$7.54 / 15 min.
CPS Community 2:1	$26.59 / 15 min.
CPS Community 2:3	$11.26 / 15 min.
CPS Facility 1:1	$13.39 / 15 min.
CPS Facility 1:1 Enhanced	$18.65 / 15 min.
CPS Facility 1:1 Enhcd LPN	$18.65 / 15 min.
CPS Facility 1:1 Enhcd RN	$18.65 / 15 min.
CPS Facility 1:11 to 1:15	$3.20 / 15 min.
CPS Facility 1:2 to 1:3	$7.39 / 15 min.
CPS Facility 1:4 to 1:6	$5.65 / 15 min.
CPS Facility 1:7 to 1:10	$3.43 / 15 min.
CPS Facility 2:1	$25.67 / 15 min.
CPS Facility 2:1 Enhcd	$30.94 / 15 min.
CPS Facility 2:1 Enhcd LPN	$30.94 / 15 min.
CPS Facility 2:1 Enhcd RN	$30.94 / 15 min.
CPS:Community OnCall/Remote Support	$1.77 / 15 min.
In-Home & Commnty Supprts (Lvl 2 Enh)	$15.31 / 15 min.
In-Home & Commnty Supprts (Lvl 2)	$11.10 / 15 min.
Licen Day Hab., Older Adult Daily Living Centers	$4.02 / 15 min.
Music Therapy (1:1)	$18.81 / 15 min.
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-4 Person-NG 1-Elig-w/Day Supports	$245.99 / 1 Day
Res Hab-4 Person-NG 2-Elig-w/Day Supports	$284.31 / 1 Day
Res Hab-4 Person-NG 3-Elig-w/Day Supports	$362.42 / 1 Day
Res Hab-4 Person-NG 4-Elig-w/Day Supports	$398.69 / 1 Day
Res Hab-Lic-3 Person-Inelig	$35.47 / 1 Day
Res Hab-Lic-4 Person-Elig-NG 1	$322.49 / 1 Day
Res Hab-Lic-4 Person-Elig-NG 2	$367.82 / 1 Day
Res Hab-Lic-4 Person-Elig-NG 3	$425.56 / 1 Day
Res Hab-Lic-4 Person-Elig-NG 4	$510.56 / 1 Day
Res Hab-Lic-4 Person-Inelig	$27.15 / 1 Day
Supplemental Habilitation 1:1 - 15 min	$6.12 / 15 min.
Supported Living-2 Person-NG1	$112.14 / 1 Day
Supported Living-2 Person-NG2	$214.77 / 1 Day
Supported Living-2 Person-NG3	$358.94 / 1 Day
Supported Living-2 Person-NG4	$576.34 / 1 Day
Supported Living-2 Person-NG5	$576.34 / 1 Day
Supported Living-3 Person-NG1	$80.09 / 1 Day
Supported Living-3 Person-NG2	$142.24 / 1 Day
Supported Living-3 Person-NG3	$249.17 / 1 Day
Supported Living-3 Person-NG4	$401.19 / 1 Day
Supported Living-3 Person-NG5	$401.19 / 1 Day
Transportation(Zone 1)-Trip	$36.54 / Trip
Transportation(Zone 2)-Trip	$65.78 / Trip
Transportation(Zone 3)-Trip	$74.73 / Trip

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

Behavioral Supports-Level 1-Initial/Ongoing	$23.85 / 15 min.
Supported Living-2 Person-NG1	$112.14 / 1 Day
Supported Living-2 Person-NG2	$214.77 / 1 Day
Supported Living-2 Person-NG3	$358.94 / 1 Day
Supported Living-2 Person-NG4	$576.34 / 1 Day
Supported Living-2 Person-NG5	$576.34 / 1 Day
Supported Living-3 Person-NG1	$80.09 / 1 Day
Supported Living-3 Person-NG2	$142.24 / 1 Day
Supported Living-3 Person-NG3	$249.17 / 1 Day
Supported Living-3 Person-NG4	$401.19 / 1 Day
Supported Living-3 Person-NG5	$401.19 / 1 Day
Transportation(Zone 1)-Trip	$36.54 / Trip
Transportation(Zone 2)-Trip	$65.78 / Trip
Transportation(Zone 3)-Trip	$74.73 / Trip

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

Behavioral Supports-Level 1-Initial/Ongoing	$23.85 / 15 min.
Supported Living-2 Person-NG1	$112.14 / 1 Day
Supported Living-2 Person-NG2	$214.77 / 1 Day
Supported Living-2 Person-NG3	$358.94 / 1 Day
Supported Living-2 Person-NG4	$576.34 / 1 Day
Supported Living-2 Person-NG5	$576.34 / 1 Day
Supported Living-3 Person-NG1	$80.09 / 1 Day
Supported Living-3 Person-NG2	$142.24 / 1 Day
Supported Living-3 Person-NG3	$249.17 / 1 Day
Supported Living-3 Person-NG4	$401.19 / 1 Day
Supported Living-3 Person-NG5	$401.19 / 1 Day
Transportation(Zone 1)-Trip	$36.54 / Trip
Transportation(Zone 2)-Trip	$65.78 / Trip
Transportation(Zone 3)-Trip	$74.73 / Trip

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

Behavioral Supports-Level 1-Initial/Ongoing	$23.85 / 15 min.
Supported Living-2 Person-NG1	$112.14 / 1 Day
Supported Living-2 Person-NG2	$214.77 / 1 Day
Supported Living-2 Person-NG3	$358.94 / 1 Day
Supported Living-2 Person-NG4	$576.34 / 1 Day
Supported Living-2 Person-NG5	$576.34 / 1 Day
Supported Living-3 Person-NG1	$80.09 / 1 Day
Supported Living-3 Person-NG2	$142.24 / 1 Day
Supported Living-3 Person-NG3	$249.17 / 1 Day
Supported Living-3 Person-NG4	$401.19 / 1 Day
Supported Living-3 Person-NG5	$401.19 / 1 Day
Transportation(Zone 1)-Trip	$36.54 / Trip
Transportation(Zone 2)-Trip	$65.78 / Trip
Transportation(Zone 3)-Trip	$74.73 / Trip

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

Behavioral Supports-Level 1-Initial/Ongoing	$23.85 / 15 min.
Music Therapy (1:1)	$18.81 / 15 min.
Supported Living-2 Person-NG1	$112.14 / 1 Day
Supported Living-2 Person-NG2	$214.77 / 1 Day
Supported Living-2 Person-NG3	$358.94 / 1 Day
Supported Living-2 Person-NG4	$576.34 / 1 Day
Supported Living-2 Person-NG5	$576.34 / 1 Day
Supported Living-3 Person-NG1	$80.09 / 1 Day
Supported Living-3 Person-NG2	$142.24 / 1 Day
Supported Living-3 Person-NG3	$249.17 / 1 Day
Supported Living-3 Person-NG4	$401.19 / 1 Day
Supported Living-3 Person-NG5	$401.19 / 1 Day
Transportation(Zone 1)-Trip	$36.54 / Trip
Transportation(Zone 2)-Trip	$65.78 / Trip
Transportation(Zone 3)-Trip	$74.73 / Trip

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

Behavioral Supports-Level 1-Initial/Ongoing	$23.85 / 15 min.
Supported Living-2 Person-NG1	$112.14 / 1 Day
Supported Living-2 Person-NG2	$214.77 / 1 Day
Supported Living-2 Person-NG3	$358.94 / 1 Day
Supported Living-2 Person-NG4	$576.34 / 1 Day
Supported Living-2 Person-NG5	$576.34 / 1 Day
Supported Living-3 Person-NG1	$80.09 / 1 Day
Supported Living-3 Person-NG2	$142.24 / 1 Day
Supported Living-3 Person-NG3	$249.17 / 1 Day
Supported Living-3 Person-NG4	$401.19 / 1 Day
Supported Living-3 Person-NG5	$401.19 / 1 Day
Transportation(Zone 1)-Trip	$36.54 / Trip
Transportation(Zone 2)-Trip	$65.78 / Trip
Transportation(Zone 3)-Trip	$74.73 / Trip

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

Behavioral Supports-Level 1-Initial/Ongoing	$23.85 / 15 min.
Supported Living-2 Person-NG1	$112.14 / 1 Day
Supported Living-2 Person-NG2	$214.77 / 1 Day
Supported Living-2 Person-NG3	$358.94 / 1 Day
Supported Living-2 Person-NG4	$576.34 / 1 Day
Supported Living-2 Person-NG5	$576.34 / 1 Day
Supported Living-3 Person-NG1	$80.09 / 1 Day
Supported Living-3 Person-NG2	$142.24 / 1 Day
Supported Living-3 Person-NG3	$249.17 / 1 Day
Supported Living-3 Person-NG4	$401.19 / 1 Day
Supported Living-3 Person-NG5	$401.19 / 1 Day
Transportation(Zone 1)-Trip	$36.54 / Trip
Transportation(Zone 2)-Trip	$65.78 / Trip
Transportation(Zone 3)-Trip	$74.73 / Trip

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

Behavioral Supports-Level 1-Initial/Ongoing	$23.85 / 15 min.
Supported Living-2 Person-NG1	$112.14 / 1 Day
Supported Living-2 Person-NG2	$214.77 / 1 Day
Supported Living-2 Person-NG3	$358.94 / 1 Day
Supported Living-2 Person-NG4	$576.34 / 1 Day
Supported Living-2 Person-NG5	$576.34 / 1 Day
Supported Living-3 Person-NG1	$80.09 / 1 Day
Supported Living-3 Person-NG2	$142.24 / 1 Day
Supported Living-3 Person-NG3	$249.17 / 1 Day
Supported Living-3 Person-NG4	$401.19 / 1 Day
Supported Living-3 Person-NG5	$401.19 / 1 Day
Transportation(Zone 1)-Trip	$36.54 / Trip
Transportation(Zone 2)-Trip	$65.78 / Trip
Transportation(Zone 3)-Trip	$74.73 / Trip

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

Behavioral Supports-Level 1-Initial/Ongoing	$23.85 / 15 min.
Supported Living-2 Person-NG1	$112.14 / 1 Day
Supported Living-2 Person-NG2	$214.77 / 1 Day
Supported Living-2 Person-NG3	$358.94 / 1 Day
Supported Living-2 Person-NG4	$576.34 / 1 Day
Supported Living-2 Person-NG5	$576.34 / 1 Day
Supported Living-3 Person-NG1	$80.09 / 1 Day
Supported Living-3 Person-NG2	$142.24 / 1 Day
Supported Living-3 Person-NG3	$249.17 / 1 Day
Supported Living-3 Person-NG4	$401.19 / 1 Day
Supported Living-3 Person-NG5	$401.19 / 1 Day
Transportation(Zone 1)-Trip	$36.54 / Trip
Transportation(Zone 2)-Trip	$65.78 / Trip
Transportation(Zone 3)-Trip	$74.73 / Trip

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

Behavioral Supports-Level 1-Initial/Ongoing	$23.85 / 15 min.
Supported Living-2 Person-NG1	$112.14 / 1 Day
Supported Living-2 Person-NG2	$214.77 / 1 Day
Supported Living-2 Person-NG3	$358.94 / 1 Day
Supported Living-2 Person-NG4	$576.34 / 1 Day
Supported Living-2 Person-NG5	$576.34 / 1 Day
Supported Living-3 Person-NG1	$80.09 / 1 Day
Supported Living-3 Person-NG2	$142.24 / 1 Day
Supported Living-3 Person-NG3	$249.17 / 1 Day
Supported Living-3 Person-NG4	$401.19 / 1 Day
Supported Living-3 Person-NG5	$401.19 / 1 Day
Transportation(Zone 1)-Trip	$36.54 / Trip
Transportation(Zone 2)-Trip	$65.78 / Trip
Transportation(Zone 3)-Trip	$74.73 / Trip

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

Behavioral Supports-Level 1-Initial/Ongoing	$23.85 / 15 min.
Supported Living-2 Person-NG1	$112.14 / 1 Day
Supported Living-2 Person-NG2	$214.77 / 1 Day
Supported Living-2 Person-NG3	$358.94 / 1 Day
Supported Living-2 Person-NG4	$576.34 / 1 Day
Supported Living-2 Person-NG5	$576.34 / 1 Day
Supported Living-3 Person-NG1	$80.09 / 1 Day
Supported Living-3 Person-NG2	$142.24 / 1 Day
Supported Living-3 Person-NG3	$249.17 / 1 Day
Supported Living-3 Person-NG4	$401.19 / 1 Day
Supported Living-3 Person-NG5	$401.19 / 1 Day
Transportation(Zone 1)-Trip	$36.54 / Trip
Transportation(Zone 2)-Trip	$65.78 / Trip
Transportation(Zone 3)-Trip	$74.73 / Trip

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

Behavioral Supports-Level 1-Initial/Ongoing	$23.85 / 15 min.
Supported Living-2 Person-NG1	$112.14 / 1 Day
Supported Living-2 Person-NG2	$214.77 / 1 Day
Supported Living-2 Person-NG3	$358.94 / 1 Day
Supported Living-2 Person-NG4	$576.34 / 1 Day
Supported Living-2 Person-NG5	$576.34 / 1 Day
Supported Living-3 Person-NG1	$80.09 / 1 Day
Supported Living-3 Person-NG2	$142.24 / 1 Day
Supported Living-3 Person-NG3	$249.17 / 1 Day
Supported Living-3 Person-NG4	$401.19 / 1 Day
Supported Living-3 Person-NG5	$401.19 / 1 Day
Transportation(Zone 1)-Trip	$36.54 / Trip
Transportation(Zone 2)-Trip	$65.78 / Trip
Transportation(Zone 3)-Trip	$74.73 / Trip

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

Behavioral Supports-Level 1-Initial/Ongoing	$23.85 / 15 min.
Supported Living-2 Person-NG1	$112.14 / 1 Day
Supported Living-2 Person-NG2	$214.77 / 1 Day
Supported Living-2 Person-NG3	$358.94 / 1 Day
Supported Living-2 Person-NG4	$576.34 / 1 Day
Supported Living-2 Person-NG5	$576.34 / 1 Day
Supported Living-3 Person-NG1	$80.09 / 1 Day
Supported Living-3 Person-NG2	$142.24 / 1 Day
Supported Living-3 Person-NG3	$249.17 / 1 Day
Supported Living-3 Person-NG4	$401.19 / 1 Day
Supported Living-3 Person-NG5	$401.19 / 1 Day
Transportation(Zone 1)-Trip	$36.54 / Trip
Transportation(Zone 2)-Trip	$65.78 / Trip
Transportation(Zone 3)-Trip	$74.73 / Trip

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

Behavioral Supports-Level 1-Initial/Ongoing	$23.85 / 15 min.
Supported Living-2 Person-NG1	$112.14 / 1 Day
Supported Living-2 Person-NG2	$214.77 / 1 Day
Supported Living-2 Person-NG3	$358.94 / 1 Day
Supported Living-2 Person-NG4	$576.34 / 1 Day
Supported Living-2 Person-NG5	$576.34 / 1 Day
Supported Living-3 Person-NG1	$80.09 / 1 Day
Supported Living-3 Person-NG2	$142.24 / 1 Day
Supported Living-3 Person-NG3	$249.17 / 1 Day
Supported Living-3 Person-NG4	$401.19 / 1 Day
Supported Living-3 Person-NG5	$401.19 / 1 Day
Transportation(Zone 1)-Trip	$36.54 / Trip
Transportation(Zone 2)-Trip	$65.78 / Trip
Transportation(Zone 3)-Trip	$74.73 / Trip

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

Behavioral Supports-Level 1-Initial/Ongoing	$23.85 / 15 min.
Supported Living-2 Person-NG1	$112.14 / 1 Day
Supported Living-2 Person-NG2	$214.77 / 1 Day
Supported Living-2 Person-NG3	$358.94 / 1 Day
Supported Living-2 Person-NG4	$576.34 / 1 Day
Supported Living-2 Person-NG5	$576.34 / 1 Day
Supported Living-3 Person-NG1	$80.09 / 1 Day
Supported Living-3 Person-NG2	$142.24 / 1 Day
Supported Living-3 Person-NG3	$249.17 / 1 Day
Supported Living-3 Person-NG4	$401.19 / 1 Day
Supported Living-3 Person-NG5	$401.19 / 1 Day
Transportation(Zone 1)-Trip	$36.54 / Trip
Transportation(Zone 2)-Trip	$65.78 / Trip
Transportation(Zone 3)-Trip	$74.73 / Trip

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

Behavioral Supports-Level 1-Initial/Ongoing	$23.85 / 15 min.
Supported Living-2 Person-NG1	$112.14 / 1 Day
Supported Living-2 Person-NG2	$214.77 / 1 Day
Supported Living-2 Person-NG3	$358.94 / 1 Day
Supported Living-2 Person-NG4	$576.34 / 1 Day
Supported Living-2 Person-NG5	$576.34 / 1 Day
Supported Living-3 Person-NG1	$80.09 / 1 Day
Supported Living-3 Person-NG2	$142.24 / 1 Day
Supported Living-3 Person-NG3	$249.17 / 1 Day
Supported Living-3 Person-NG4	$401.19 / 1 Day
Supported Living-3 Person-NG5	$401.19 / 1 Day
Transportation(Zone 1)-Trip	$36.54 / Trip
Transportation(Zone 2)-Trip	$65.78 / Trip
Transportation(Zone 3)-Trip	$74.73 / Trip

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

Behavioral Supports-Level 1-Initial/Ongoing	$23.85 / 15 min.
Supported Living-2 Person-NG1	$112.14 / 1 Day
Supported Living-2 Person-NG2	$214.77 / 1 Day
Supported Living-2 Person-NG3	$358.94 / 1 Day
Supported Living-2 Person-NG4	$576.34 / 1 Day
Supported Living-2 Person-NG5	$576.34 / 1 Day
Supported Living-3 Person-NG1	$80.09 / 1 Day
Supported Living-3 Person-NG2	$142.24 / 1 Day
Supported Living-3 Person-NG3	$249.17 / 1 Day
Supported Living-3 Person-NG4	$401.19 / 1 Day
Supported Living-3 Person-NG5	$401.19 / 1 Day
Transportation(Zone 1)-Trip	$36.54 / Trip
Transportation(Zone 2)-Trip	$65.78 / Trip
Transportation(Zone 3)-Trip	$74.73 / Trip

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

Behavioral Supports-Level 1-Initial/Ongoing	$23.85 / 15 min.
Supported Living-2 Person-NG1	$112.14 / 1 Day
Supported Living-2 Person-NG2	$214.77 / 1 Day
Supported Living-2 Person-NG3	$358.94 / 1 Day
Supported Living-2 Person-NG4	$576.34 / 1 Day
Supported Living-2 Person-NG5	$576.34 / 1 Day
Supported Living-3 Person-NG1	$80.09 / 1 Day
Supported Living-3 Person-NG2	$142.24 / 1 Day
Supported Living-3 Person-NG3	$249.17 / 1 Day
Supported Living-3 Person-NG4	$401.19 / 1 Day
Supported Living-3 Person-NG5	$401.19 / 1 Day
Transportation(Zone 1)-Trip	$36.54 / Trip
Transportation(Zone 2)-Trip	$65.78 / Trip
Transportation(Zone 3)-Trip	$74.73 / Trip

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

Behavioral Supports-Level 1-Initial/Ongoing	$23.85 / 15 min.
Supported Living-2 Person-NG1	$112.14 / 1 Day
Supported Living-2 Person-NG2	$214.77 / 1 Day
Supported Living-2 Person-NG3	$358.94 / 1 Day
Supported Living-2 Person-NG4	$576.34 / 1 Day
Supported Living-2 Person-NG5	$576.34 / 1 Day
Supported Living-3 Person-NG1	$80.09 / 1 Day
Supported Living-3 Person-NG2	$142.24 / 1 Day
Supported Living-3 Person-NG3	$249.17 / 1 Day
Supported Living-3 Person-NG4	$401.19 / 1 Day
Supported Living-3 Person-NG5	$401.19 / 1 Day
Transportation(Zone 1)-Trip	$36.54 / Trip
Transportation(Zone 2)-Trip	$65.78 / Trip
Transportation(Zone 3)-Trip	$74.73 / Trip

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

Behavioral Supports-Level 1-Initial/Ongoing	$23.85 / 15 min.
Behavioral Supports-Level 2-Initial/Ongoing	$25.55 / 15 min.
CPS Community 1:1	$13.83 / 15 min.
CPS Community 1:2 or 1:3	$7.54 / 15 min.
CPS Community 2:1	$26.59 / 15 min.
CPS Community 2:3	$11.26 / 15 min.
CPS Facility 1:1	$13.39 / 15 min.
CPS Facility 1:1 Enhanced	$18.65 / 15 min.
CPS Facility 1:1 Enhcd LPN	$18.65 / 15 min.
CPS Facility 1:1 Enhcd RN	$18.65 / 15 min.
CPS Facility 1:11 to 1:15	$3.20 / 15 min.
CPS Facility 1:2 to 1:3	$7.39 / 15 min.
CPS Facility 1:4 to 1:6	$5.65 / 15 min.
CPS Facility 1:7 to 1:10	$3.43 / 15 min.
CPS Facility 2:1	$25.67 / 15 min.
CPS Facility 2:1 Enhcd	$30.94 / 15 min.
CPS Facility 2:1 Enhcd LPN	$30.94 / 15 min.
CPS Facility 2:1 Enhcd RN	$30.94 / 15 min.
CPS:Community OnCall/Remote Support	$1.77 / 15 min.
In-Home & Commnty Supprts (Lvl 2 Enh)	$15.31 / 15 min.
In-Home & Commnty Supprts (Lvl 2)	$11.10 / 15 min.
Licen Day Hab., Older Adult Daily Living Centers	$4.02 / 15 min.
Music Therapy (1:1)	$18.81 / 15 min.
Res Hab-1 Person-NG 4-Elig	$1,185.86 / 1 Day
Res Hab-1 Person-NG 4-Elig-w/Day Supports	$871.56 / 1 Day
Res Hab-1 Person-NG5-Elig	$1,754.51 / 1 Day
Res Hab-1 Person-NG5-Elig-w/Day Supports	$1,341.85 / 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-4 Person-NG 1-Elig-w/Day Supports	$245.99 / 1 Day
Res Hab-4 Person-NG 2-Elig-w/Day Supports	$284.31 / 1 Day
Res Hab-4 Person-NG 3-Elig-w/Day Supports	$362.42 / 1 Day
Res Hab-4 Person-NG 4-Elig-w/Day Supports	$398.69 / 1 Day
Res Hab-Lic-1 Person-Inelig	$93.64 / 1 Day
Res Hab-Lic-3 Person-Inelig	$35.47 / 1 Day
Res Hab-Lic-4 Person-Elig-NG 1	$322.49 / 1 Day
Res Hab-Lic-4 Person-Elig-NG 2	$367.82 / 1 Day
Res Hab-Lic-4 Person-Elig-NG 3	$425.56 / 1 Day
Res Hab-Lic-4 Person-Elig-NG 4	$510.56 / 1 Day
Res Hab-Lic-4 Person-Inelig	$27.15 / 1 Day
Respite Base-Emerg Lic 6400 24 Hrs Lvl 2 Enh-TD U2	Not Set
Respite Base-Emerg Lic 6400 24 Hrs Lvl 2 Enh-TE U2	Not Set
Respite Base-Emerg Lic 6400 24 Hrs Lvl 3 Enh-TD U2	Not Set
Respite Base-Emerg Lic 6400 24 Hrs Lvl 3 Enh-TE U2	Not Set
Respite, Base-Emerg Licen 6400 24 Hrs Basic-U2	Not Set
Respite, Base-Emerg Licen 6400 24 Hrs Lvl 1-U2	Not Set
Respite, Base-Emerg Licen 6400 24 Hrs Lvl 2 Enh-U2	Not Set
Respite, Base-Emerg Licen 6400 24 Hrs Lvl 2-U2	Not Set
Respite, Base-Emerg Licen 6400 24 Hrs Lvl 3 Enh-U2	Not Set
Respite, Base-Emerg Licen 6400 24 Hrs Lvl 3-U2	Not Set
Respite-Base Out-of-Home 24 Hours (Basic)-Day	Not Set
Respite-Base Out-of-Home 24 Hours (Level 1)-Day	Not Set
Respite-Base Out-of-Home 24 Hours (Level 2 Enh)	Not Set
Respite-Base Out-of-Home 24 Hours (Level 2 Enh)-TD	Not Set
Respite-Base Out-of-Home 24 Hours (Level 2 Enh)-TE	Not Set
Respite-Base Out-of-Home 24 Hours (Level 2)-Day	Not Set
Respite-Base Out-of-Home 24 Hours (Level 3 Enh)	Not Set
Respite-Base Out-of-Home 24 Hours (Level 3 Enh)-TD	Not Set
Respite-Base Out-of-Home 24 Hours (Level 3 Enh)-TE	Not Set
Respite-Base Out-of-Home 24 Hours (Level 3)	Not Set
Respite-Lic-Day-1 person-NG 3	$906.68 / 1 Day
Respite-Lic-Day-1 person-NG 3-ECS	Not Set
Respite-Lic-Day-1 person-NG 3-Emergency	$906.68 / 1 Day
Respite-Lic-Day-1 person-NG 3-Emergency-ECS	Not Set
Respite-Lic-Day-1 person-NG 4	$987.27 / 1 Day
Respite-Lic-Day-1 person-NG 4-ECS	Not Set
Respite-Lic-Day-1 person-NG 4-Emergency	$987.27 / 1 Day
Respite-Lic-Day-1 person-NG 4-Emergency-ECS	Not Set
Respite-Lic-Day-1 person-NG5	$987.25 / 1 Day
Respite-Lic-Day-1 person-NG5-ECS	Not Set
Respite-Lic-Day-1 person-NG5-Emergency	$987.25 / 1 Day
Respite-Lic-Day-1 person-NG5-Emergency-ECS	Not Set
Respite-Lic-Day-2 person-NG 1-Emergency	$503.18 / 1 Day
Respite-Lic-Day-2 person-NG 1-Emergency-ECS	Not Set
Respite-Lic-Day-2 person-NG 2	$616.04 / 1 Day
Respite-Lic-Day-2 person-NG 2-ECS	Not Set
Respite-Lic-Day-2 person-NG 2-Emergency	$616.04 / 1 Day
Respite-Lic-Day-2 person-NG 2-Emergency-ECS	Not Set
Respite-Lic-Day-2 person-NG 3	$738.67 / 1 Day
Respite-Lic-Day-2 person-NG 3-ECS	Not Set
Respite-Lic-Day-2 person-NG 3-Emergency	$738.67 / 1 Day
Respite-Lic-Day-2 person-NG 3-Emergency-ECS	Not Set
Respite-Lic-Day-2 person-NG 4	$800.99 / 1 Day
Respite-Lic-Day-2 person-NG 4-ECS	Not Set
Respite-Lic-Day-2 person-NG 4-Emergency	$800.99 / 1 Day
Respite-Lic-Day-2 person-NG 4-Emergency-ECS	Not Set
Respite-Lic-Day-2 person-NG1	$503.18 / 1 Day
Respite-Lic-Day-2 person-NG1-ECS	Not Set
Respite-Lic-Day-2 person-NG5	$800.99 / 1 Day
Respite-Lic-Day-2 person-NG5-ECS	Not Set
Respite-Lic-Day-2 person-NG5-Emergency	$800.99 / 1 Day
Respite-Lic-Day-2 person-NG5-Emergency-ECS	Not Set
Respite-Lic-Day-3 person-NG 1	$369.73 / 1 Day
Respite-Lic-Day-3 person-NG 1-ECS	Not Set
Respite-Lic-Day-3 person-NG 1-Emergency	$369.73 / 1 Day
Respite-Lic-Day-3 person-NG 1-Emergency-ECS	Not Set
Respite-Lic-Day-3 person-NG 2	$419.25 / 1 Day
Respite-Lic-Day-3 person-NG 2-ECS	Not Set
Respite-Lic-Day-3 person-NG 2-Emergency	$419.25 / 1 Day
Respite-Lic-Day-3 person-NG 2-Emergency-ECS	Not Set
Respite-Lic-Day-3 person-NG 3	$524.92 / 1 Day
Respite-Lic-Day-3 person-NG 3-ECS	Not Set
Respite-Lic-Day-3 person-NG 3-Emergency	$524.92 / 1 Day
Respite-Lic-Day-3 person-NG 3-Emergency-ECS	Not Set
Respite-Lic-Day-3 person-NG 4	$570.64 / 1 Day
Respite-Lic-Day-3 person-NG 4-ECS	Not Set
Respite-Lic-Day-3 person-NG 4-Emergency	$570.64 / 1 Day
Respite-Lic-Day-3 person-NG 4-Emergency-ECS	Not Set
Respite-Lic-Day-3 person-NG5	$570.64 / 1 Day
Respite-Lic-Day-3 person-NG5-ECS	Not Set
Respite-Lic-Day-3 person-NG5-Emergency	$570.64 / 1 Day
Respite-Lic-Day-3 person-NG5-Emergency-ECS	Not Set
Respite-Unlic-Day (Basic 1:4) Out-of-Home	$97.84 / 1 Day
Respite-Unlic-Day (Basic 1:4) Out-of-Home-ECS	Not Set
Respite-Unlic-Day (Level 1, 1:3) Out-of-Home	$128.64 / 1 Day
Respite-Unlic-Day (Level 1, 1:3) Out-of-Home-ECS	Not Set
Respite-Unlic-Day (Level 2, 1:2) Out-of-Home	$190.26 / 1 Day
Respite-Unlic-Day (Level 2, 1:2) Out-of-Home-ECS	Not Set
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) Out-of-Home	$343.22 / 1 Day
Respite-Unlic-Day (Level 3, 1:1) Out-of-Home-ECS	Not Set
Respite-Unlic-Day (Level 4, 2:1) ECS-Out-of-Home	Not Set
Respite-Unlic-Day (Level 4, 2:1) Out-of-Home	$681.46 / 1 Day
Respite-Unlic-Day(Level 3, 1:1 Enh)Out-of-Home-ECS	Not Set
Respite-Unlic-Day(Level 3, 1:1 Enh)OutofHme-ECS-TD	Not Set
Respite-Unlic-Day(Level 3, 1:1 Enh)OutofHme-ECS-TE	Not Set
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
Respite-Unlic-Day(Lvl 4-2:1 Enh)Out-of-Home-ECS-TD	Not Set
Respite-Unlic-Day(Lvl 4-2:1 Enhcd)Out-of-Home-ECS	Not Set
Supplemental Habilitation 1:1 - 15 min	$6.12 / 15 min.
Supported Living-1 Person-NG1	$160.19 / 1 Day
Supported Living-1 Person-NG2	$268.46 / 1 Day
Supported Living-1 Person-NG3	$428.64 / 1 Day
Supported Living-1 Person-NG4	$576.34 / 1 Day
Supported Living-1 Person-NG5	$576.34 / 1 Day
Supported Living-2 Person-NG1	$112.14 / 1 Day
Supported Living-2 Person-NG2	$214.77 / 1 Day
Supported Living-2 Person-NG3	$358.94 / 1 Day
Supported Living-2 Person-NG4	$576.34 / 1 Day
Supported Living-2 Person-NG5	$576.34 / 1 Day
Supported Living-3 Person-NG1	$80.09 / 1 Day
Supported Living-3 Person-NG2	$142.24 / 1 Day
Supported Living-3 Person-NG3	$249.17 / 1 Day
Supported Living-3 Person-NG4	$401.19 / 1 Day
Supported Living-3 Person-NG5	$401.19 / 1 Day
Transportation(Zone 1)-Trip	$36.54 / Trip
Transportation(Zone 2)-Trip	$65.78 / Trip
Transportation(Zone 3)-Trip	$74.73 / Trip

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

Behavioral Supports-Level 1-Initial/Ongoing	$23.85 / 15 min.
Supported Living-2 Person-NG1	$112.14 / 1 Day
Supported Living-2 Person-NG2	$214.77 / 1 Day
Supported Living-2 Person-NG3	$358.94 / 1 Day
Supported Living-2 Person-NG4	$576.34 / 1 Day
Supported Living-2 Person-NG5	$576.34 / 1 Day
Supported Living-3 Person-NG1	$80.09 / 1 Day
Supported Living-3 Person-NG2	$142.24 / 1 Day
Supported Living-3 Person-NG3	$249.17 / 1 Day
Supported Living-3 Person-NG4	$401.19 / 1 Day
Supported Living-3 Person-NG5	$401.19 / 1 Day
Transportation(Zone 1)-Trip	$36.54 / Trip
Transportation(Zone 2)-Trip	$65.78 / Trip
Transportation(Zone 3)-Trip	$74.73 / Trip

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

Behavioral Supports-Level 1-Initial/Ongoing	$23.85 / 15 min.
CPS Community 1:1	$13.83 / 15 min.
CPS Community 1:2 or 1:3	$7.54 / 15 min.
CPS Community 2:1	$26.59 / 15 min.
CPS Community 2:3	$11.26 / 15 min.
CPS Facility 1:1	$13.39 / 15 min.
CPS Facility 1:1 Enhanced	$18.65 / 15 min.
CPS Facility 1:1 Enhcd LPN	$18.65 / 15 min.
CPS Facility 1:1 Enhcd RN	$18.65 / 15 min.
CPS Facility 1:11 to 1:15	$3.20 / 15 min.
CPS Facility 1:2 to 1:3	$7.39 / 15 min.
CPS Facility 1:4 to 1:6	$5.65 / 15 min.
CPS Facility 1:7 to 1:10	$3.43 / 15 min.
CPS Facility 2:1	$25.67 / 15 min.
CPS Facility 2:1 Enhcd	$30.94 / 15 min.
CPS Facility 2:1 Enhcd LPN	$30.94 / 15 min.
CPS Facility 2:1 Enhcd RN	$30.94 / 15 min.
CPS:Community OnCall/Remote Support	$1.77 / 15 min.
Music Therapy (1:1)	$18.81 / 15 min.
Res Hab-1 Person-NG 1-Elig	$554.38 / 1 Day
Res Hab-1 Person-NG 1-Elig-w/Day Supports	$433.05 / 1 Day
Res Hab-1 Person-NG 2-Elig	$643.34 / 1 Day
Res Hab-1 Person-NG 2-Elig-w/Day Supports	$545.91 / 1 Day
Res Hab-1 Person-NG 3-Elig	$980.38 / 1 Day
Res Hab-1 Person-NG 3-Elig-w/Day Supports	$790.99 / 1 Day
Res Hab-1 Person-NG 4-Elig	$1,185.86 / 1 Day
Res Hab-1 Person-NG 4-Elig-w/Day Supports	$871.56 / 1 Day
Res Hab-1 Person-NG5-Elig	$1,754.51 / 1 Day
Res Hab-1 Person-NG5-Elig-w/Day Supports	$1,341.85 / 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-Lic-1 Person-Inelig	$93.64 / 1 Day
Res Hab-Lic-3 Person-Inelig	$35.47 / 1 Day
Supplemental Habilitation 1:1 - 15 min	$6.12 / 15 min.
Supplemental Habilitation 2:1 - 15 min	$12.22 / 15 min.
Supported Living-2 Person-NG1	$112.14 / 1 Day
Supported Living-2 Person-NG2	$214.77 / 1 Day
Supported Living-2 Person-NG3	$358.94 / 1 Day
Supported Living-2 Person-NG4	$576.34 / 1 Day
Supported Living-2 Person-NG5	$576.34 / 1 Day
Supported Living-3 Person-NG1	$80.09 / 1 Day
Supported Living-3 Person-NG2	$142.24 / 1 Day
Supported Living-3 Person-NG3	$249.17 / 1 Day
Supported Living-3 Person-NG4	$401.19 / 1 Day
Supported Living-3 Person-NG5	$401.19 / 1 Day
Transportation(Zone 1)-Trip	$36.54 / Trip
Transportation(Zone 2)-Trip	$65.78 / Trip
Transportation(Zone 3)-Trip	$74.73 / Trip

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

Behavioral Supports-Level 1-Initial/Ongoing	$23.85 / 15 min.
Supported Living-2 Person-NG1	$112.14 / 1 Day
Supported Living-2 Person-NG2	$214.77 / 1 Day
Supported Living-2 Person-NG3	$358.94 / 1 Day
Supported Living-2 Person-NG4	$576.34 / 1 Day
Supported Living-2 Person-NG5	$576.34 / 1 Day
Supported Living-3 Person-NG1	$80.09 / 1 Day
Supported Living-3 Person-NG2	$142.24 / 1 Day
Supported Living-3 Person-NG3	$249.17 / 1 Day
Supported Living-3 Person-NG4	$401.19 / 1 Day
Supported Living-3 Person-NG5	$401.19 / 1 Day
Transportation(Zone 1)-Trip	$36.54 / Trip
Transportation(Zone 2)-Trip	$65.78 / Trip
Transportation(Zone 3)-Trip	$74.73 / Trip

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