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PROVIDER DEMOGRAPHIC INFORMATION Supporting line for group header


Name:	WHOLE LIFE SERVICE INC
Address:	1565 E STATE ST HERMITAGE, PA 16148-1824
Phone:	(724) 347-5595
Fax:	(724) 347-5596
E-mail:	dnicastro@wholelifepa.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:	Corporate Office
Name:	Whole Life Services, Inc
Address:	1565 E STATE ST HERMITAGE, PA 16148-1851
Phone:	(724) 347-5595
Fax:	(724) 347-5596

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PROVIDER SERVICES AND RATES Supporting line for group header


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

Companion Services (Level 2)	$7.71 / 15 min.
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-Lic-2 Person-Inelig	$47.38 / 1 Day
Res Hab-Lic-3 Person-Inelig	$33.46 / 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-Unlic-15-min(Level 3, 1:1)In-Home	$7.95 / 15 min.

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

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-Lic-2 Person-Inelig	$47.38 / 1 Day
Res Hab-Lic-3 Person-Inelig	$33.46 / 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-Unlic-15-min(Level 3, 1:1)In-Home	$7.95 / 15 min.

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

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-Lic-2 Person-Inelig	$47.38 / 1 Day
Res Hab-Lic-3 Person-Inelig	$33.46 / 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-Unlic-15-min(Level 3, 1:1)In-Home	$7.95 / 15 min.

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

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-Lic-2 Person-Inelig	$47.38 / 1 Day
Res Hab-Lic-3 Person-Inelig	$33.46 / 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-Unlic-15-min(Level 3, 1:1)In-Home	$7.95 / 15 min.

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

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-Lic-2 Person-Inelig	$47.38 / 1 Day
Res Hab-Lic-3 Person-Inelig	$33.46 / 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-Unlic-15-min(Level 3, 1:1)In-Home	$7.95 / 15 min.

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

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-Lic-2 Person-Inelig	$47.38 / 1 Day
Res Hab-Lic-3 Person-Inelig	$33.46 / 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-Unlic-15-min(Level 3, 1:1)In-Home	$7.95 / 15 min.

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

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-Lic-2 Person-Inelig	$47.38 / 1 Day
Res Hab-Lic-3 Person-Inelig	$33.46 / 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-Unlic-15-min(Level 3, 1:1)In-Home	$7.95 / 15 min.

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

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-Lic-2 Person-Inelig	$47.38 / 1 Day
Res Hab-Lic-3 Person-Inelig	$33.46 / 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-Unlic-15-min(Level 3, 1:1)In-Home	$7.95 / 15 min.

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

CPS Community 1:1	$12.81 / 15 min.
CPS Community 1:1 Enhanced	$17.83 / 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.
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-Lic-1 Person-Inelig	$88.34 / 1 Day
Res Hab-Lic-2 Person-Inelig	$47.38 / 1 Day
Res Hab-Lic-3 Person-Inelig	$33.46 / 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-Unlic-15-min(Level 3, 1:1)In-Home	$7.95 / 15 min.
Small Group Employment (Level 2)-15 min	$6.96 / 15 min.
Supplemental Habilitation 1:1 - 15 min	$5.77 / 15 min.
Supplemental Habilitation 2:1 - 15 min	$11.53 / 15 min.

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

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-Lic-2 Person-Inelig	$47.38 / 1 Day
Res Hab-Lic-3 Person-Inelig	$33.46 / 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-Unlic-15-min(Level 3, 1:1)In-Home	$7.95 / 15 min.

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

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-Lic-2 Person-Inelig	$47.38 / 1 Day
Res Hab-Lic-3 Person-Inelig	$33.46 / 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-Unlic-15-min(Level 3, 1:1)In-Home	$7.95 / 15 min.

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

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-Lic-2 Person-Inelig	$47.38 / 1 Day
Res Hab-Lic-3 Person-Inelig	$33.46 / 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-Unlic-15-min(Level 3, 1:1)In-Home	$7.95 / 15 min.

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

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-Lic-2 Person-Inelig	$47.38 / 1 Day
Res Hab-Lic-3 Person-Inelig	$33.46 / 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-Unlic-15-min(Level 3, 1:1)In-Home	$7.95 / 15 min.

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

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-Lic-2 Person-Inelig	$47.38 / 1 Day
Res Hab-Lic-3 Person-Inelig	$33.46 / 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-Unlic-15-min(Level 3, 1:1)In-Home	$7.95 / 15 min.

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

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-Lic-2 Person-Inelig	$47.38 / 1 Day
Res Hab-Lic-3 Person-Inelig	$33.46 / 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-Unlic-15-min(Level 3, 1:1)In-Home	$7.95 / 15 min.

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

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-Lic-2 Person-Inelig	$47.38 / 1 Day
Res Hab-Lic-3 Person-Inelig	$33.46 / 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-Unlic-15-min(Level 3, 1:1)In-Home	$7.95 / 15 min.

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

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-Lic-2 Person-Inelig	$47.38 / 1 Day
Res Hab-Lic-3 Person-Inelig	$33.46 / 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-Unlic-15-min(Level 3, 1:1)In-Home	$7.95 / 15 min.

County : Crawford
\|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 1)	$5.76 / 15 min.
In-Home & Commnty Supprts (Lvl 2)	$10.28 / 15 min.
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-Lic-2 Person-Inelig	$47.38 / 1 Day
Res Hab-Lic-3 Person-Inelig	$33.46 / 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-Unlic-15-min(Level 3, 1:1)In-Home	$7.95 / 15 min.
Transportation(Zone 1)-Trip	$33.83 / Trip
Transportation(Zone 2)-Trip	$60.91 / Trip

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

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-Lic-2 Person-Inelig	$47.38 / 1 Day
Res Hab-Lic-3 Person-Inelig	$33.46 / 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-Unlic-15-min(Level 3, 1:1)In-Home	$7.95 / 15 min.

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

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-Lic-2 Person-Inelig	$47.38 / 1 Day
Res Hab-Lic-3 Person-Inelig	$33.46 / 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-Unlic-15-min(Level 3, 1:1)In-Home	$7.95 / 15 min.

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

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-Lic-2 Person-Inelig	$47.38 / 1 Day
Res Hab-Lic-3 Person-Inelig	$33.46 / 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-Unlic-15-min(Level 3, 1:1)In-Home	$7.95 / 15 min.

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

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-Lic-2 Person-Inelig	$47.38 / 1 Day
Res Hab-Lic-3 Person-Inelig	$33.46 / 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-Unlic-15-min(Level 3, 1:1)In-Home	$7.95 / 15 min.

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

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-Lic-2 Person-Inelig	$47.38 / 1 Day
Res Hab-Lic-3 Person-Inelig	$33.46 / 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-Unlic-15-min(Level 3, 1:1)In-Home	$7.95 / 15 min.

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

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-Lic-2 Person-Inelig	$47.38 / 1 Day
Res Hab-Lic-3 Person-Inelig	$33.46 / 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-Unlic-15-min(Level 3, 1:1)In-Home	$7.95 / 15 min.

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

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-Lic-2 Person-Inelig	$47.38 / 1 Day
Res Hab-Lic-3 Person-Inelig	$33.46 / 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-Unlic-15-min(Level 3, 1:1)In-Home	$7.95 / 15 min.

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

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-Lic-2 Person-Inelig	$47.38 / 1 Day
Res Hab-Lic-3 Person-Inelig	$33.46 / 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-Unlic-15-min(Level 3, 1:1)In-Home	$7.95 / 15 min.

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

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-Lic-2 Person-Inelig	$47.38 / 1 Day
Res Hab-Lic-3 Person-Inelig	$33.46 / 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-Unlic-15-min(Level 3, 1:1)In-Home	$7.95 / 15 min.

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

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-Lic-2 Person-Inelig	$47.38 / 1 Day
Res Hab-Lic-3 Person-Inelig	$33.46 / 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-Unlic-15-min(Level 3, 1:1)In-Home	$7.95 / 15 min.

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

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-Lic-2 Person-Inelig	$47.38 / 1 Day
Res Hab-Lic-3 Person-Inelig	$33.46 / 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-Unlic-15-min(Level 3, 1:1)In-Home	$7.95 / 15 min.

County : Lawrence
\|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.
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-Lic-1 Person-Inelig	$88.34 / 1 Day
Res Hab-Lic-2 Person-Inelig	$47.38 / 1 Day
Res Hab-Lic-3 Person-Inelig	$33.46 / 1 Day
Respite-Lic-Day-2 person-NG 2	$581.17 / 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-Unlic-15-min(Level 3, 1:1)In-Home	$7.95 / 15 min.
Small Group Employment (Level 3)-15 Mins	$13.15 / 15 min.
Supported Emplymnt-Job Support-1:2	$10.72 / 15 min.
Transportation(Zone 2)-Trip	$60.91 / Trip

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

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-Lic-2 Person-Inelig	$47.38 / 1 Day
Res Hab-Lic-3 Person-Inelig	$33.46 / 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-Unlic-15-min(Level 3, 1:1)In-Home	$7.95 / 15 min.

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

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-Lic-2 Person-Inelig	$47.38 / 1 Day
Res Hab-Lic-3 Person-Inelig	$33.46 / 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-Unlic-15-min(Level 3, 1:1)In-Home	$7.95 / 15 min.

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

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-Lic-2 Person-Inelig	$47.38 / 1 Day
Res Hab-Lic-3 Person-Inelig	$33.46 / 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-Unlic-15-min(Level 3, 1:1)In-Home	$7.95 / 15 min.

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

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-Lic-2 Person-Inelig	$47.38 / 1 Day
Res Hab-Lic-3 Person-Inelig	$33.46 / 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-Unlic-15-min(Level 3, 1:1)In-Home	$7.95 / 15 min.

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

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-Lic-2 Person-Inelig	$47.38 / 1 Day
Res Hab-Lic-3 Person-Inelig	$33.46 / 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-Unlic-15-min(Level 3, 1:1)In-Home	$7.95 / 15 min.

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

Behavioral Supports-Level 1-Initial/Ongoing	$22.08 / 15 min.
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.
Companion Services (Level 1)	$4.42 / 15 min.
Companion Services (Level 2)	$7.71 / 15 min.
In-Home & Commnty Supprts (Lvl 1)	$5.76 / 15 min.
In-Home & Commnty Supprts (Lvl 2)	$10.28 / 15 min.
Licen Day Hab., Older Adult Daily Living Centers	$3.72 / 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
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	$88.34 / 1 Day
Res Hab-Lic-2 Person-Inelig	$47.38 / 1 Day
Res Hab-Lic-3 Person-Inelig	$33.46 / 1 Day
Respite-Base Out-of-Home 24 Hours (Level 1)-Day	Not Set
Respite-Base Out-of-Home 24 Hours (Level 2)-Day	$237.60 / 1 Day
Respite-Lic-Day-2 person-NG 1-Emergency	$474.70 / 1 Day
Respite-Lic-Day-2 person-NG 2	$581.17 / 1 Day
Respite-Lic-Day-2 person-NG 2-Emergency	$581.17 / 1 Day
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-2 person-NG1	$474.70 / 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-Unlic-15-min(Level 3, 1:1)In-Home	$7.95 / 15 min.
Respite-Unlic-15-min(Level 3, 1:1)Out-of-Home	$7.95 / 15 min.
Respite-Unlic-Day (Level 3, 1:1) In-Home	$317.80 / 1 Day
Respite-Unlic-Day (Level 3, 1:1) Out-of-Home	$317.80 / 1 Day
Small Group Employment (Level 2)-15 min	$6.96 / 15 min.
Small Group Employment (Level 3)-15 Mins	$13.15 / 15 min.
Supplemental Habilitation 1:1 - 15 min	$5.77 / 15 min.
Supplemental Habilitation 2:1 - 15 min	$11.53 / 15 min.
Support (Medical Environment) (Level 3)-15 Mins	Not Set
Supported Emplymnt-Career Assessment	$17.91 / 15 min.
Supported Emplymnt-Job Finding/Job Development	$17.91 / 15 min.
Supported Emplymnt-Job Support - 1:1	$17.91 / 15 min.
Supported Emplymnt-Job Support-1:2	$10.72 / 15 min.
Transportation(Zone 1)-Trip	$33.83 / Trip
Transportation(Zone 2)-Trip	$60.91 / Trip
Transportation(Zone 3)-Trip	$69.19 / Trip

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

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-Lic-2 Person-Inelig	$47.38 / 1 Day
Res Hab-Lic-3 Person-Inelig	$33.46 / 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-Unlic-15-min(Level 3, 1:1)In-Home	$7.95 / 15 min.

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

In-Home & Commnty Supprts (Lvl 2)	$10.28 / 15 min.
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-Lic-2 Person-Inelig	$47.38 / 1 Day
Res Hab-Lic-3 Person-Inelig	$33.46 / 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-Unlic-15-min(Level 3, 1:1)In-Home	$7.95 / 15 min.
Small Group Employment (Level 3)-15 Mins	$13.15 / 15 min.
Supplemental Habilitation 1:1 - 15 min	$5.77 / 15 min.
Supported Emplymnt-Career Assessment	$17.91 / 15 min.
Supported Emplymnt-Job Finding/Job Development	$17.91 / 15 min.
Supported Emplymnt-Job Support - 1:1	$17.91 / 15 min.
Supported Emplymnt-Job Support-1:2	$10.72 / 15 min.

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

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-Lic-2 Person-Inelig	$47.38 / 1 Day
Res Hab-Lic-3 Person-Inelig	$33.46 / 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-Unlic-15-min(Level 3, 1:1)In-Home	$7.95 / 15 min.

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

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-Lic-2 Person-Inelig	$47.38 / 1 Day
Res Hab-Lic-3 Person-Inelig	$33.46 / 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-Unlic-15-min(Level 3, 1:1)In-Home	$7.95 / 15 min.

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

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-Lic-2 Person-Inelig	$47.38 / 1 Day
Res Hab-Lic-3 Person-Inelig	$33.46 / 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-Unlic-15-min(Level 3, 1:1)In-Home	$7.95 / 15 min.

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

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-Lic-2 Person-Inelig	$47.38 / 1 Day
Res Hab-Lic-3 Person-Inelig	$33.46 / 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-Unlic-15-min(Level 3, 1:1)In-Home	$7.95 / 15 min.

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

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-Lic-2 Person-Inelig	$47.38 / 1 Day
Res Hab-Lic-3 Person-Inelig	$33.46 / 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-Unlic-15-min(Level 3, 1:1)In-Home	$7.95 / 15 min.

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

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-Lic-2 Person-Inelig	$47.38 / 1 Day
Res Hab-Lic-3 Person-Inelig	$33.46 / 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-Unlic-15-min(Level 3, 1:1)In-Home	$7.95 / 15 min.

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

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-Lic-2 Person-Inelig	$47.38 / 1 Day
Res Hab-Lic-3 Person-Inelig	$33.46 / 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-Unlic-15-min(Level 3, 1:1)In-Home	$7.95 / 15 min.

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

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-Lic-2 Person-Inelig	$47.38 / 1 Day
Res Hab-Lic-3 Person-Inelig	$33.46 / 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-Unlic-15-min(Level 3, 1:1)In-Home	$7.95 / 15 min.

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

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-Lic-2 Person-Inelig	$47.38 / 1 Day
Res Hab-Lic-3 Person-Inelig	$33.46 / 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-Unlic-15-min(Level 3, 1:1)In-Home	$7.95 / 15 min.

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

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-Lic-2 Person-Inelig	$47.38 / 1 Day
Res Hab-Lic-3 Person-Inelig	$33.46 / 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-Unlic-15-min(Level 3, 1:1)In-Home	$7.95 / 15 min.

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