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NC_Fee_NF.BHI_Renewal_20240701-20250630

Submitted by rajesh.kolli@t… on
File - Approval Letter Media
NC_Fee_NF.BHI_Renewal_20240701-20250630
Approval Date
Effective Date
State
North Carolina
Payment Type
Fee schedule
Provider Class
Behavioral health inpatient service
Nursing facility services
Review Type
Renewal
State Rating Period Start Date
Approval Period
Single Rating Period
State Rating Period End Date

NC_Fee_HCBS_BHO_Renewal_20240701-20250630

Submitted by rajesh.kolli@t… on
File - Approval Letter Media
NC_Fee_HCBS_BHO_Renewal_20240701-20250630
Approval Date
Effective Date
State
North Carolina
Payment Type
Fee schedule
Provider Class
Behavioral health outpatient services
Review Type
Renewal
State Rating Period Start Date
Approval Period
Single Rating Period
State Rating Period End Date

NC_Fee_BHI_Renewal_20240701-20250630

Submitted by rajesh.kolli@t… on
File - Approval Letter Media
NC_Fee_BHI_Renewal_20240701-20250630
Approval Date
Effective Date
State
North Carolina
Payment Type
Fee schedule
Provider Class
Behavioral health inpatient service
Review Type
Renewal
State Rating Period Start Date
Approval Period
Single Rating Period
State Rating Period End Date

NC_Fee_AMC_Renewal_20230701-20240630

Submitted by rajesh.kolli@t… on
File - Approval Letter Media
NC_Fee_AMC_Renewal_20230701-20240630
Approval Date
Effective Date
State
North Carolina
Payment Type
Fee schedule
Provider Class
Professional services at an academic medical center
Review Type
Renewal
State Rating Period Start Date
Approval Period
Single Rating Period
State Rating Period End Date

MO_Fee_OPH_Renewal_20240701-20250630

Submitted by rajesh.kolli@t… on
File - Approval Letter Media
MO_Fee_OPH_Renewal_20240701-20250630
Approval Date
Effective Date
State
Missouri
Payment Type
Fee schedule
Provider Class
Outpatient hospital service
Review Type
Renewal
State Rating Period Start Date
Approval Period
Single Rating Period
State Rating Period End Date

MO_Fee_IPH_Renewal_20240701-20250630

Submitted by rajesh.kolli@t… on
File - Approval Letter Media
MO_Fee_IPH_Renewal_20240701-20250630
Approval Date
Effective Date
State
Missouri
Payment Type
Fee schedule
Provider Class
Inpatient hospital service
Review Type
Renewal
State Rating Period Start Date
Approval Period
Single Rating Period
State Rating Period End Date

KS_Fee_IPH.OPH3_Renewal_20240101-20241231

Submitted by rajesh.kolli@t… on
File - Approval Letter Media
KS_Fee_IPH.OPH3_Renewal_20240101-20241231
Approval Date
Effective Date
State
Kansas
Payment Type
Fee schedule
Provider Class
Inpatient hospital service
Outpatient hospital service
Review Type
Renewal
State Rating Period Start Date
Approval Period
Single Rating Period
State Rating Period End Date

KS_Fee_AMC_Renewal_20240101-20241231

Submitted by rajesh.kolli@t… on
File - Approval Letter Media
KS_Fee_AMC_Renewal_20240101-20241231
Approval Date
Effective Date
State
Kansas
Payment Type
Fee schedule
Provider Class
Professional services at an academic medical center
Review Type
Renewal
State Rating Period Start Date
Approval Period
Single Rating Period
State Rating Period End Date

IL_Fee_IPH.OPH_Renewal_20240101-20241231

Submitted by rajesh.kolli@t… on
File - Approval Letter Media
IL_Fee_IPH.OPH_Renewal_20240101-20241231
Approval Date
Effective Date
State
Illinois
Payment Type
Fee schedule
Provider Class
Inpatient hospital service
Outpatient hospital service
Review Type
Renewal
State Rating Period Start Date
Approval Period
Single Rating Period
State Rating Period End Date

CA_Fee_IPH.OPH.AMC.PC.SP.NF_Renewal_20240101-20241231

Submitted by rajesh.kolli@t… on
File - Approval Letter Media
CA_Fee_IPH.OPH.AMC.PC.SP.NF_Renewal_20240101-20241231
Approval Date
Effective Date
State
California
Payment Type
Fee schedule
Provider Class
Inpatient hospital service
Nursing facility services
Outpatient hospital service
Primary care services
Professional services at an academic medical center
Specialty physician services
Review Type
Renewal
State Rating Period Start Date
Approval Period
Single Rating Period
State Rating Period End Date
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