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MA_Fee_IPH.OPH3_Renewal_20230101-20230331

Submitted by tomoe.koketsu@… on
File - Approval Letter Media
MA_Fee_IPH.OPH3_Renewal_20230101-20230331
Approval Date
Effective Date
State
Massachusetts
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

MA_Fee_IPH.OPH3_Renewal_20220101-20221231

Submitted by tomoe.koketsu@… on
File - Approval Letter Media
MA_Fee_IPH.OPH3_Renewal_20220101-20221231
Approval Date
Effective Date
State
Massachusetts
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

MA_Fee_BHO2_Renewal_20230101-20230331

Submitted by tomoe.koketsu@… on
File - Approval Letter Media
MA_Fee_BHO2_Renewal_20230101-20230331
Approval Date
Effective Date
State
Massachusetts
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

MA_Fee_BHO_Renewal_20230101-20230331

Submitted by tomoe.koketsu@… on
File - Approval Letter Media
MA_Fee_BHO_Renewal_20230101-20230331
Approval Date
Effective Date
State
Massachusetts
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

MA_Fee_BHI2_Renewal_20230101-20230331

Submitted by tomoe.koketsu@… on
File - Approval Letter Media
MA_Fee_BHI2_Renewal_20230101-20230331
Approval Date
Effective Date
State
Massachusetts
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

IN_Fee_PC.SP.NF.BHO.DS.Oth_New_20240101-20241231

Submitted by tomoe.koketsu@… on
File - Approval Letter Media
IN_Fee_PC.SP.NF.BHO.DS.Oth_New_20240101-20241231
Approval Date
Effective Date
State
Indiana
Payment Type
Fee schedule
Provider Class
Behavioral health outpatient services
Dental services
Nursing facility services
Other
Primary care services
Specialty physician services
Review Type
New
State Rating Period Start Date
Approval Period
Single Rating Period
State Rating Period End Date

IN_Fee_PC.SP.BHO.Oth_New_20240101- 20241231

Submitted by tomoe.koketsu@… on
File - Approval Letter Media
IN_Fee_PC.SP.BHO.Oth_New_20240101-20241231
Approval Date
Effective Date
State
Indiana
Payment Type
Fee schedule
Provider Class
Behavioral health outpatient services
Other
Primary care services
Specialty physician services
Review Type
New
State Rating Period Start Date
Approval Period
Single Rating Period
State Rating Period End Date

IA_Fee_IPH.OPH_Amend_20210701-20220630

Submitted by tomoe.koketsu@… on
File - Approval Letter Media
IA_Fee_IPH.OPH_Amend_20210701-20220630
Approval Date
Effective Date
State
Iowa
Payment Type
Fee schedule
Provider Class
Inpatient hospital service
Outpatient hospital service
Review Type
Amendment
State Rating Period Start Date
Approval Period
Single Rating Period
State Rating Period End Date

IA_Fee_AMC_Amend_20210701- 20220630

Submitted by tomoe.koketsu@… on
File - Approval Letter Media
IA_Fee_AMC_Amend_20210701-20220630
Approval Date
Effective Date
State
Iowa
Payment Type
Fee schedule
Provider Class
Professional services at an academic medical center
Review Type
Amendment
State Rating Period Start Date
Approval Period
Single Rating Period
State Rating Period End Date

DE_Fee_NF_New_20230101-20231231

Submitted by tomoe.koketsu@… on
File - Approval Letter Media
DE_Fee_NF_New_20230101-20231231
Approval Date
Effective Date
State
Delaware
Payment Type
Fee schedule
Provider Class
Nursing facility services
Review Type
New
State Rating Period Start Date
Approval Period
Single Rating Period
State Rating Period End Date
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