"hospital_Vista Behavioral Hospital, LLC" last_updated_ 2023-12-31 version_1 "hospital_Riverside, California" hospital_address 5900 Brockton Avenue license_ 25000476 | CA "To the best of its knowledge and belief, this hospital has included all applicable standard charge information in accordance with the requirements of 45 CFR 180.50, and the information encoded in this machine-readable file is true, accurate, and complete as of the date indicated in this file" description code |1 code|1|type billing_class setting drug_unit_of_measurement drug_type_of_measurement modifiers standard_charge | gross standard_charge|discounted_cash standard_charge|min standard_charge | max standard_charge|[payer_AETNA BEHAVIORAL HEALTH| HMO/PPO] standard_charge|[payer_AETNA BEHAVIORAL HEALTH| HMO/PPO] |percent standard_charge|[payer_AETNA BEHAVIORAL HEALTH| HMO/PPO] |contracting_method additional_payer_notes |[payer_AETNA BEHAVIORAL HEALTH| HMO/PPO] standard_charge|[payer_AETNA MEDICARE| MANAGED MEDICARE] standard_charge|[payer_AETNA MEDICARE| MANAGED MEDICARE] |percent standard_charge|[payer_AETNA MEDICARE| MANAGED MEDICARE] |contracting_method additional_payer_notes |[payer_AETNA MEDICARE| MANAGED MEDICARE] standard_charge|[payer_ALIGNMENT| MANAGED MEDICARE] standard_charge|[payer_ALIGNMENT| MANAGED MEDICARE] |percent standard_charge|[payer_ALIGNMENT| MANAGED MEDICARE] |contracting_method additional_payer_notes |[payer_ALIGNMENT| MANAGED MEDICARE] standard_charge|[payer_BCBS| BLUE CROSS] standard_charge|[payer_BCBS| BLUE CROSS] |percent standard_charge|[payer_BCBS| BLUE CROSS] |contracting_method additional_payer_notes |[payer_BCBS| BLUE CROSS] standard_charge|[payer_BCBS FEP| BLUE CROSS] standard_charge|[payer_BCBS FEP| BLUE CROSS] |percent standard_charge|[payer_BCBS FEP| BLUE CROSS] |contracting_method additional_payer_notes |[payer_BCBS FEP| BLUE CROSS] standard_charge|[payer_BCBS MEDICARE| MANAGED MEDICARE] standard_charge|[payer_BCBS MEDICARE| MANAGED MEDICARE] |percent standard_charge|[payer_BCBS MEDICARE| MANAGED MEDICARE] |contracting_method additional_payer_notes |[payer_BCBS MEDICARE| MANAGED MEDICARE] standard_charge|[payer_BCBS OOS| BLUE CROSS] standard_charge|[payer_BCBS OOS| BLUE CROSS] |percent standard_charge|[payer_BCBS OOS| BLUE CROSS] |contracting_method additional_payer_notes |[payer_BCBS OOS| BLUE CROSS] standard_charge|[payer_BLUE SHIELD MEDICARE| MANAGED MEDICARE] standard_charge|[payer_BLUE SHIELD MEDICARE| MANAGED MEDICARE] |percent standard_charge|[payer_BLUE SHIELD MEDICARE| MANAGED MEDICARE] |contracting_method additional_payer_notes |[payer_BLUE SHIELD MEDICARE| MANAGED MEDICARE] standard_charge|[payer_BLUE SHIELD MHSA| BLUE CROSS] standard_charge|[payer_BLUE SHIELD MHSA| BLUE CROSS] |percent standard_charge|[payer_BLUE SHIELD MHSA| BLUE CROSS] |contracting_method additional_payer_notes |[payer_BLUE SHIELD MHSA| BLUE CROSS] standard_charge|[payer_BLUE SHIELD OF CALIFORNIA| BLUE CROSS] standard_charge|[payer_BLUE SHIELD OF CALIFORNIA| BLUE CROSS] |percent standard_charge|[payer_BLUE SHIELD OF CALIFORNIA| BLUE CROSS] |contracting_method additional_payer_notes |[payer_BLUE SHIELD OF CALIFORNIA| BLUE CROSS] standard_charge|[payer_CARELON| COMMERCIAL] standard_charge|[payer_CARELON| COMMERCIAL] |percent standard_charge|[payer_CARELON| COMMERCIAL] |contracting_method additional_payer_notes |[payer_CARELON| COMMERCIAL] standard_charge|[payer_CARELON| MANAGED MEDICARE] standard_charge|[payer_CARELON| MANAGED MEDICARE] |percent standard_charge|[payer_CARELON| MANAGED MEDICARE] |contracting_method additional_payer_notes |[payer_CARELON| MANAGED MEDICARE] standard_charge|[payer_CAREMORE| MANAGED MEDICARE] standard_charge|[payer_CAREMORE| MANAGED MEDICARE] |percent standard_charge|[payer_CAREMORE| MANAGED MEDICARE] |contracting_method additional_payer_notes |[payer_CAREMORE| MANAGED MEDICARE] standard_charge|[payer_CENTRAL HEALTH PLAN OF CA| MANAGED MEDICARE] standard_charge|[payer_CENTRAL HEALTH PLAN OF CA| MANAGED MEDICARE] |percent standard_charge|[payer_CENTRAL HEALTH PLAN OF CA| MANAGED MEDICARE] |contracting_method additional_payer_notes |[payer_CENTRAL HEALTH PLAN OF CA| MANAGED MEDICARE] standard_charge|[payer_CHAMP VA| VETERANS ADMIN] standard_charge|[payer_CHAMP VA| VETERANS ADMIN] |percent standard_charge|[payer_CHAMP VA| VETERANS ADMIN] |contracting_method additional_payer_notes |[payer_CHAMP VA| VETERANS ADMIN] standard_charge|[payer_CIGNA| HMO/PPO] standard_charge|[payer_CIGNA| HMO/PPO] |percent standard_charge|[payer_CIGNA| HMO/PPO] |contracting_method additional_payer_notes |[payer_CIGNA| HMO/PPO] standard_charge|[payer_COMMERCIAL GENERIC| COMMERCIAL] standard_charge|[payer_COMMERCIAL GENERIC| COMMERCIAL] |percent standard_charge|[payer_COMMERCIAL GENERIC| COMMERCIAL] |contracting_method additional_payer_notes |[payer_COMMERCIAL GENERIC| COMMERCIAL] standard_charge|[payer_DESERT OASIS COMMERICAL| HMO/PPO] standard_charge|[payer_DESERT OASIS COMMERICAL| HMO/PPO] |percent standard_charge|[payer_DESERT OASIS COMMERICAL| HMO/PPO] |contracting_method additional_payer_notes |[payer_DESERT OASIS COMMERICAL| HMO/PPO] standard_charge|[payer_DESERT OASIS MEDICARE| MANAGED MEDICARE] standard_charge|[payer_DESERT OASIS MEDICARE| MANAGED MEDICARE] |percent standard_charge|[payer_DESERT OASIS MEDICARE| MANAGED MEDICARE] |contracting_method additional_payer_notes |[payer_DESERT OASIS MEDICARE| MANAGED MEDICARE] standard_charge|[payer_EPIC MEDICARE| MANAGED MEDICARE] standard_charge|[payer_EPIC MEDICARE| MANAGED MEDICARE] |percent standard_charge|[payer_EPIC MEDICARE| MANAGED MEDICARE] |contracting_method additional_payer_notes |[payer_EPIC MEDICARE| MANAGED MEDICARE] standard_charge|[payer_EXCLUSIVE CARE| HMO/PPO] standard_charge|[payer_EXCLUSIVE CARE| HMO/PPO] |percent standard_charge|[payer_EXCLUSIVE CARE| HMO/PPO] |contracting_method additional_payer_notes |[payer_EXCLUSIVE CARE| HMO/PPO] standard_charge|[payer_FIRST HEALTH| HMO/PPO] standard_charge|[payer_FIRST HEALTH| HMO/PPO] |percent standard_charge|[payer_FIRST HEALTH| HMO/PPO] |contracting_method additional_payer_notes |[payer_FIRST HEALTH| HMO/PPO] standard_charge|[payer_GAB WORKERS COMP| WORKERS COMP] standard_charge|[payer_GAB WORKERS COMP| WORKERS COMP] |percent standard_charge|[payer_GAB WORKERS COMP| WORKERS COMP] |contracting_method additional_payer_notes |[payer_GAB WORKERS COMP| WORKERS COMP] standard_charge|[payer_GEHA| HMO/PPO] standard_charge|[payer_GEHA| HMO/PPO] |percent standard_charge|[payer_GEHA| HMO/PPO] |contracting_method additional_payer_notes |[payer_GEHA| HMO/PPO] standard_charge|[payer_HEALTHNET PPO| HMO/PPO] standard_charge|[payer_HEALTHNET PPO| HMO/PPO] |percent standard_charge|[payer_HEALTHNET PPO| HMO/PPO] |contracting_method additional_payer_notes |[payer_HEALTHNET PPO| HMO/PPO] standard_charge|[payer_HEMET VALLEY GRP MEDICARE| MANAGED MEDICARE] standard_charge|[payer_HEMET VALLEY GRP MEDICARE| MANAGED MEDICARE] |percent standard_charge|[payer_HEMET VALLEY GRP MEDICARE| MANAGED MEDICARE] |contracting_method additional_payer_notes |[payer_HEMET VALLEY GRP MEDICARE| MANAGED MEDICARE] standard_charge|[payer_HMC HEALTHWORKS| HMO/PPO] standard_charge|[payer_HMC HEALTHWORKS| HMO/PPO] |percent standard_charge|[payer_HMC HEALTHWORKS| HMO/PPO] |contracting_method additional_payer_notes |[payer_HMC HEALTHWORKS| HMO/PPO] standard_charge|[payer_HMO OF CALIFORNIA| MANAGED MEDICARE] standard_charge|[payer_HMO OF CALIFORNIA| MANAGED MEDICARE] |percent standard_charge|[payer_HMO OF CALIFORNIA| MANAGED MEDICARE] |contracting_method additional_payer_notes |[payer_HMO OF CALIFORNIA| MANAGED MEDICARE] standard_charge|[payer_HOLMAN GROUP| BLUE CROSS] standard_charge|[payer_HOLMAN GROUP| BLUE CROSS] |percent standard_charge|[payer_HOLMAN GROUP| BLUE CROSS] |contracting_method additional_payer_notes |[payer_HOLMAN GROUP| BLUE CROSS] standard_charge|[payer_HUMANA MEDICARE| MANAGED MEDICARE] standard_charge|[payer_HUMANA MEDICARE| MANAGED MEDICARE] |percent standard_charge|[payer_HUMANA MEDICARE| MANAGED MEDICARE] |contracting_method additional_payer_notes |[payer_HUMANA MEDICARE| MANAGED MEDICARE] standard_charge|[payer_IEHP MEDICARE| MANAGED MEDICARE] standard_charge|[payer_IEHP MEDICARE| MANAGED MEDICARE] |percent standard_charge|[payer_IEHP MEDICARE| MANAGED MEDICARE] |contracting_method additional_payer_notes |[payer_IEHP MEDICARE| MANAGED MEDICARE] standard_charge|[payer_INDIAN HEALTH INC| COMMERCIAL] standard_charge|[payer_INDIAN HEALTH INC| COMMERCIAL] |percent standard_charge|[payer_INDIAN HEALTH INC| COMMERCIAL] |contracting_method additional_payer_notes |[payer_INDIAN HEALTH INC| COMMERCIAL] standard_charge|[payer_INNOVAGE| MANAGED MEDICARE] standard_charge|[payer_INNOVAGE| MANAGED MEDICARE] |percent standard_charge|[payer_INNOVAGE| MANAGED MEDICARE] |contracting_method additional_payer_notes |[payer_INNOVAGE| MANAGED MEDICARE] standard_charge|[payer_INTER VALLEY MEDICARE| MANAGED MEDICARE] standard_charge|[payer_INTER VALLEY MEDICARE| MANAGED MEDICARE] |percent standard_charge|[payer_INTER VALLEY MEDICARE| MANAGED MEDICARE] |contracting_method additional_payer_notes |[payer_INTER VALLEY MEDICARE| MANAGED MEDICARE] standard_charge|[payer_INTERMOUNTAIN HEALTHCARE| COMMERCIAL] standard_charge|[payer_INTERMOUNTAIN HEALTHCARE| COMMERCIAL] |percent standard_charge|[payer_INTERMOUNTAIN HEALTHCARE| COMMERCIAL] |contracting_method additional_payer_notes |[payer_INTERMOUNTAIN HEALTHCARE| COMMERCIAL] standard_charge|[payer_INTERMOUNTAIN HEALTHCARTE| COMMERCIAL] standard_charge|[payer_INTERMOUNTAIN HEALTHCARTE| COMMERCIAL] |percent standard_charge|[payer_INTERMOUNTAIN HEALTHCARTE| COMMERCIAL] |contracting_method additional_payer_notes |[payer_INTERMOUNTAIN HEALTHCARTE| COMMERCIAL] standard_charge|[payer_KAISER MEDICARE| MANAGED MEDICARE] standard_charge|[payer_KAISER MEDICARE| MANAGED MEDICARE] |percent standard_charge|[payer_KAISER MEDICARE| MANAGED MEDICARE] |contracting_method additional_payer_notes |[payer_KAISER MEDICARE| MANAGED MEDICARE] standard_charge|[payer_KAISER PERMANENTE| HMO/PPO] standard_charge|[payer_KAISER PERMANENTE| HMO/PPO] |percent standard_charge|[payer_KAISER PERMANENTE| HMO/PPO] |contracting_method additional_payer_notes |[payer_KAISER PERMANENTE| HMO/PPO] standard_charge|[payer_LOMA LINDA RISK MGNMT| COMMERCIAL] standard_charge|[payer_LOMA LINDA RISK MGNMT| COMMERCIAL] |percent standard_charge|[payer_LOMA LINDA RISK MGNMT| COMMERCIAL] |contracting_method additional_payer_notes |[payer_LOMA LINDA RISK MGNMT| COMMERCIAL] standard_charge|[payer_LOS ANGELES IMD EXCLUDED| MANAGED MEDICAID] standard_charge|[payer_LOS ANGELES IMD EXCLUDED| MANAGED MEDICAID] |percent standard_charge|[payer_LOS ANGELES IMD EXCLUDED| MANAGED MEDICAID] |contracting_method additional_payer_notes |[payer_LOS ANGELES IMD EXCLUDED| MANAGED MEDICAID] standard_charge|[payer_MEDI CAL RIVERSIDE| MEDICAID] standard_charge|[payer_MEDI CAL RIVERSIDE| MEDICAID] |percent standard_charge|[payer_MEDI CAL RIVERSIDE| MEDICAID] |contracting_method additional_payer_notes |[payer_MEDI CAL RIVERSIDE| MEDICAID] standard_charge|[payer_MEDI CAL SAN BERNARDINO| MEDICAID] standard_charge|[payer_MEDI CAL SAN BERNARDINO| MEDICAID] |percent standard_charge|[payer_MEDI CAL SAN BERNARDINO| MEDICAID] |contracting_method additional_payer_notes |[payer_MEDI CAL SAN BERNARDINO| MEDICAID] standard_charge|[payer_MEDI-CAL| MEDICAID] standard_charge|[payer_MEDI-CAL| MEDICAID] |percent standard_charge|[payer_MEDI-CAL| MEDICAID] |contracting_method additional_payer_notes |[payer_MEDI-CAL| MEDICAID] standard_charge|[payer_MEDICAL SHORT DOYLE| MEDICAID] standard_charge|[payer_MEDICAL SHORT DOYLE| MEDICAID] |percent standard_charge|[payer_MEDICAL SHORT DOYLE| MEDICAID] |contracting_method additional_payer_notes |[payer_MEDICAL SHORT DOYLE| MEDICAID] standard_charge|[payer_MEDICARE| MEDICARE] standard_charge|[payer_MEDICARE| MEDICARE] |percent standard_charge|[payer_MEDICARE| MEDICARE] |contracting_method additional_payer_notes |[payer_MEDICARE| MEDICARE] standard_charge|[payer_MHN| HMO/PPO] standard_charge|[payer_MHN| HMO/PPO] |percent standard_charge|[payer_MHN| HMO/PPO] |contracting_method additional_payer_notes |[payer_MHN| HMO/PPO] standard_charge|[payer_MHN MEDICARE| MANAGED MEDICARE] standard_charge|[payer_MHN MEDICARE| MANAGED MEDICARE] |percent standard_charge|[payer_MHN MEDICARE| MANAGED MEDICARE] |contracting_method additional_payer_notes |[payer_MHN MEDICARE| MANAGED MEDICARE] standard_charge|[payer_MISC MANAGED MEDICARE| MANAGED MEDICARE] standard_charge|[payer_MISC MANAGED MEDICARE| MANAGED MEDICARE] |percent standard_charge|[payer_MISC MANAGED MEDICARE| MANAGED MEDICARE] |contracting_method additional_payer_notes |[payer_MISC MANAGED MEDICARE| MANAGED MEDICARE] standard_charge|[payer_MOLINA MARKETPLACE| HMO/PPO] standard_charge|[payer_MOLINA MARKETPLACE| HMO/PPO] |percent standard_charge|[payer_MOLINA MARKETPLACE| HMO/PPO] |contracting_method additional_payer_notes |[payer_MOLINA MARKETPLACE| HMO/PPO] standard_charge|[payer_MOLINA MEDICARE| MANAGED MEDICARE] standard_charge|[payer_MOLINA MEDICARE| MANAGED MEDICARE] |percent standard_charge|[payer_MOLINA MEDICARE| MANAGED MEDICARE] |contracting_method additional_payer_notes |[payer_MOLINA MEDICARE| MANAGED MEDICARE] standard_charge|[payer_MULTIPLAN| COMMERCIAL] standard_charge|[payer_MULTIPLAN| COMMERCIAL] |percent standard_charge|[payer_MULTIPLAN| COMMERCIAL] |contracting_method additional_payer_notes |[payer_MULTIPLAN| COMMERCIAL] standard_charge|[payer_PRIMECARE| HMO/PPO] standard_charge|[payer_PRIMECARE| HMO/PPO] |percent standard_charge|[payer_PRIMECARE| HMO/PPO] |contracting_method additional_payer_notes |[payer_PRIMECARE| HMO/PPO] standard_charge|[payer_PRIMECARE MEDICARE| MANAGED MEDICARE] standard_charge|[payer_PRIMECARE MEDICARE| MANAGED MEDICARE] |percent standard_charge|[payer_PRIMECARE MEDICARE| MANAGED MEDICARE] |contracting_method additional_payer_notes |[payer_PRIMECARE MEDICARE| MANAGED MEDICARE] standard_charge|[payer_PROSPECT MEDICAL GROUP| COMMERCIAL] standard_charge|[payer_PROSPECT MEDICAL GROUP| COMMERCIAL] |percent standard_charge|[payer_PROSPECT MEDICAL GROUP| COMMERCIAL] |contracting_method additional_payer_notes |[payer_PROSPECT MEDICAL GROUP| COMMERCIAL] standard_charge|[payer_REDLANDS COMMTY HOSPITAL| HMO/PPO] standard_charge|[payer_REDLANDS COMMTY HOSPITAL| HMO/PPO] |percent standard_charge|[payer_REDLANDS COMMTY HOSPITAL| HMO/PPO] |contracting_method additional_payer_notes |[payer_REDLANDS COMMTY HOSPITAL| HMO/PPO] standard_charge|[payer_REGAL COMM| HMO/PPO] standard_charge|[payer_REGAL COMM| HMO/PPO] |percent standard_charge|[payer_REGAL COMM| HMO/PPO] |contracting_method additional_payer_notes |[payer_REGAL COMM| HMO/PPO] standard_charge|[payer_REGAL/HERRITAGE MEDICARE| MANAGED MEDICARE] standard_charge|[payer_REGAL/HERRITAGE MEDICARE| MANAGED MEDICARE] |percent standard_charge|[payer_REGAL/HERRITAGE MEDICARE| MANAGED MEDICARE] |contracting_method additional_payer_notes |[payer_REGAL/HERRITAGE MEDICARE| MANAGED MEDICARE] standard_charge|[payer_RIVERSIDE DEPT MENTAL HL| LOCAL GOVT] standard_charge|[payer_RIVERSIDE DEPT MENTAL HL| LOCAL GOVT] |percent standard_charge|[payer_RIVERSIDE DEPT MENTAL HL| LOCAL GOVT] |contracting_method additional_payer_notes |[payer_RIVERSIDE DEPT MENTAL HL| LOCAL GOVT] standard_charge|[payer_RIVERSIDE IMD EXCLUDE| MANAGED MEDICAID] standard_charge|[payer_RIVERSIDE IMD EXCLUDE| MANAGED MEDICAID] |percent standard_charge|[payer_RIVERSIDE IMD EXCLUDE| MANAGED MEDICAID] |contracting_method additional_payer_notes |[payer_RIVERSIDE IMD EXCLUDE| MANAGED MEDICAID] standard_charge|[payer_SAN BERNADINO IMD EXLUDE| MANAGED MEDICAID] standard_charge|[payer_SAN BERNADINO IMD EXLUDE| MANAGED MEDICAID] |percent standard_charge|[payer_SAN BERNADINO IMD EXLUDE| MANAGED MEDICAID] |contracting_method additional_payer_notes |[payer_SAN BERNADINO IMD EXLUDE| MANAGED MEDICAID] standard_charge|[payer_SAN LUIS OBISPO IMD| MANAGED MEDICAID] standard_charge|[payer_SAN LUIS OBISPO IMD| MANAGED MEDICAID] |percent standard_charge|[payer_SAN LUIS OBISPO IMD| MANAGED MEDICAID] |contracting_method additional_payer_notes |[payer_SAN LUIS OBISPO IMD| MANAGED MEDICAID] standard_charge|[payer_SCAN HEALTH PLAN| MANAGED MEDICARE] standard_charge|[payer_SCAN HEALTH PLAN| MANAGED MEDICARE] |percent standard_charge|[payer_SCAN HEALTH PLAN| MANAGED MEDICARE] |contracting_method additional_payer_notes |[payer_SCAN HEALTH PLAN| MANAGED MEDICARE] standard_charge|[payer_TRICARE FOR LIFE| TRICARE] standard_charge|[payer_TRICARE FOR LIFE| TRICARE] |percent standard_charge|[payer_TRICARE FOR LIFE| TRICARE] |contracting_method additional_payer_notes |[payer_TRICARE FOR LIFE| TRICARE] standard_charge|[payer_TRIWEST| TRICARE] standard_charge|[payer_TRIWEST| TRICARE] |percent standard_charge|[payer_TRIWEST| TRICARE] |contracting_method additional_payer_notes |[payer_TRIWEST| TRICARE] standard_charge|[payer_TRIWEST VA CCN| VETERANS ADMIN] standard_charge|[payer_TRIWEST VA CCN| VETERANS ADMIN] |percent standard_charge|[payer_TRIWEST VA CCN| VETERANS ADMIN] |contracting_method additional_payer_notes |[payer_TRIWEST VA CCN| VETERANS ADMIN] standard_charge|[payer_UBH MEDICARE| MANAGED MEDICARE] standard_charge|[payer_UBH MEDICARE| MANAGED MEDICARE] |percent standard_charge|[payer_UBH MEDICARE| MANAGED MEDICARE] |contracting_method additional_payer_notes |[payer_UBH MEDICARE| MANAGED MEDICARE] standard_charge|[payer_UNITED BEHAVIORAL HEALTH| HMO/PPO] standard_charge|[payer_UNITED BEHAVIORAL HEALTH| HMO/PPO] |percent standard_charge|[payer_UNITED BEHAVIORAL HEALTH| HMO/PPO] |contracting_method additional_payer_notes |[payer_UNITED BEHAVIORAL HEALTH| HMO/PPO] standard_charge|[payer_WORKMANS COMP GENERIC| WORKERS COMP] standard_charge|[payer_WORKMANS COMP GENERIC| WORKERS COMP] |percent standard_charge|[payer_WORKMANS COMP GENERIC| WORKERS COMP] |contracting_method additional_payer_notes |[payer_WORKMANS COMP GENERIC| WORKERS COMP] ROOM AND BOARD ADULT PSYCH 124 RC facility Inpatient 2495 800 765 2422 990 per diem 990 per diem 962 per diem 962 per diem 962 per diem 962 per diem 935 per diem 1100 per diem 1094 per diem 1510 per diem 1119 per diem 2422 per diem 955 per diem 1050 per diem 990 per diem 2422 per diem 990 per diem 900 per diem 1200 per diem 1034 per diem 1050 per diem 975 per diem 1200 per diem 2422 per diem 1002 per diem 1002 per diem 2422 per diem 895 per diem 839 per diem 847 per diem 1097 per diem 1135 per diem 2422 per diem 1200 per diem 1043 per diem 1043 per diem 2422 per diem 765 per diem 984 per diem 984 per diem 1097 per diem 1097 per diem 1097 per diem 1097 per diem 781 per diem 814 per diem 942 per diem 2422 per diem ROOM AND BOARD ADULT DETOX 126 RC facility Inpatient 2495 800 765 2422 990 per diem 990 per diem 962 per diem 962 per diem 962 per diem 962 per diem 935 per diem 1100 per diem 1094 per diem 1510 per diem 1119 per diem 2422 per diem 955 per diem 1050 per diem 990 per diem 2422 per diem 990 per diem 900 per diem 1200 per diem 1034 per diem 945 per diem 975 per diem 1200 per diem 2422 per diem 1002 per diem 1002 per diem 2422 per diem 1135 per diem 850 per diem 1200 per diem 1043 per diem 1043 per diem 2422 per diem 765 per diem 984 per diem 984 per diem 781 per diem 781 per diem 942 per diem 2422 per diem ROOM AND BOARD ADULT CD REHAB 128 RC facility Inpatient 2495 650 521 2422 861 per diem 886 per diem 887 per diem 1510 per diem 1017 per diem 2422 per diem 874 per diem 800 per diem 827 per diem 2422 per diem 827 per diem 750 per diem 950 per diem 750 per diem 950 per diem 2422 per diem 905 per diem 950 per diem 910 per diem 910 per diem 521 per diem 900 per diem 900 per diem 781 per diem 781 per diem 887 per diem 2422 per diem INTENSIVE OUTPATIENT PROGRAM PSYCH ADULT PGM 905 RC facility Outpatient 571 350 182 571 278 per diem 278 per diem 182 per diem 217 per diem 217 per diem 217 per diem 308 per diem 301 per diem 317 per diem 315 per diem 571 per diem 182 per diem 182 per diem 297 per diem 571 per diem 182 per diem 182 per diem 300 per diem 278 per diem 571 per diem 300 per diem 182 per diem 350 per diem 260 per diem 302 per diem 182 per diem 237 per diem 400 per diem 300 per diem 182 per diem 571 per diem 278 per diem 571 per diem 571 per diem 530 per diem 182 per diem 378 per diem 182 per diem 182 per diem 262 per diem 350 per diem 300 per diem 300 per diem 571 per diem 231 per diem 242 per diem 242 per diem 182 per diem 182 per diem 182 per diem 182 per diem 239 per diem 239 per diem 571 per diem TELEHEALTH INTENSIVE OUTPATIENT PROGRAM PSYCH 905 RC facility Outpatient 571 350 182 571 278 per diem 278 per diem 182 per diem 217 per diem 217 per diem 217 per diem 308 per diem 301 per diem 317 per diem 315 per diem 571 per diem 182 per diem 182 per diem 297 per diem 571 per diem 182 per diem 182 per diem 300 per diem 278 per diem 571 per diem 300 per diem 182 per diem 350 per diem 260 per diem 302 per diem 182 per diem 237 per diem 400 per diem 300 per diem 182 per diem 571 per diem 278 per diem 571 per diem 571 per diem 530 per diem 182 per diem 378 per diem 182 per diem 182 per diem 262 per diem 350 per diem 300 per diem 300 per diem 571 per diem 231 per diem 242 per diem 242 per diem 182 per diem 182 per diem 182 per diem 182 per diem 239 per diem 239 per diem 571 per diem INTENSIVE OUTPATIENT PROGRAM CD ADULT PGM 906 RC facility Outpatient 571 350 182 571 278 per diem 278 per diem 182 per diem 217 per diem 217 per diem 217 per diem 308 per diem 301 per diem 317 per diem 315 per diem 571 per diem 182 per diem 182 per diem 297 per diem 571 per diem 182 per diem 182 per diem 300 per diem 278 per diem 571 per diem 300 per diem 182 per diem 350 per diem 260 per diem 302 per diem 182 per diem 237 per diem 400 per diem 300 per diem 182 per diem 571 per diem 571 per diem 571 per diem 182 per diem 378 per diem 182 per diem 182 per diem 262 per diem 350 per diem 300 per diem 300 per diem 571 per diem 231 per diem 242 per diem 242 per diem 182 per diem 182 per diem 182 per diem 182 per diem 239 per diem 239 per diem 571 per diem TELEHEALTH INTENSIVE OUTPATIENT PROGRAM CD 906 RC facility Outpatient 571 350 182 571 278 per diem 278 per diem 182 per diem 217 per diem 217 per diem 217 per diem 308 per diem 301 per diem 317 per diem 315 per diem 571 per diem 182 per diem 182 per diem 297 per diem 571 per diem 182 per diem 182 per diem 300 per diem 278 per diem 571 per diem 300 per diem 182 per diem 350 per diem 260 per diem 302 per diem 182 per diem 237 per diem 400 per diem 300 per diem 182 per diem 571 per diem 571 per diem 571 per diem 182 per diem 378 per diem 182 per diem 182 per diem 262 per diem 350 per diem 300 per diem 300 per diem 571 per diem 231 per diem 242 per diem 242 per diem 182 per diem 182 per diem 182 per diem 182 per diem 239 per diem 239 per diem 571 per diem CD PARTIAL HOSPITAL PROGRAM PROGRAM 912 RC facility Outpatient 860 500 303 860 496 per diem 496 per diem 303 per diem 433 per diem 433 per diem 433 per diem 517 per diem 489 per diem 533 per diem 430 per diem 493 per diem 303 per diem 500 per diem 496 per diem 860 per diem 400 per diem 570 per diem 410 per diem 522 per diem 420 per diem 500 per diem 400 per diem 303 per diem 860 per diem 348 per diem 347 per diem 860 per diem 860 per diem 449 per diem 303 per diem 303 per diem 550 per diem 482 per diem 482 per diem 860 per diem 368 per diem 405 per diem 405 per diem 303 per diem 303 per diem 303 per diem 439 per diem 439 per diem 860 per diem PARTIAL HOSPITAL PROGRAM CD ADULT PGM 912 RC facility Outpatient 860 500 303 860 496 per diem 496 per diem 303 per diem 433 per diem 433 per diem 433 per diem 517 per diem 489 per diem 533 per diem 430 per diem 493 per diem 303 per diem 500 per diem 496 per diem 860 per diem 400 per diem 570 per diem 410 per diem 522 per diem 420 per diem 500 per diem 400 per diem 303 per diem 860 per diem 348 per diem 347 per diem 860 per diem 860 per diem 449 per diem 303 per diem 303 per diem 550 per diem 482 per diem 482 per diem 860 per diem 368 per diem 405 per diem 405 per diem 303 per diem 303 per diem 303 per diem 439 per diem 439 per diem 860 per diem PARTIAL HOSPITAL PROGRAM PSYCH ADULT PGM 912 RC facility Outpatient 860 500 303 860 496 per diem 496 per diem 303 per diem 433 per diem 433 per diem 433 per diem 517 per diem 489 per diem 533 per diem 430 per diem 493 per diem 303 per diem 500 per diem 496 per diem 860 per diem 400 per diem 570 per diem 410 per diem 522 per diem 420 per diem 500 per diem 400 per diem 303 per diem 860 per diem 348 per diem 347 per diem 860 per diem 860 per diem 449 per diem 303 per diem 303 per diem 550 per diem 482 per diem 482 per diem 860 per diem 368 per diem 405 per diem 405 per diem 303 per diem 303 per diem 303 per diem 439 per diem 439 per diem 860 per diem PYSCH PARTIAL HOSPITAL PROGRAM PROGRAM 912 RC facility Outpatient 860 500 303 860 496 per diem 496 per diem 303 per diem 433 per diem 433 per diem 433 per diem 517 per diem 489 per diem 533 per diem 430 per diem 493 per diem 303 per diem 500 per diem 496 per diem 860 per diem 400 per diem 570 per diem 410 per diem 522 per diem 420 per diem 500 per diem 400 per diem 303 per diem 860 per diem 348 per diem 347 per diem 860 per diem 860 per diem 449 per diem 303 per diem 303 per diem 550 per diem 482 per diem 482 per diem 860 per diem 368 per diem 405 per diem 405 per diem 303 per diem 303 per diem 303 per diem 439 per diem 439 per diem 860 per diem TELEHEALTH PARTIAL HOSPITAL PROGRAM CD 912 RC facility Outpatient 860 500 303 860 496 per diem 496 per diem 303 per diem 433 per diem 433 per diem 433 per diem 517 per diem 489 per diem 533 per diem 430 per diem 493 per diem 303 per diem 500 per diem 496 per diem 860 per diem 400 per diem 570 per diem 410 per diem 522 per diem 420 per diem 500 per diem 400 per diem 303 per diem 860 per diem 348 per diem 347 per diem 860 per diem 860 per diem 449 per diem 303 per diem 303 per diem 550 per diem 482 per diem 482 per diem 860 per diem 368 per diem 405 per diem 405 per diem 303 per diem 303 per diem 303 per diem 439 per diem 439 per diem 860 per diem TELEHEALTH PARTIAL HOSPITAL PROGRAM PSYCH 912 RC facility Outpatient 860 500 303 860 496 per diem 496 per diem 303 per diem 433 per diem 433 per diem 433 per diem 517 per diem 489 per diem 533 per diem 430 per diem 493 per diem 303 per diem 500 per diem 496 per diem 860 per diem 400 per diem 570 per diem 410 per diem 522 per diem 420 per diem 500 per diem 400 per diem 303 per diem 860 per diem 348 per diem 347 per diem 860 per diem 860 per diem 449 per diem 303 per diem 303 per diem 550 per diem 482 per diem 482 per diem 860 per diem 368 per diem 405 per diem 405 per diem 303 per diem 303 per diem 303 per diem 439 per diem 439 per diem 860 per diem INTENSIVE OUTPATIENT PROGRAM MCR CD PROC 1 915 RC facility Outpatient 191 0 239 860 517 per diem 430 per diem 860 per diem 303 per diem 303 per diem 860 per diem 303 per diem 303 per diem 303 per diem 303 per diem 400 per diem 303 per diem 830 per diem 303 per diem 303 per diem 303 per diem 303 per diem 550 per diem 482 per diem 482 per diem 405 per diem 405 per diem 303 per diem 303 per diem 303 per diem 303 per diem 239 per diem INTENSIVE OUTPATIENT PROGRAM MCR PSC PROC 1 915 RC facility Outpatient 191 0 239 860 517 per diem 430 per diem 860 per diem 303 per diem 303 per diem 860 per diem 303 per diem 303 per diem 303 per diem 303 per diem 400 per diem 303 per diem 830 per diem 303 per diem 303 per diem 303 per diem 303 per diem 550 per diem 482 per diem 482 per diem 405 per diem 405 per diem 303 per diem 303 per diem 303 per diem 303 per diem 239 per diem MCR PARTIAL HOSPITAL PROGRAM PSY PG 3 915 RC facility Outpatient 223 0 239 860 517 per diem 430 per diem 860 per diem 303 per diem 303 per diem 860 per diem 303 per diem 303 per diem 303 per diem 303 per diem 400 per diem 303 per diem 830 per diem 303 per diem 303 per diem 303 per diem 303 per diem 550 per diem 482 per diem 482 per diem 405 per diem 405 per diem 303 per diem 303 per diem 303 per diem 303 per diem 239 per diem PARTIAL HOSPITAL PROGRAM MCR CD PG 3 915 RC facility Outpatient 223 0 239 860 517 per diem 430 per diem 860 per diem 303 per diem 303 per diem 860 per diem 303 per diem 303 per diem 303 per diem 303 per diem 400 per diem 303 per diem 830 per diem 303 per diem 303 per diem 303 per diem 303 per diem 550 per diem 482 per diem 482 per diem 405 per diem 405 per diem 303 per diem 303 per diem 303 per diem 303 per diem 239 per diem PROCESS GROUP 1 CD 915 RC facility Outpatient 224 0 239 860 517 per diem 430 per diem 860 per diem 303 per diem 303 per diem 860 per diem 303 per diem 303 per diem 303 per diem 303 per diem 400 per diem 303 per diem 830 per diem 303 per diem 303 per diem 303 per diem 303 per diem 550 per diem 482 per diem 482 per diem 405 per diem 405 per diem 303 per diem 303 per diem 303 per diem 303 per diem 239 per diem TH INTENSIVE OUTPATIENT PROGRAM MCR/T MH PRC 915 RC facility Outpatient 191 0 239 860 517 per diem 430 per diem 860 per diem 303 per diem 303 per diem 860 per diem 303 per diem 303 per diem 303 per diem 303 per diem 400 per diem 303 per diem 830 per diem 303 per diem 303 per diem 303 per diem 303 per diem 550 per diem 482 per diem 482 per diem 405 per diem 405 per diem 303 per diem 303 per diem 303 per diem 303 per diem 239 per diem TH INTENSIVE OUTPATIENT PROGRAM MH MCR/T PGP2 915 RC facility Outpatient 190 0 239 860 517 per diem 430 per diem 860 per diem 303 per diem 303 per diem 860 per diem 303 per diem 303 per diem 303 per diem 303 per diem 400 per diem 303 per diem 830 per diem 303 per diem 303 per diem 303 per diem 303 per diem 550 per diem 482 per diem 482 per diem 405 per diem 405 per diem 303 per diem 303 per diem 303 per diem 303 per diem 239 per diem TH MCR PARTIAL HOSPITAL PROGRAM CD PG 3 915 RC facility Outpatient 223 0 239 860 517 per diem 430 per diem 860 per diem 303 per diem 303 per diem 860 per diem 303 per diem 303 per diem 303 per diem 303 per diem 400 per diem 303 per diem 830 per diem 303 per diem 303 per diem 303 per diem 303 per diem 550 per diem 482 per diem 482 per diem 405 per diem 405 per diem 303 per diem 303 per diem 303 per diem 303 per diem 239 per diem TH PARTIAL HOSPITAL PROGRAM CD MC PROC 1 915 RC facility Outpatient 224 0 239 860 517 per diem 430 per diem 860 per diem 303 per diem 303 per diem 860 per diem 303 per diem 303 per diem 303 per diem 303 per diem 400 per diem 303 per diem 830 per diem 303 per diem 303 per diem 303 per diem 303 per diem 550 per diem 482 per diem 482 per diem 405 per diem 405 per diem 303 per diem 303 per diem 303 per diem 303 per diem 239 per diem