HSS Fee Schedule
For a listing of program contact numbers please see the directory listing.
Health Standards Payment Procedure
Health Standards Fee Scale Definitions
Waiver (Home & Community Based) Programs Fee Scale
Program |
Initial |
Renewal |
$/unit |
$/offsite, branch or satellite |
Delinquent Renewal Fee |
CHOW |
Change Name -$ per license printed |
Change Address |
Change Service |
Bed/Capacity Change |
Payment Link |
Abortion Clinic |
600 |
600 |
n/a |
n/a |
100 |
600 |
25 |
600 |
n/a |
n/a |
|
Adult Day Health Care | 600 | 600 | n/a | n/a | 100 | 600 | 25 | 600 | n/a | 25 | |
Adult Brain Injury |
250 |
250 |
n/a |
250 |
100 |
250 |
25 |
250 |
n/a |
25 |
|
Adult Residential Care |
600 |
250 or |
5 |
n/a |
100 |
600 |
25 |
600 |
n/a |
$25 bed decrease; $25 bed increase plus $5 for each additional unit |
|
Ambulatory Surgical Center |
600 |
600 |
n/a |
n/a |
100 |
600 |
25 |
600 |
n/a |
n/a |
ASC Online Applications/ Payments |
Behavioral Health Service Provider | 600 | 600 | 5 | 300 | 100 | 600 | 25 | 600 | 25 | $25 bed decrease; $25 bed increase plus $5 for each additional unit | |
Emergency Medical Transportation |
150 |
100 |
75 |
n/a |
100 |
150 |
25 |
25 |
75/unit |
n/a |
|
End Stage Renal Disease |
600 |
600 |
5/station |
n/a |
100 |
600 |
25 |
600 |
n/a |
n/a |
|
Forensic Supervised Transitional Residential & Aftercare |
250 |
250 |
n/a |
n/a |
100 |
250 |
25 |
250 |
n/a |
n/a |
|
Home Health |
600 |
600 |
n/a |
300 |
100 |
600 |
25 |
*600/300 |
n/a |
n/a |
|
Hospice |
600 |
600 |
5 |
300 outpatient or 600 Inpatient |
100 |
600 |
25 |
*600/300 |
n/a |
n/a |
|
Hospital |
600 |
600 |
5 |
300 |
100 |
600 |
25 |
600 |
n/a |
25 plus $5 for each hospital room over what you already have licensed |
|
Hospital -add Trauma Center |
200 |
200 every 3 years |
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Hospital - add Crisis Receiving Center |
25 |
25 |
|||||||||
ICF/DD |
600 |
600 |
5 |
n/a |
100 |
600 |
25 |
600 |
25 |
$25 bed decrease; $25 bed increase plus $5 for each additional unit |
|
Nursing Home |
600 |
600 |
5 |
n/a |
100 |
600 |
25 |
600 |
n/a |
$25 bed decrease; $25 bed increase plus $5 for each additional unit |
|
Nurse Staffing Agencies |
1200 |
1200 every two (2) years |
n/a |
600 |
100 |
1200 |
25 |
1200 |
n/a |
n/a |
|
Pain Management Clinic |
600 |
600 |
n/a |
n/a |
100 |
600 |
25 |
600 |
n/a |
n/a |
|
Pediatric Day Health Care |
600 |
600 |
n/a |
n/a |
100 |
600 |
25 |
600 |
n/a |
n/a |
|
PRTF (Psychiatric Residential Treatment Facilities) | 600 | 600 | 5 | n/a | 100 | 600 | 25 | 600 | n/a |
$25 bed decrease; $25 bed increase plus $5 for each additional unit |
|
Rural Health Clinic |
600 |
600 |
n/a |
300 if an outpatient department of hospital |
100 |
600 |
25 |
600 |
n/a |
n/a |
|
Therapeutic Group Home | 600 | 600 | 5 | n/a | 100 | 600 | 25 | 600 | n/a |
$25 bed decrease; $25 bed increase plus $5 for each additional unit |