Health Standards 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
600 (see rule)

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

                 

Hospital - add Crisis Receiving Center

25

25

                 

ICF/DD

600

600

5

300

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