Appendix VIII, RUG IPC Cost Limits
6-2017
Resource Utilization Group (RUG) Individual Plan of Care (IPC) Cost Limits
RUG | Criteria | IPC Cost Limit |
---|---|---|
SE3 | Extensive Services 3 / ADL > 6 | $42,174 |
SE2 | Extensive Services 2 / ADL > 6 | $35,985 |
SE1 | Extensive Services 1 / ADL > 6 | $31,403 |
RAD | Rehabilitation All Levels / ADL 17-18 | $35,505 |
RAC | Rehabilitation All Levels / ADL 14-16 | $31,500 |
RAB | Rehabilitation All Levels / ADL 10-13 | $29,656 |
RAA | Rehabilitation All Levels / ADL 4-9 | $26,223 |
SSC | Special Care / ADL 17-18 | $30,697 |
SSB | Special Care / ADL 15-16 | $29,085 |
SSA | Special Care / ADL 4-14 | $29,023 |
CC2 | Clinically Complex with Depression / ADL 17-18 | $25,291 |
CC1 | Clinically Complex / ADL 17-18 | $24,019 |
CB2 | Clinically Complex with Depression / ADL 12-16 | $23,298 |
CB1 | Clinically Complex / ADL 12-16 | $22,300 |
CA2 | Clinically Complex with Depression / ADL 4-11 | $21,230 |
CA1 | Clinically Complex / ADL 4-11 | $20,029 |
IB2 | Cog. Impairment with Nursing Rehab / ADL 6-10 | $21,261 |
IB1 | Cog. Impairment / ADL 6-10 | $19,902 |
IA2 | Cog. Impairment with Nursing Rehab / ADL 4-5 | $18,277 |
IA1 | Cog. Impairment / ADL 4-5 | $17,396 |
BB2 | Behavior Problem with Nursing Rehab / ADL 6-10 | $20,898 |
BB1 | Behavior Problem / ADL 6-10 | $19,026 |
BA2 | Behavior Problem with Nursing Rehab / ADL 4-5 | $17,956 |
BA1 | Behavior Problem / ADL 4-5 | $16,361 |
PE2 | Physical Function with Nursing Rehab / ADL 16-18 | $22,413 |
PE1 | Physical Function / ADL 16-18 | $21,254 |
PD2 | Physical Function with Nursing Rehab / ADL 11-15 | $21,537 |
PD1 | Physical Function / ADL 11-15 | $20,336 |
PC2 | Physical Function with Nursing Rehab / ADL 9-10 | $19,829 |
PC1 | Physical Function / ADL 9-10 | $19,062 |
PB2 | Physical Function with Nursing Rehab / ADL 6-8 | $18,589 |
PB1 | Physical Function / ADL 6-8 | $17,746 |
PA2 | Physical Function with Nursing Rehab / ADL 4-5 | $16,715 |
PA1 | Physical Function / ADL 4-5 | $15,837 |