Reimbursement rates for hospital and health related services under no-fault for treatment rendered on and after January 1, 1983 (See also CL 1 (1984) on this listing).

April 14, 1983 SUBJECT: INSURANCE CIRCULAR LETTER NO. 6 (1983) WITHDRAWN TO: ALL INSURERS LICENSED TO WRITE AUTOMOBILE INSURANCE IN NEW YORK STATE SUBJECT: Reimbursement Rates for Hospital and Health related services under No-Fault for treatment rendered on and after January 1, 1983. Pursuant to the provisions of 11NYCRR 68.2 (Regulation 83), on and after January 1, 1978, the schedule of all inclusive rates for hospital services and health related services provided in conformance to Section 671(1)(a) of the Insurance Law shall be the rates approved by the Chairman of the Workers" Compensation Board in accordance with the provisions of Chapter 767 of the Laws of 1977 as amended. The attached schedule of rates has been approved by the Chairman, and shall be used by no-fault insurers for payment of hospital outpatient and inpatient services rendered on and after January 1, 1983 through December 31, 1983. Very truly yours, [SIGNATURE] JAMES P. CORCORAN Superintendent of Insurance JPC/bmb Attach. STATE OF NEW YORK WORKERS' COMPENSATION BOARD OFFICE OF THE CHAIRMAN HOSPITAL FEE SCHEDULE Effective January 1, 1983 This revision of the Hospital Fee Schedule Inpatient Rates was recommended and certified by the State Commissioner of Health and approved by the Chairman of the Workers" Compensation Board. Pursuant to Chapter 767, Laws of 1977, as amended by Chapter 536 of the Laws of 1982 and Part 86 of the Commissioner of Health Administrative Rules and Regulations, these rates are for the use in payment of claims under the Workers" Compensation Law and the Volunteer Firemen's Benefit Law. The third column of this schedule applies to emergency service. [SIGNATURE] CHAIRMAN WORKERS' COMPENSATION SCHEDULE OF RATES FOR THE PERIOD JANUARY 1, 1983 THROUGH DECEMBER 31, 1983 Rates for Outpatient Services Room other than operating room when used for minor surgery or emergency treatment: For the medical service provided whether by employed staff, attending staff or by contractual arrangement with the physician groups the fee for this service is the fee as appears on Line 90010 of the Schedule of Medical Fees. For the hospital providing intern or resident staffing or by physician group contractual coverage the total fee is the fee for physician services as appears on Line 90010 of the Schedule of Medical Fees plus the fee for use of the Emergency Service Room as shown in this schedule. When the care is provided by an attending physician, the hospital fee is the Emergency Service Room fee as shown in this schedule, with the physician billing separately. Note: These fees include common or ordinary medications Crutches, mechanical splints and appliances Rental or Sale at Cost Plaster Cast and/or Splint Cost of Plaster Radium and deep therapy A & A * E.K.G., E.E.G., X-ray, P.T., and Laboratory Charges Rates in Schedule of Medical Fees Promulgated by the Chairman Workers" Compensation Board Materials supplied by the Emergency Room (i.e. sterile trays, medications, etc.) over and above those usually included with the Emergency Room visit may be charged for separately. Itemize these on the bill submitted. __________*"Authorization and Arrangement" COMMON OR ORDINARY DRUGS COVERED BY THE EMERGENCY ROOM HOSPITAL RATES A study was undertaken to determine the low-cost drugs which a large number of hospitals in New York State regard as fairly common or ordinary and for which no charges are made apart from the inclusive Emergency Room rates. A partial list of such drugs is furnished below. It is expected that the list will be enlarged or augmented from time to time. In the meanwhile, the drugs shown below or on any future similar list or heretofore regarded as common or ordinary or any additional drugs so regarded should be considered as covered by the applicable Emergency Room rate. No charge should be made for any drugs, whether or not listed hereunder, in connection with hospitalized patients. Current List of "No Charge" Drugs and Pharmaceutical Supplies Acetaminophen 325 mg. tablet Alcohol 70 percent Alcohol swabs Antacid (e.g. Mylanta, Maalox, etc.) Aspirin 325 mg. tablet Aromatic Spirits of Ammonia Atropine 2 percent Ophthalmic Solution Atropine 0.4 mg/ml Bacitracin ointment Castor Oil Calamine lotion Collodion Flexible Cold Cream Clinitest tablets Dibucaine 1 percent ointment (e.g. Nupercainal) Epinephrine Injection Ethyl Chloride spray Gelfoam Glycerin suppository Hematest tablets Hydrocortisone 1 percent ointment Hydrogen Peroxide Iodine Ipecac Syrup Lidocaine 2 percent viscous (e.g. Xylocaine) Lidocaine 1 percent with/without Epinephrine Lidocaine 2 percent with/without Epinephrine Lidocaine 5 percent ointment Lindane lotion (e.g. Kwell) Lubricating jelly Magnesium Sulfate Meperidine injection (e.g. Demerol) Merthiolate Neomycin and Polymyxin B Sulfates w/Hydrocortisone ophthalmic suspension (e.g. Cortisporin) Nitroglycerin 0.4 mg. s. 1. tablet Nitroglycerin 0.6 mg. s. 1. tablet Peppermint Spirit Petrolatum Providone-Iodine solution (e.g. Betadine) Pralidoxime Chloride (e.g. Protopam) Silver Nitrate Sticks Silver Sulfadiazine cream (e.g. Silvadene) Sodium Chloride - injection Sodium Chloride for irrigation Sterile Water for irrigation Talcum powder Tetanus Toxoid Tuberculin PPD (1st and 2nd strength) Witch Hazel Zinc Oxide ointment WORKERS' COMPENSATION HOSPITAL RATE SCHEDULE WESTERN NEW YORK REGION EFFECTIVE 01/01/83 - 12/31/83 EMERGENCY DAILY SERVICE RATE EXCLUSIONS: ROOM RATE ALLEGANY CUBA MEMORIAL HOSPITAL INC $ 259.00 ALL INCLUSIVE $ 27.00 INPATIENT ACUTE CARE MEMORIAL HOSPITAL OF WM F & GERTRUDE F JONES A/K/A JONES MEMORIAL INPATIENT ACUTE CARE $ 232.00 ALL INCLUSIVE $ 26.00 CATTARAUGUS OLEAN GENERAL HOSPITAL INPATIENT ACUTE CARE $ 260.00 A $ 35.00 SALAMANCA HOSPITAL DISTRICT AUTHORITY INPATIENT $ 190.00 ALL INCLUSIVE $ 27.00 ACUTE CARE ST FRANCIS HOSPITAL OF OLEAN INPATIENT ACUTE CARE $ 229.00 B. OTHER: ER PHYS $ 35.00 TRI-COUNTY MEMORIAL HOSPITAL INPATIENT ACUTE CARE $ 228.00 A,B $ 26.00 CHAUTAUQUA BROOKS MEMORIAL HOSPITAL INPATIENT ACUTE CARE $ 248.00 A,B $ 27.00 JAMESTOWN GENERAL HOSPITAL INPATIENT ACUTE CARE $ 236.00 A,B $ 26.00 LAKE SHORE HOSPITAL INC INPATIENT ACUTE CARE $ 208.00 B, OTHER: EKG $ 27.00 WESTFIELD MEMORIAL HOSPITAL INC STRESS TESTING INPATIENT ACUTE CARE $ 244.00 B $ 35.00 WOMANS CHRISTIAN ASSOCIATION INPATIENT ACUTE CARE $ 239.00 A,B $ 27.00 ERIE BERTRAND CHAFFEE HOSPITAL INPATIENT ACUTE CARE $ 227.00 ALL INCLUSIVE $ 26.00 BUFFALO COLUMBUS HOSPITAL INPATIENT ACUTE CARE $ 267.00 ALL INCLUSIVE $ 26.00 BUFFALO GENERAL HOSPITAL INPATIENT ACUTE CARE $ 305.00 A $ 30.00 CHILDRENS HOSPITAL INPATIENT ACUTE CARE $ 375.00 A $ 26.00 ERIE COUNTY MEDICAL CENTER INPATIENT ACUTE CARE $ 378.00 A,B,C,D $ 35.00 KENMORE MERCY HOSPITAL INPATIENT ACUTE CARE $ 229.00 A,OTHER: EKG $ 27.00 LAFAYETTE GENERAL HOSPITAL INPATIENT ACUTE CARE $ 215.00 A,B $ 26.00 MERCY HOSPITAL OF BUFFALO INPATIENT ACUTE CARE $ 245.00 A $ 26.00 MILLARD FILLMORE HOSPITAL INPATIENT ACUTE CARE $ 293.00 A $ 30.00 OUR LADY OF VICTORY HOSPITAL OF LACKAWANNA INPATIENT ACUTE CARE $ 238.00 A,B. OTHER: $ 30.00 ENDOSCOPY, STRESS TESTS-SONOGRAMS, ENDOCARDIOGRAMS, ELECTROMIOGRAPHS ERIE ROSWELL PARK MEMORIAL INSTITUTE INPATIENT ACUTE CARE $ 456.00 ALL INCLUSIVE NO E.R. SERVICE SAINT FRANCIS HOSPITAL OF BUFFALO INPATIENT ACUTE CARE $ 188.00 A $ 27.00 SHEEHAN MEMORIAL EMERGENCY HOSPITAL INC INPATIENT ACUTE CARE $ 239.00 A,B $ 35.00 SHERIDAN PARK HOSPITAL INC INPATIENT ACUTE CARE $ 274.00 A $ 26.00 SISTERS OF CHARITY HOSPITAL INPATIENT ACUTE CARE $ 234.00 A $ 35.00 ST JOSEPH INTERCOMMUNITY HOSPITAL INPATIENT ACUTE CARE $ 201.00 A $ 27.00 GENESEE GENESEE MEMORIAL HOSPITAL INPATIENT ACUTE CARE $ 212.00 A $ 27.00 ST JEROME HOSPITAL INPATIENT ACUTE CARE $ 213.00 A $ 30.00 NIAGARA DEGRAFF MEMORIAL HOSPITAL INPATIENT ACUTE CARE $ 225.00 A $ 26.00 INTER-COMMUNITY MEMORIAL HOSPITAL AT NEWFANE INC INPATIENT ACUTE CARE $ 186.00 A $ 27.00 LOCKPORT MEMORIAL HOSPITAL INPATIENT ACUTE CARE $ 196.00 A,B. OTHER: EKG, $ 30.00 EEG, MOUNT ST MARYS HOSPITAL OF NUCLEAR MEDICINE NIAGARA FALLS INPATIENT ACUTE CARE $ 259.00 A $ 26.00 NIAGARA FALLS MEMORIAL MEDICAL CENTER INPATIENT ACUTE CARE $ 227.00 A $ 35.00 ORLEANS ARNOLD GREGORY MEMORIAL HOSPITAL INPATIENT ACUTE CARE $ 247.00 A $ 26.00 MEDINA MEMORIAL HOSPITAL INPATIENT ACUTE CARE $ 198.00 A,B $ 27.00 WYOMING WYOMING COUNTY COMMUNITY HOSPITAL $ 273.00 A,B $ 30.00 INPATIENT ACUTE CARE WORKERS' COMPENSATION HOSPITAL RATE SCHEDULE ROCHESTER NEW YORK REGION EFFECTIVE 01/01/83 - 12/31/83 DAILY EMERGENCY SERVICE RATE EXCLUSIONS: ROOM RATE CHEMUNG ARNOT-OGDEN MEMORIAL HOSPITAL INPATIENT ACUTE CARE $ 346.00 A,B* $ 30.00 ST JOSEPHS HOSPITAL OF ELMIRA INPATIENT ACUTE CARE $ 263.00 A $ 35.00 LIVINGSTON NICHOLAS H NOYES MEMORIAL HOSPITAL INPATIENT ACUTE CARE $ 234.00 A,B $ 30.00 MONROE GENESEE HOSPITAL INPATIENT ACUTE CARE $ 347.00 A,B $ 35.00 HIGHLAND HOSPITAL INPATIENT ACUTE CARE $ 188.00 A,B $ 35.00 LAKESIDE MEMORIAL HOSPITAL INPATIENT ACUTE CARE $ 118.00 A,B $ 30.00 MONROE COMMUNITY HOSPITAL INPATIENT ACUTE CARE $ 358.00 ALL INCLUSIVE NO E.R. SERVICE PARK RIDGE HOSPITAL INPATIENT ACUTE CARE $ 379.00 A,B,C $ 35.00 ROCHESTER GENERAL HOSPITAL INPATIENT ACUTE CARE $ 367.00 A,B $ 35.00 ST MARYS HOSPITAL OF ROCHESTER INPATIENT ACUTE CARE $ 308.00 A,B,C, OTHER: $ 35.00 EKG STRONG MEMORIAL HOSPITAL ECHOCARDIOGRAMS, STRESS TESTING INPATIENT ACUTE CARE $ 560.00 A,B $ 35.00 ONTARIO CLIFTON SPRINGS HOSPITAL AND CLINIC INPATIENT ACUTE CARE $ 318.00 B, OTHER: EKG $ 35.00 F F THOMPSON HOSPITAL INPATIENT ACUTE CARE $ 126.00 ALL INCLUSIVE $ 35.00 GENEVA GENERAL HOSPITAL INPATIENT ACUTE CARE $ 258.00 A $ 35.00 SCHUYLER SCHUYLER HOSPITAL INPATIENT ACUTE CARE $ 281.00 A,B $ 26.00 SENECA SENECA FALLS HOSPITAL INPATIENT ACUTE CARE $ 329.00 A $ 35.00 WATERLOO MEMORIAL HOSPITAL INC D/B/A TAYLOR-BROWN MEMORIAL HOSP INPATIENT ACUTE CARE $ 151.00 A $ 27.00 STEUBEN BETHESDA HOSPITAL INPATIENT ACUTE CARE $ 210.00 A,B,C $ 27.00 CORNING HOSPITAL INPATIENT ACUTE CARE $ 273.00 A $ 35.00 IRA DAVENPORT MEMORIAL HOSPITAL INC INPATIENT ACUTE CARE $ 265.00 A,C $ 35.00 ST JAMES MERCY HOSPITAL INPATIENT ACUTE CARE $ 235.00 A,B $ 35.00 WAYNE MYERS COMMUNITY HOSPITAL FOUNDATION INC INPATIENT ACUTE CARE $ 188.00 A $ 35.00 NEWARK-WAYNE COMMUNITY HOSPITAL INC INPATIENT ACUTE CARE $ 201.00 A $ 35.00 YATES SOLDIERS AND SAILORS MEMORIAL HOSPITAL OF YATES COUNTY INC INPATIENT ACUTE CARE $ 153.00 A $ 30.00 *EFFECTIVE 7/1/82 -   12/31/83 WORKERS' COMPENSATION HOSPITAL RATE SCHEDULE CENTRAL NEW YORK REGION EFFECTIVE 01/01/83 - 12/31/83 DAILY EMERGENCY SERVICE RATE EXCLUSIONS: ROOM RATE BROOME OUR LADY OF LOURDES MEMORIAL HOSPITAL INPATIENT ACUTE CARE $ 309.00 A,B $ 27.00 UNITED HEALTH SERVICES INC INPATIENT ACUTE CARE $ 406.00 A,B $ 30.00 CAYUGA AUBURN MEMORIAL HOSPITAL INPATIENT ACUTE CARE $ 206.00 A $ 30.00 CHENANGO CHENANGO MEMORIAL HOSPITAL INC INPATIENT ACUTE CARE $ 302.00 A $ 30.00 CORTLAND CORTLAND MEMORIAL HOSPITAL INC INPATIENT ACUTE CARE $ 243.00 A,B,C $ 35.00 HERKIMER HERKIMER MEMORIAL HOSPITAL INC INPATIENT ACUTE CARE $ 197.00 A,B $ 26.00 LITTLE FALLS HOSPITAL INPATIENT ACUTE CARE $ 192.00 A,B,C $ 35.00 MOHAWK VALLEY GENERAL HOSPITAL INPATIENT ACUTE CARE $ 220.00 ALL INCLUSIVE $ 26.00 JEFFERSON CARTHAGE AREA HOSPITAL INC INPATIENT ACUTE CARE $ 236.00 B $ 30.00 EDWARD JOHN NOBLE HOSPITAL OF ALEXANDRIA BAY INPATIENT ACUTE CARE $ 234.00 B $ 27.00 HOUSE OF THE GOOD SAMARITAN INPATIENT ACUTE CARE $ 243.00 A,B $ 35.00 MERCY HOSPITAL OF WATERTOWN INPATIENT ACUTE CARE $ 260.00 A,B $ 35.00 LEWIS LEWIS COUNTY GENERAL HOSPITAL INPATIENT ACUTE CARE $ 322.00 B $ 35.00 MADISON COMMUNITY MEMORIAL HOSPITAL INC INPATIENT ACUTE CARE $ 207.00 A $ 27.00 ONEIDA CITY HOSPITAL INPATIENT ACUTE CARE $ 265.00 A,B $ 27.00 ONEIDA CHILDRENS HOSPITAL AND REHABILITATION CENTER REHABILITATION $ 241.00 A,C,OTHER: EMG, NO E.R. SERVICE Cardiology ONEIDA FAXTON HOSPITAL INPATIENT ACUTE CARE $ 245.00 A,C, OTHER: $ 27.00 EMG, Cardiology ROME HOSPITAL AND MURPHY MEMORIAL HOSPITAL INPATIENT ACUTE CARE $ 232.00 A,C $ 30.00 ROSE HOSPITAL INPATIENT ACUTE CARE $ 248.00 A $ 27.00 ST ELIZABETH HOSPITAL INPATIENT ACUTE CARE $ 328.00 A,B,C $ 35.00 ST LUKES MEMORIAL HOSPITAL CENTER INPATIENT ACUTE CARE $ 269.00 A,C, OTHER: $ 30.00 EKG, EEG ONONDAGA COMMUNITY GENERAL HOSPITAL OF GREATER SYRACUSE INPATIENT ACUTE CARE $ 296.00 A,B,OTHER: $ 35.00 NUCLEAR MEDICINE, NON-INVASIVE VASCULAR LAB CROUSE - IRVING MEMORIAL HOSPITAL INPATIENT ACUTE CARE $ 363.00 A,B,D, OTHER: $ 35.00 CARDIOLOGY, NUCLEAR MEDICINE, PSYCHIATRY, NEUROLOGY ST JOSEPHS HOSPITAL HEALTH CENTER INPATIENT ACUTE CARE $ 339.00 A,B,C, OTHER: $ 27.00 PERIPHERAL VASCULAR LAB, PULMONARY FUNCTION LAB, PATHOLOGY, FROZEN SECTIONS, CARDIO VASCULAR LAB STATE UNIVERSITY HOSPITAL UPSTATE MEDICAL CENTER INPATIENT ACUTE CARE $ 444.00 A,B $ 35.00 OSWEGO ALBERT LINDLEY LEE MEMORIAL HOSPITAL INPATIENT ACUTE CARE $ 244.00 A,B $ 30.00 OSWEGO HOSPITAL INPATIENT ACUTE CARE $ 231.00 A $ 35.00 ST LAWRENCE A BARTON HEPBURN HOSPITAL INPATIENT ACUTE CARE $ 295.00 A $ 27.00 CANTON-POTSDAM HOSPITAL INPATIENT ACUTE CARE $ 252.00 A $ 27.00 CLIFTON-FINE HOSPITAL INPATIENT ACUTE CARE $ 351.00 ALL INCLUSIVE $ 26.00 EDWARD JOHN NOBLE HOSPITAL OF GOUVERNEUR INPATIENT ACUTE CARE $ 286.00 ALL INCLUSIVE $ 30.00 MASSENA MEMORIAL HOSPITAL INPATIENT ACUTE CARE $ 258.00 A $ 27.00 TIOGA TIOGA GENERAL HOSPITAL INPATIENT ACUTE CARE $ 372.00 A $ 35.00 TOMPKINS TOMPKINS COUNTY HOSPITAL INPATIENT ACUTE CARE $ 238.00 A,B $ 35.00 WORKERS' COMPENSATION HOSPITAL RATE SCHEDULE NORTHEASTERN NEW YORK REGION EFFECTIVE 01/01/83 - 12/31/83 DAILY EMERGENCY SERVICE RATE EXCLUSIONS: ROOM RATE ALBANY ALBANY MEDICAL CENTER HOSPITAL INPATIENT ACUTE CARE $ 400.00 A,B, OTHER: $ 35.00 ULTRASOUND CHILDS HOSPITAL INPATIENT ACUTE CARE $ 246.00 A NO E.R. SERVICE COHOES MEMORIAL HOSPITAL INPATIENT ACUTE CARE $ 218.00 A,B,C $ 35.00 MEMORIAL HOSPITAL OF ALBANY INPATIENT ACUTE CARE $ 269.00 A,B,C, OTHER: $ 35.00 ULTRASOUND, NUCLEAR MEDICINE ST PETERS HOSPITAL INPATIENT ACUTE CARE $ 266.00 A,B $ 35.00 CLINTON CHAMPLAIN VALLEY PHYSICIANS HOSPITAL MEDICAL CTR INPATIENT ACUTE CARE $ 201.00 A,B, OTHER: EKG $ 27.00 COLUMBIA COLUMBIA MEMORIAL HOSPITAL INPATIENT ACUTE CARE $ 262.00 B $ 30.00 DELAWARE A LINDSAY & OLIVE B OCONNOR HOSPITAL INPATIENT ACUTE CARE $ 347.00 A,C $ 26.00 COMMUNITY HOSPITAL OF STAMFORD INPATIENT ACUTE CARE $ 231.00 A $ 26.00 DELAWARE VALLEY HOSPITAL INC INPATIENT ACUTE CARE $ 327.00 ALL INCLUSIVE $ 26.00 MARGARETVILLE MEMORIAL HOSPITAL INPATIENT ACUTE CARE $ 411.00 ALL INCLUSIVE $ 30.00 THE HOSPITAL INPATIENT ACUTE CARE $ 237.00 A,B, OTHER: $ 30.00 ULTRASOUND, ELECTRO- CARDIOLOGY ESSEX ELIZABETHTOWN COMMUNITY HOSPITAL INPATIENT ACUTE CARE $ 235.00 B, OTHER: $ 30.00 ELECTROCARDIOLOGY MOSES LUDINGTON HOSPITAL INPATIENT ACUTE CARE $ 422.00 ALL INCLUSIVE $ 35.00 PLACID MEMORIAL HOSPITAL INC INPATIENT ACUTE CARE $ 348.00 B $ 26.00 FRANKLIN ALICE HYDE MEMORIAL HOSPITAL INPATIENT ACUTE CARE $ 191.00 B $ 26.00 GENERAL HOSPITAL OF SARANAC LAKE INPATIENT ACUTE CARE $ 204.00 A,B,C $ 27.00 MERCY GENERAL HOSPITAL OF TUPPER LAKE INPATIENT ACUTE CARE $ 214.00 B NO E.R. SERVICE FULTON JOHNSTOWN HOSPITAL INPATIENT ACUTE CARE $ 213.00 A,C $ 35.00 NATHAN LITTAUER HOSPITAL INPATIENT ACUTE CARE $ 234.00 A,B,C $ 30.00 GREENE MEMORIAL HOSPITAL OF GREENE COUNTY INPATIENT ACUTE CARE $ 282.00 B,C $ 35.00 MONTGOMERY AMSTERDAM MEMORIAL HOSPITAL INPATIENT ACUTE CARE $ 244.00 A,C $ 27.00 ST MARYS HOSPITAL AT AMSTERDAM INPATIENT ACUTE CARE $ 268.00 A,C $ 35.00 OTSEGO AURELIA OSBORN FOX MEMORIAL HOSPITAL INPATIENT ACUTE CARE $ 264.00 A,B,C $ 35.00 MARY IMOGENE BASSETT HOSPITAL INPATIENT ACUTE CARE $ 440.00 ALL INCLUSIVE $ 30.00 RENSSELAER LEONARD HOSPITAL INPATIENT ACUTE CARE $ 235.00 A,B,C $ 35.00 SAMARITAN HOSPITAL OF TROY INPATIENT ACUTE CARE $ 227.00 A,B $ 30.00 ST MARYS HOSPITAL OF TROY INPATIENT ACUTE CARE $ 232.00 A,B,C $ 30.00 SARATOGA ADIRONDACK REGIONAL HOSPITAL INPATIENT ACUTE CARE $ 245.00 B $ 26.00 SARATOGA HOSPITAL INPATIENT ACUTE CARE $ 269.00 A,B $ 35.00 SCHENECTADY BELLEVUE MATERNITY HOSPITAL INC INPATIENT ACUTE CARE $ 312.00 A NO E.R. SERVICE ELLIS HOSPITAL INPATIENT ACUTE CARE $ 351.00 A,B,C, OTHER: $ 35.00 NUCLEAR MEDICINE, SPEC. HEMATOLOGY LAB ST CLARES HOSPITAL OF SCHENECTADY INPATIENT ACUTE CARE $ 307.00 A,B, OTHER: NUCLEAR $ 30.00 MEDICINE, GASTROENTEROLOGY PROCTOLOGY SUNNYVIEW HOSPITAL AND REHABILITATION CENTER INPATIENT ACUTE CARE $ 220.00 A,B,C,D NO E.R. SERVICE SCHOHARIE COMMUNITY HOSPITAL OF SCHOHARIE COUNTY INC INPATIENT ACUTE CARE $ 254.00 C $ 35.00 WARREN GLENS FALLS HOSPITAL INPATIENT ACUTE CARE $ 248.00 A,B, OTHER: EMG $ 27.00 WASHINGTON EMMA LAING STEVENS HOSPITAL INPATIENT ACUTE CARE $ 208.00 ALL INCLUSIVE $ 35.00 MARY MCCLELLAN HOSPITAL INPATIENT ACUTE CARE $ 251.00 C $ 35.00 WORKERS' COMPENSATION HOSPITAL RATE SCHEDULE NORTHERN METROPOLITAN REGION EFFECTIVE 01/01/83 - 12/31/83 DAILY EMERGENCY SERVICE RATE EXCLUSIONS: ROOM RATE DUTCHESS HIGHLAND HOSPITAL OF BEACON INPATIENT ACUTE CARE $ 273.00 A $ 27.00 NORTHERN DUTCHESS HOSPITAL INPATIENT ACUTE CARE $ 236.00 A $ 35.00 ST FRANCIS HOSPITAL OF POUGHKEEPSIE INPATIENT ACUTE CARE $ 319.00 A,B $ 35.00 VASSAR BROTHERS HOSPITAL INPATIENT ACUTE CARE $ 287.00 A,B, OTHER: $ 30.00 RADIATION THERAPY ORANGE ARDEN HILLHOSPITAL INPATIENT ACUTE CARE $ 300.00 A, OTHER: EMG $ 35.00 CORNWALL HOSPITAL INPATIENT ACUTE CARE $ 274.00 A,B,OTHER: $ 30.00 NUCLEAR MEDICINE, ULTRASOUND DOCTORS SUNNYSIDE HOSPITAL INPATIENT ACUTE CARE $ 238.00 ALL INCLUSIVE $ 30.00 E A HORTON MEMORIAL HOSPITAL INPATIENT ACUTE CARE $ 303.00 A $ 35.00 ST ANTHONY COMMUNITY HOSPITAL INPATIENT ACUTE CARE $ 313.00 A $ 35.00 ST FRANCIS HOSPITAL OF PORT JERVIS NEW YORK INPATIENT ACUTE CARE $ 276.00 A,C $ 26.00 ST LUKES HOSPITAL OF NEWBURGH INPATIENT ACUTE CARE $ 264.00 A $ 30.00 TUXEDO MEMORIAL HOSPITAL INPATIENT ACUTE CARE $ 238.00 A $ 35.00 PUTNAM JULIA BUTTERFIELD MEMORIAL HOSPITAL INPATIENT ACUTE CARE $ 282.00 A,C $ 35.00 PUTNAM COMMUNITY HOSPITAL INPATIENT ACUTE CARE $ 272.00 A $ 27.00 ROCKLAND GOOD SAMARITAN HOSPITAL OF SUFFERN INPATIENT ACUTE CARE $ 344.00 A, OTHER: EMG $ 35.00 HELEN HAYES HOSPITAL INPATIENT ACUTE CARE $ 541.00 ALL INCLUSIVE NO E.R. SERVICE NYACK HOSPITAL INPATIENT ACUTE CARE $ 319.00 A,B $ 27.00 SUMMIT PARK HOSPITAL-ROCKLAND COUNTY INFIRMARY INPATIENT ACUTE CARE $ 217.00 ALL INCLUSIVE NO E.R. SERVICE PSYCHIATRIC CARE $ 177.00 ALL INCLUSIVE NO E.R. SERVICE SULLIVAN COMMUNITY GENERAL HOSPITAL OF SULLIVAN COUNTY - HARRIS INPATIENT ACUTE CARE $ 326.00 A $ 35.00 COMMUNITY GENERAL HOSPITAL OF SULLIVAN COUNTY G HERMAN DIV INPATIENT ACUTE CARE $ 281.00 A $ 35.00 ULSTER BENEDICTINE HOSPITAL INPATIENT ACUTE CARE $ 266.00 A $ 35.00 ELLENVILLE COMMUNITY HOSPITAL INPATIENT ACUTE CARE $ 258.00 ALL INCLUSIVE $ 26.00 KINGSTON HOSPITAL INPATIENT ACUTE CARE $ 249.00 A $ 30.00 WESTCHESTER BLYTHEDALE CHILDRENS HOSPITAL INPATIENT ACUTE CARE $ 314.00 ALL INCLUSIVE NO E.R. SERVICE BURKE REHABILITATION CENTER INPATIENT ACUTE CARE $ 388.00 ALL INCLUSIVE NO E.R. SERVICE DOBBS FERRY HOSPITAL INPATIENT ACUTE CARE $ 229.00 A $ 26.00 LAWRENCE HOSPITAL INPATIENT ACUTE CARE $ 303.00 A $ 35.00 MOUNT VERNON HOSPITAL INPATIENT ACUTE CARE $ 301.00 A $ 30.00 NEW ROCHELLE HOSPITAL MEDICAL CENTER INPATIENT ACUTE CARE $ 385.00 A,B $ 35.00 NEW YORK HOSPITAL-CORNELL MEDICAL CENTER WESTCHESTER DIVISION PSYCHIATRIC CARE $ 325.00 ALL INCLUSIVE NO E.R. SERVICE NORTHERN WESTCHESTER HOSPITAL INPATIENT ACUTE CARE $ 386.00 A,B,C, OTHER: $ 35.00 ULTRASOUND, CATSCANS, RADIATION THERAPY PEEKSKILL HOSPITAL INPATIENT ACUTE CARE $ 297.00 A $ 30.00 PHELPS MEMORIAL HOSPITAL ASSOCIATION INPATIENT ACUTE CARE $ 364.00 A,B,C, OTHER: $ 35.00 NUCLEAR MEDICINE, ULTRASOUND RADIOISOTOPES ST AGNES HOSPITAL INPATIENT ACUTE CARE $ 320.00 A,C $ 35.00 ST JOHNS RIVERSIDE HOSPITAL INPATIENT ACUTE CARE $ 327.00 A, OTHER: EMG $ 26.00 ST JOSEPHS HOSPITAL YONKERS INPATIENT ACUTE CARE $ 288.00 ALL INCLUSIVE $ 35.00 ST VINCENTS HOSP AND MEDICAL CTR OF NY WESTCHESTER BRANCH PSYCHIATRIC CARE $ 272.00 A NO E.R. SERVICE UNITED HOSPITAL INPATIENT ACUTE CARE $ 359.00 A,B $ 30.00 WESTCHESTER COUNTY MEDICAL CENTER INPATIENT ACUTE CARE $ 546.00 A,B,C, OTHER: $ 35.00 ALL PROF. SERVICES WHITE PLAINS HOSPITAL MEDICAL CENTER INPATIENT ACUTE CARE $ 350.00 A,C $ 35.00 YONKERS GENERAL HOSPITAL INPATIENT ACUTE CARE $ 254.00 A,C $ 35.00 WORKERS' COMPENSATION HOSPITAL RATE SCHEDULE LONG ISLAND REGION EFFECTIVE 01/01/83 - 12/31/83 DAILY EMERGENCY SERVICE RATE EXCLUSIONS: ROOM RATE NASSAU CENTRAL GENERAL HOSPITAL INPATIENT ACUTE CARE $ 305.00 A,B $ 35.00 COMMUNITY HOSPITAL AT GLEN COVE INPATIENT ACUTE CARE $ 350.00 A $ 27.00 FRANKLIN GENERAL HOSPITAL INPATIENT ACUTE CARE $ 308.00 A $ 30.00 HEMPSTEAD GENERAL HOSPITAL INPATIENT ACUTE CARE $ 339.00 A, B, C $ 30.00 LONG BEACH MEMORIAL HOSPITAL INPATIENT ACUTE CARE $ 289.00 A $ 30.00 LONG ISLAND JEWISH - HILLSIDE MEDICAL CENTER (MANHASSET DIV.) INPATIENT ACUTE CARE $ 490.00 A, OTHER: CARDIAC $ 35.00 CATHERIZATION LYDIA E HALL HOSPITAL INPATIENT ACUTE CARE $ 317.00 A,B, OTHER: $ 30.00 NUCLEAR MEDICINE MASSAPEQUA GENERAL HOSPITAL INPATIENT ACUTE CARE $ 384.00 A $ 30.00 MERCY HOSPITAL OF ROCKVILLE CENTER INPATIENT ACUTE CARE $ 315.00 A $ 35.00 MID-ISLAND HOSPITAL INPATIENT ACUTE CARE $ 309.00 A,C $ 27.00 NASSAU COUNTY MEDICAL CENTER EAST MEADOW DIV INPATIENT ACUTE CARE $ 513.00 ALL INCLUSIVE $ 30.00 NASSAU HOSPITAL INPATIENT ACUTE CARE $ 366.00 A,B,C $ 35.00 NORTH SHORE UNIVERSITY HOSPITAL INPATIENT ACUTE CARE $ 463.00 A $ 35.00 SOUTH NASSAU COMMUNITIES HOSPITAL INPATIENT ACUTE CARE $ 278.00 A $ 26.00 ST FRANCIS HOSPITAL OF ROSLYN INPATIENT ACUTE CARE $ 464.00 A,C $ 35.00 SUFFOLK BROOKHAVEN MEMORIAL HOSPITAL INPATIENT ACUTE CARE $ 326.00 A,C $ 35.00 BRUNSWICK HOSPITAL CENTER INC INPATIENT ACUTE CARE $ 393.00 A,C, OTHER: EKG, $ 35.00 EEG, ELECTROMYOGRAPHY, NUCLEAR SCANS, SONOGRAMS REHABILITATION $ 385.00 A,C CENTRAL SUFFOLK HOSPITAL ASSOCIATION INPATIENT ACUTE CARE $ 261.00 A $ 27.00 EASTERN LONG ISLAND HOSPITAL INPATIENT ACUTE CARE $ 373.00 A $ 35.00 GOOD SAMARITAN HOSPITAL OF WEST ISLIP INPATIENT ACUTE CARE $ 296.00 A $ 30.00 HUNTINGTON HOSPITAL INPATIENT ACUTE CARE $ 301.00 A, OTHER: DIALYSIS, $ 27.00 CHEMOTHERAPY, RESPIRATORY THERAPY SUFFOLK JOHN T MATHER MEMORIAL HOSPITAL OF PORT JEFFERSON NEW YORK INC INPATIENT ACUTE CARE $ 299.00 A,C $ 35.00 SMITHTOWN GENERAL HOSPITAL INPATIENT ACUTE CARE $ 311.00 A $ 27.00 SOUTHAMPTON HOSPITAL INPATIENT ACUTE CARE $ 334.00 A $ 27.00 SOUTHSIDE HOSPITAL INPATIENT ACUTE CARE $ 301.00 A,C $ 30.00 ST CHARLES HOSPITAL INPATIENT ACUTE CARE $ 309.00 A $ 27.00 ST JOHNS EPISCOPAL HOSPITAL SMITHTOWN INPATIENT ACUTE CARE $ 352.00 A,B,C $ 35.00 UNIVERSITY HOSPITAL OF STONY BROOK INPATIENT ACUTE CARE $ 583.00 A,C $ 35.00 WORKERS' COMPENSATION HOSPITAL RATE SCHEDULE NEW YORK CITY REGION EFFECTIVE 01/01/83 - 12/31/83 DAILY EMERGENCY SERVICE RATE EXCLUSIONS: ROOM RATE ASTORIA GENERAL HOSPITAL INPATIENT ACUTE CARE $ 284.00 A,OTHER:EEG, $ 27.00 NUCLEAR MEDICINE BAPTIST MEDICAL CENTER OF NEW YORK INPATIENT ACUTE CARE $ 368.00 A $ 27.00 BAYLEY SETON HOSPITAL INPATIENT ACUTE CARE $ 710.00 ALL INCLUSIVE $ 35.00 BETH ISRAEL MEDICAL CENTER INPATIENT ACUTE CARE $ 531.00 A,OTHER: $ 35.00 PHYSICIANS SERVICES BOOTH MEMORIAL MEDICAL CENTER INPATIENT ACUTE CARE $ 472.00 A,B $ 35.00 BOULEVARD HOSPITAL INPATIENT ACUTE CARE $ 243.00 A,OTHER: $ 26.00 NUCLEAR BRONX-LEBANON HOSPITAL MEDICINE CENTER INPATIENT ACUTE CARE $ 430.00 A,C $ 30.00 BROOKDALE HOSPITAL MEDICAL CENTER INPATIENT ACUTE CARE $ 412.00 A,C $ 35.00 BROOKLYN HOSPITAL INPATIENT ACUTE CARE $ 489.00 A,OTHER: $ 27.00 RADIOLOGICAL SURGICAL INTERVENTION PROCEDURES PHYSIOTHERAPY CONSULTANTS CABRINI HEALTH CARE CTR INPATIENT ACUTE CARE $ 437.00 A,B,C, OTHER: EEG, $ 35.00 EKG, RADIOISOTOPES, ULTRASOUND CALEDONIAN HOSPITAL OF THE CITY OF NY INPATIENT ACUTE CARE (SEE BROOKLYN HOSPITAL) CALVARY HOSPITAL INPATIENT ACUTE CARE $ 384.00 ALL INCLUSIVE NO E.R. SERVICE CATHOLIC MEDICAL CENTER INPATIENT ACUTE CARE $ 490.00 ALL INCLUSIVE $ 27.00 COMMUNITY HOSPITAL OF BROOKLYN INC. INPATIENT ACUTE CARE $ 318.00 A,OTHER: $ 26.00 NUCLEAR MEDICINE, ULTRASOUND DEEPDALE GENERAL HOSPITAL INPATIENT ACUTE CARE $ 290.00 A,B,C $ 26.00 DOCTORS HOSPITAL INC INPATIENT ACUTE CARE $ 385.00 A,C $ 35.00 DOCTORS HOSPITAL OF STATEN ISLAND INPATIENT ACUTE CARE $ 313.00 A $ 27.00 FLATBUSH GENERAL HOSPITAL INPATIENT ACUTE CARE $ 306.00 A $ 26.00 FLUSHING HOSPITAL AND MEDICAL CENTER INPATIENT ACUTE CARE $ 370.00 A $ 30.00 H I P HOSPITAL INC INPATIENT ACUTE CARE $ 370.00 A $ 35.00 HOSPITAL FOR JOINT DISEASES AND MEDICAL CENTER ORTHOPEDIC INSTITUTE INPATIENT ACUTE CARE $ 718.00 A,C NO E.R. SERVICE HOSPITAL FOR SPECIAL SURGERY INPATIENT ACUTE CARE $ 511.00 A,B NO E.R. SERVICE INSTITUTE OF REHAB MEDICINE NY UNIVERSITY REHABILITATION $ 403.00 A,C,D NO E.R. SERVICE JAMAICA HOSPITAL INPATIENT ACUTE CARE $ 412.00 A,B,D $ 27.00 JEWISH HOSPITAL AND MEDICAL CENTER OF BROOKLYN INPATIENT ACUTE CARE $ 452.00 A $ 35.00 JEWISH MEMORIAL HOSPITAL INPATIENT ACUTE CARE $ 272.00 A $ 35.00 JOINT DISEASES NORTH GENERAL HOSPITAL INPATIENT ACUTE CARE $ 407.00 ALL INCLUSIVE $ 35.00 KINGS HIGHWAY HOSPITAL INPATIENT ACUTE CARE $ 298.00 A,C $ 27.00 KINGSBROOK JEWISH MEDICAL CENTER INPATIENT ACUTE CARE $ 399.00 A,B,C $ 35.00 LENOX HILL HOSPITAL INPATIENT ACUTE CARE $ 468.00 A,C,OTHER: EMG $ 35.00 LONG ISLAND COLLEGE HOSPITAL INPATIENT ACUTE CARE $ 470.00 A,B,C $ 30.00 LONG ISLAND JEWISH-HILLSIDE MED CTR INPATIENT ACUTE CARE $ 490.00 A,B,OTHER: $ 35.00 CARDIAC- CATHERIZATION LUTHERAN MEDICAL CENTER INPATIENT ACUTE CARE $ 381.00 A $ 30.00 MAIMONIDES MEDICAL CENTER INPATIENT ACUTE CARE $ 506.00 A,B $ 35.00 MANHATTAN EYE EAR AND THROAT HOSPITAL INPATIENT ACUTE CARE $ 473.00 A,B,C, OTHER: EKG $ 26.00** MEDICAL ARTS CENTER HOSPITAL INPATIENT ACUTE CARE $ 302.00 A $ 26.00 MEMORIAL HOSPITAL FOR CANCER AND ALLIED DISEASES INPATIENT ACUTE CARE $ 751.00 ALL INCLUSIVE NO E.R. SERVICE METHODIST HOSPITAL OF BROOKLYN INPATIENT ACUTE CARE $ 435.00 A, OTHER: $ 35.00 PSYCHIATRY MISERICORDIA HOSPITAL MEDICAL CENTER INPATIENT ACUTE CARE $ 359.00 A,B,OTHER: CARDIO- $ 35.00 PULMONARY, RENAL MONTEFIORE HOSPITAL & MEDICAL CENTER INPATIENT ACUTE CARE $ 598.00 A,B, OTHER: $ 35.00 NUCLEAR MEDICINE (RADIOISTOPES) MOUNT SINAI HOSPITAL INPATIENT ACUTE CARE $ 577.00 A,B, OTHER: EKG, $ 30.00 NUCLEAR MEDICINE NY EYE AND EAR INFIRMARY INPATIENT ACUTE CARE $ 462.00 A NO E.R. SERVICE NEW YORK HOSPITAL AND PAYNE WHITNEY PSYCHIATRIC CLINIC INPATIENT ACUTE CARE $ 541.00 A,B. OTHER: $ 35.00 SURGICAL PATHOLOGY, CYTOLOGY NY INFIRMARY BEEKMAN DOWNTOWN HOSPITAL INPATIENT ACUTE CARE $ 494.00 ALL INCLUSIVE $ 35.00 NY UNIVERSITY MEDICAL CENTER INPATIENT ACUTE CARE $ 530.00 A,B,C $ 35.00 OSTEOPATHIC HOSPITAL AND CLINIC OF NEW YORK D/B/A HILLCREST GENERAL HOSPITAL INPATIENT ACUTE CARE $ 309.00 A $ 27.00 PARKWAY HOSPITAL INPATIENT ACUTE CARE $ 298.00 A $ 27.00 PARSONS HOSPITAL INPATIENT ACUTE CARE $ 241.00 A,C $ 30.00 PELHAM BAY GENERAL HOSPITAL INPATIENT ACUTE CARE $ 329.00 A,C $ 27.00 PENINSULA HOSPITAL CENTER INPATIENT ACUTE CARE $ 377.00 A,B,C,OTHER: $ 30.00 NUCLEAR MEDICINE, ULTRASOUND RADIATION THERAPY PHYSICIANS HOSPITAL INPATIENT ACUTE CARE $ 278.00 A $ 26.00 PRESBYTERIAN HOSPITAL IN THE CITY OF NEW YORK INPATIENT ACUTE CARE $ 545.00 A,B $ 30.00 PROSPECT HOSPITAL INPATIENT ACUTE CARE $ 209.00 A $ 26.00 RICHMOND MEMORIAL HOSPITAL AND HEALTH CENTER INPATIENT ACUTE CARE $ 299.00 A $ 35.00 ROCKEFELLER UNIVERSITY HOSPITAL INPATIENT ACUTE CARE $ 278.00 ALL INCLUSIVE NO E.R. SERVICE ST BARNABAS HOSPITAL INPATIENT ACUTE CARE $ 366.00 B $ 35.00 ST CLARES HOSPITAL AND HEALTH CENTER INPATIENT ACUTE CARE $ 376.00 A,B,C $ 30.00 ST JOHNS EPISCOPAL HOSPITAL INPATIENT ACUTE CARE $ 352.00 A,B,C $ 35.00 ST LUKES - ROOSEVELT HOSPITAL CENTER INPATIENT ACUTE CARE $ 485.00 A $ 30.00 DETOXIFICATION UNIT $ 181.00 ST MARYS HOSPITAL OF BROOKLYN INPATIENT ACUTE CARE $ 474.00 ALL INCLUSIVE $ 35.00 ST VINCENTS HOSPITAL AND MEDICAL CENTER OF NY INPATIENT ACUTE CARE $ 493.00 A,B $ 27.00 ST VINCENTS MEDICAL CENTER OF RICHMOND INPATIENT ACUTE CARE $ 362.00 B $ 35.00 STATE UNIVERSITY HOSPITAL DOWNSTATE MEDICAL CENTER INPATIENT ACUTE CARE $ 493.00 A,B NO E.R. SERVICE STATEN ISLAND HOSPITAL INPATIENT ACUTE CARE $ 472.00 A,B, OTHER: $ 35.00 TERRACE HEIGHTS HOSPITAL PULMONARY INPATIENT ACUTE CARE $ 266.00 A $ 27.00 UNION HOSPITAL OF THE BRONX INPATIENT ACUTE CARE $ 264.00 A,C $ 26.00 VICTORY MEMORIAL HOSPITAL INPATIENT ACUTE CARE $ 305.00 A,B,C,OTHER: EKG $ 26.00 WESTCHESTER SQUARE HOSPITAL INPATIENT ACUTE CARE $ 367.00 A $ 35.00 WYCKOFF HEIGHTS HOSPITAL INPATIENT ACUTE CARE $ 328.00 A,C,OTHER: $ 35.00 CARDIOLOGY HEALTH AND HOSPITAL CORPORATION BELLEVUE HOSPITAL CENTER INPATIENT ACUTE CARE $ 527.00 ALL INCLUSIVE $ 35.00 EXCLUDING PHYSICIANS $ 513.00 BRONX MUNICIPAL HOSPITAL CENTER INPATIENT ACUTE CARE $ 590.00 ALL INCLUSIVE $ 30.00 CITY HOSPITAL CENTER AT ELMHURST INPATIENT ACUTE CARE $ 514.00 ALL INCLUSIVE $ 27.00 EXCLUDING PHYSICIANS $ 488.00 COLER MEMORIAL HOSPITAL AND HOME INPATIENT ACUTE CARE $ 278.00 ALL INCLUSIVE NO E.R. SERVICE CONEY ISLAND HOSPITAL INPATIENT ACUTE CARE $ 491.00 A,C $ 30.00 EXCLUDING PHYSICIANS $ 480.00 CUMBERLAND HOSPITAL INPATIENT ACUTE CARE $ 629.00 ALL INCLUSIVE $ 26.00 GOLDWATER MEMORIAL HOSPITAL INPATIENT ACUTE CARE $ 237.00 ALL INCLUSIVE NO E.R. SERVICE HARLEM HOSPITAL CENTER INPATIENT ACUTE CARE $ 633.00 ALL INCLUSIVE $ 30.00 EXCLUDING PHYSICIANS $ 615.00 KINGS COUNTY HOSPITAL CENTER INPATIENT ACUTE CARE $ 512.00 ALL INCLUSIVE $ 26.00 LINCOLN MEDICAL & MENTAL HEALTH CENTER INPATIENT ACUTE CARE $ 535.00 ALL INCLUSIVE $ 35.00 METROPOLITAN HOSPITAL CENTER INPATIENT ACUTE CARE $ 607.00 ALL INCLUSIVE $ 35.00 EXCLUDING PHYSICIANS $ 585.00 NORTH CENTRAL BRONX HOSPITAL INPATIENT ACUTE CARE $ 637.00 ALL INCLUSIVE $ 35.00 QUEENS HOSPITAL CENTER INPATIENT ACUTE CARE $ 573.00 ALL INCLUSIVE $ 35.00 WOODHULL MEDICAL AND MENTAL HEALTH CENTER INPATIENT ACUTE CARE $ 647.00 ALL INCLUSIVE $ 35.00 **EFECTIVE 1/1/82 - 12/31/83