NEW YORK INSURANCE NOTICES AND BULLETINS

March 4, 1980

SUBJECT: INSURANCE

Circular LETTER NO. 4 (1980)

WITHDRAWN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

Pursuant to the provisions of 11 NYCRR 68.2 (Regulation 83), on and after January 1, 1978, the schedule of all inclusive rates for hospital services and health related services, including home health services, provided pursuant 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.

Pursuant to the provisions of Regulation 83 and effective with services rendered on and after January 1, 1980, through December 31, 1980, the attached schedules shall be utilized by no-fault insurers for payment of hospital outpatient and inpatient services. The rates appearing in the attached schedules have been developed in accordance with Chapter 767 of the Laws of 1977 as amended by Chapter 213 of the Laws of 1978 and Chapter 271 of the Laws of 1979 (extending the provisions of Chapter 767 for an additional year) and have been approved by the Chairman of the Workers" Compensation Board.

Also attached is a schedule of revised rates certified by the Commissioner of Health and approved by the Chairman of the Workers" Compensation Board relating to specified facilities. Pursuant to the provisions of Regulation 83 these revised rates shall be utilized by no-fault insurers for payment of hospital inpatient services for the effective periods set forth in the schedule.

Very truly yours,

[SIGNATURE]

ALBERT B. LEWIS

Superintendent of Insurance

 

This schedule of revised 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 213, Laws of 1978 and Chapter 271, Laws of 1979, these rates are for use in payment of claims under the Workers" Compensation Law and Volunteer Firemen's Benefit Law.

These rates apply to the following facilities for the periods indicated:

NEW YORK CITY REGION - REVISED RATES

       

INPATIENT

FROM

TO

EFFECTIVE PERIOD

Hosp. for Joint Diseases

$ 241.00

$ 339.00

1/1/79 - 1/31/79

 ("Old" Facility)

241.00

341.00

2/1/79 - 7/9/79

       

Orthopedica Institute

0

524.00

7/10/79 - 10/31/79

 

0

534.00

11/1/79 - 12/31/79

       

North General Hospital

0

240.00

7/10/79 - 12/31/79

[SIGNATURE]

Chairman

DISTRIBUTION: BS

STATE OF NEW YORK

WORKERS" COMPENSATION BOARD

OFFICE OF THE CHAIRMAN

HOSPITAL FEE SCHEDULE

Effective January 1, 1980

This schedule 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 213, Laws of 1978 and Chapter 271, Laws of 1979, these rates are for use in payment of claims under the Workers" Compensation Law and the Volunteer Firemen's Benefit Law.

[SIGNATURE]

Chairman

WORKERS" COMPENSATION SCHEDULE OF RATES FOR THE PERIOD JANUARY 1, 1980 THROUGH DECEMBER 31, 1980

Rates for Outpatient Services

Room other than operating room or operating room when used for minor surgery or emergency treatment:

For the medical service provided whether by employed staff,

$ 13.00

attending staff or by contractual arrangement with the

 

physician groups the fee for this service is limited to

 

the first visit fee of as appears on line 90010 of the

 

Schedule of Medical Fees.

 
   

For the hospital providing intern or resident staffing

$ 36.00

or by physician group contractual coverage the total

 

fee is

 
   

When the care is provided by an attending, the hospital fee

$ 23.00

is 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 some time ago 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 at the discretion of the hospital should be considered as covered by the applicable Emergency Room rate. No charge should be made for [A> ANY <A] drugs, whether or not listed hereunder, in connection with hospitalized patients.

Current List of "No Charge" Drugs and Pharmaceutical Supplies

Alcohol 70%

Alcohol for burning

Alkaline Aromatic (Seilers) Tablets (Used as a mouth wash)

Aluminum Hydroxide Gel.

Ammonium Chloride Tabs.

A. P. C.

Aromatic Sp. Ammonia

Aromatic Fl. Ext. Cascara

Aspirin

Atropine Sulphate H.T.'s

Belladonna Tincture

Benedicts Qualitative Solution

Benzalkonium Chloride

Benzoin Tincture

Calamine Lotion

Carbon Tetrachloride

Castor Oil

Chloral Hydrate

Citrocarbonate Granules

Clinitest Tablets

Codeine Sulphate H.T.

Cold Cream Ointment

Collodian Flexible

Comp. Licorice Powd.

Comp. Tr. Benzoin

Demoral

Dicumarol Tabs.

Digitoxin Tabs. O.1. mg.

Distilled Water Inject.

Ferric Chloride Solution

Ferric Subsulphate (Mansels) Solution

Ferrous Sulphate

Glycerin

Glycerin Supp.

H. I. Syrup

Hydrogen Peroxide

Iodine

Iron Quinine & Strychnine Elixir

Laxative Tabs.

Liquid Soap

Lubricating Jelly

Magnesium Sulphate

Metaphen Tincture

Methiolate Sol.

Methyl Salicylate

Milk of Magnesia

Mineral Oil

Morphine Injection

Mouth Wash

Nitroglycerine H.T.'s

Normal Saline Inject.

Pento Barbital Sodium Capsules

Peppermint

Petralatum

Phenobarbital

Procaine HCL

Rhubarb & Soda Mixture

Rubbing Alcohol

Scopolamine H.T.

Secobarbital Sodium Caps

Silver Nitrate Appl.

Sodium Bicarbonate

Sodium Salicylate Tabs.

Talcum Powder

Terpin Hydrate El.

Tuberculin Purified Protein Derivative (1st and 2nd strength)

Witch Hazel

Xylocaine 1%, 2% with or without Epinephrine

Zinc Oxide Ointment

Zinc Stearate Powder

WORKERS" COMPENSATION

 

HOSPITAL RATE SCHEDULE

 

WESTERN NEW YORK REGION

 
       
   

EFFECTIVE

 
 

DAILY

01/01/80 -

 
   

12/31/80

 
 

RATE

EXCLUSIONS:

 

ALLEGANY

     

 CUBA MEMORIAL HOSPITAL INC

$ 183.00

ALL INCLUSIVE

 

   INPATIENT ACUTE CARE

     
       

 MEMORIAL HOSPITAL OF WM F & GERTRUDE F JONES

     

 A/K/A JONES MEMORIAL

     

   INPATIENT ACUTE CARE

$ 164.00

ALL INCLUSIVE

 
       

CATTARAUGUS

     

 OLEAN GENERAL HOSPITAL

     

   INPATIENT ACUTE CARE

$ 163.00

ALL INCLUSIVE

 
       

 SALAMANCA HOSPITAL DISTRICT AUTHORITY

     

   INPATIENT ACUTE CARE

$ 129.00

B,C

 
       

 ST FRANCIS HOSPITAL

     

   INPATIENT ACUTE CARE

$ 157.00

B

 
       

 TRI-COUNTY MEMORIAL HOSPITAL

     

   INPATIENT ACUTE CARE

$ 133.00

B

 
       

CHAUTAUQUA

     

 BROOKS MEMORIAL HOSPITAL

     

   INPATIENT ACUTE CARE

$ 134.00

A,B

 
       

 JAMESTOWN GENERAL HOSPITAL

     

   INPATIENT ACUTE CARE

$ 147.00

A,B,C

 
       

 LAKE SHORE HOSPITAL INC

     

   INPATIENT ACUTE CARE

$ 143.00

A,B

 
       

 WESTFIELD MEMORIAL HOSPITAL INC

     

   INPATIENT ACUTE CARE

$ 114.00

B,C

 
       

 WOMANS CHRISTIAN ASSOCIATION

     

   INPATIENT ACUTE CARE

$ 155.00

A,B

 
       

ERIE

     

 BERTRAND CHAFFEE HOSPITAL

     

   INPATIENT ACUTE CARE

$ 161.00

A

 
       

 BRY-LIN HOSPITAL

     

   PSYCHIATRIC CARE

$ 135.00

A

 
       

 BUFFALO COLUMBUS HOSPITAL

     

   INPATIENT ACUTE CARE

$ 108.00

A,C,D

 
       

 BUFFALO GENERAL HOSPITAL

     

   INPATIENT ACUTE CARE

$ 198.00

ALL INCLUSIVE

 
       

 CHILDRENS HOSPITAL

     

   INPATIENT ACUTE CARE

$ 281.00

A

 
       

 ERIE COUNTY MEDICAL CENTER

     

   INPATIENT ACUTE CARE

$ 281.00

ALL INCLUSIVE

 
       

 KENMORE MERCY HOSPITAL

     

   INPATIENT ACUTE CARE

$ 158.00

A, OTHER: EKG

 
       

 LAFAYETTE GENERAL HOSPITAL

     

   INPATIENT ACUTE CARE

$ 128.00

A

 
       

 MERCY HOSPITAL

     

   INPATIENT ACUTE CARE

$ 153.00

A

 
       

 MILLARD FILLMORE HOSPITAL

     

   INPATIENT ACUTE CARE

$ 202.00

A

 
       

 OUR LADY OF VICTORY HOSPITAL OF LACKAWANNA

     

   INPATIENT ACUTE CARE

$ 154.00

A,B

 
       

ERIE

     

 ROSWELL PARK MEMORIAL INSTITUTE

     

   INPATIENT ACUTE CARE

$ 251.00

ALL INCLUSIVE

 
       

 SAINT FRANCIS HOSPITAL OF BUFFALO

     

   INPATIENT ACUTE CARE

$ 139.00

A

 
       

 SHEEHAN MEMORIAL EMERGENCY HOSPITAL INC

     

   INPATIENT ACUTE CARE

$ 158.00

A,B

 
       

 SHERIDAN PARK HOSPITAL INC

     

   INPATIENT ACUTE CARE

$ 141.00

A

 
       

 SISTERS OF CHARITY HOSPITAL

     

   INPATIENT ACUTE CARE

$ 154.00

A

 
       

 ST JOSEPH INTERCOMMUNITY HOSPITAL

     

   INPATIENT ACUTE CARE

$ 128.00

A

 
       

GENESEE

     

 GENESEE MEMORIAL HOSPITAL

     

   INPATIENT ACUTE CARE

$ 155.00

A

 
       

 ST JEROME HOSPITAL

     

   INPATIENT ACUTE CARE

$ 164.00

A

 
       

NIAGARA

     

 DEGRAFF MEMORIAL HOSPITAL

     

   INPATIENT ACUTE CARE

$ 149.00

A

 
       

 INTER-COMMUNITY MEMORIAL HOSPITAL AT

     

 NEWFANE INC

     

   INPATIENT ACUTE CARE

$ 140.00

A

 
       

 LOCKPORT MEMORIAL HOSPITAL

     

   INPATIENT ACUTE CARE

$ 155.00

A,B

 
       

 MOUNT ST MARYS HOSPITAL OF NIAGARA FALLS

     

   INPATIENT ACUTE CARE

$ 144.00

A

 
       

 NIAGARA FALLS MEMORIAL MEDICAL CENTER

     

   INPATIENT ACUTE CARE

$ 160.00

A

 
       

ORLEANS

     

 ARNOLD GREGORY MEMORIAL HOSPITAL

     

   INPATIENT ACUTE CARE

$ 156.00

A,C

 
       

 MEDINA MEMORIAL HOSPITAL

     

   INPATIENT ACUTE CARE

$ 145.00

A,B

 
       

WYOMING

     

 WYOMING COUNTY COMMUNITY HOSPITAL

     

   INPATIENT ACUTE CARE

$ 169.00

A

 
       

A-ANESTHESIOLOGIST, B-RADIOLOGIST, C-PHYSIOTHERAPIST, D-PATHOLOGIST

 

WORKERS" COMPENSATION

HOSPITAL RATE SCHEDULE

ROCHESTER NEW YORK REGION

     
   

EFFECTIVE

 

DAILY

01/01/80 - 12/31/80

 

RATE

EXCLUSIONS:

CHEMUNG

   

 ARNOT-OGDEN MEMORIAL HOSPITAL

   

   INPATIENT ACUTE CARE

$ 178.00

A

     

 ST JOSEPHS HOSPITAL

   

   INPATIENT ACUTE CARE

$ 149.00

A

     

LIVINGSTON

   

 NICHOLAS H NOYES MEMORIAL HOSPITAL

   

   INPATIENT ACUTE CARE

$ 172.00

A

     

MONROE

   

 GENESEE HOSPITAL

   

   INPATIENT ACUTE CARE

$ 266.00

A

     

 HIGHLAND HOSPITAL

   

   INPATIENT ACUTE CARE

$ 223.00

A,B

     

 LAKESIDE MEMORIAL HOSPITAL

   

   INPATIENT ACUTE CARE

$ 176.00

A

     

 MONROE COMMUNITY HOSPITAL

   

   INPATIENT ACUTE CARE

$ 292.00

ALL INCLUSIVE

     

 PARK RIDGE HOSPITAL

   

   INPATIENT ACUTE CARE

$ 208.00

A,B

     

 ROCHESTER GENERAL HOSPITAL

   

   INPATIENT ACUTE CARE

$ 262.00

A

     

 ST MARYS HOSPITAL

   

   INPATIENT ACUTE CARE

$ 210.00

A,C

     

 STRONG MEMORIAL HOSPITAL

   

   INPATIENT ACUTE CARE

$ 300.00

A, Other-Diagnostic Radio

     

ONTARIO

   

 CLIFTON SPRINGS HOSPITAL AND CLINIC

   

   INPATIENT ACUTE CARE

$ 162.00

A

     

 F F THOMPSON HOSPITAL

   

   INPATIENT ACUTE CARE

$ 143.00

A

     

 GENEVA GENERAL HOSPITAL

   

   INPATIENT ACUTE CARE

$ 187.00

A

     

SCHUYLER

   

 SCHUYLER HOSPITAL

   

   INPATIENT ACUTE CARE

$ 178.00

A

     

SENECA

   

 SENECA FALLS HOSPITAL

   

   INPATIENT ACUTE CARE

$ 171.00

ALL INCLUSIVE

     

 WATERLOO MEMORIAL HOSPITAL INC D/B/A

   

 TAYLOR-BROWN MEMORIAL HOSP

   

   INPATIENT ACUTE CARE

$ 149.00

A

     

STEUBEN

   

 BETHESDA HOSPITAL

   

   INPATIENT ACUTE CARE

$ 153.00

A

     

 CORNING HOSPITAL

   

   INPATIENT ACUTE CARE

$ 164.00

A

     

 IRA DAVENPORT MEMORIAL HOSPITAL INC

   

   INPATIENT ACUTE CARE

$ 151.00

A, C

     

 ST JAMES MERCY HOSPITAL

   

   INPATIENT ACUTE CARE

$ 143.00

A

     

WAYNE

   

 MYERS COMMUNITY HOSPITAL FOUNDATION INC

   

   INPATIENT ACUTE CARE

$ 153.00

A

     

 NEWARK-WAYNE COMMUNITY HOSPITAL INC

   

   INPATIENT ACUTE CARE

$ 168.00

A

     

YATES

   

 SOLDIERS AND SAILORS MEMORIAL HOSPITAL

   

 OF YATES COUNTY INC

   

   INPATIENT ACUTE CARE

$ 165.00

A

     

A-ANESTHESIOLOGIST, B-RADIOLOGIST, C-PHYSIOTHERAPIST, D-PATHOLOGIST

WORKERS" COMPENSATION

HOSPITAL RATE SCHEDULE

CENTRAL NEW YORK REGION

     
   

EFFECTIVE

 

DAILY

01/01/80 - 12/31/80

 

RATE

EXCLUSIONS:

BROOME

   

 BINGHAMTON GENERAL HOSPITAL

   

   INPATIENT ACUTE CARE

$ 178.00

A,B,C

     

 CHARLES S WILSON MEMORIAL HOSPITAL

   

   INPATIENT ACUTE CARE

$ 209.00

A

     

 IDEAL HOSPITAL OF ENDICOTT

   

   INPATIENT ACUTE CARE

$ 131.00

A,B,C

     

 OUR LADY OF LOURDES MEMORIAL HOSPITAL

   

   INPATIENT ACUTE CARE

$ 175.00

A, OTHER: DIAGNOSTIC

   

RADIOLOGY, ULTRASOUND

   

DIAGNOSTIC

     

CAYUGA

   

 AUBURN MEMORIAL HOSPITAL

   

   INPATIENT ACUTE CARE

$ 160.00

A

     

CHENANGO

   

 CHENANGO MEMORIAL HOSPITAL INC

   

   INPATIENT ACUTE CARE

$ 209.00

A

     

CORTLAND

   

 CORTLAND MEMORIAL HOSPITAL INC

   

   INPATIENT ACUTE CARE

$ 202.00

A,B

     

HERKIMER

   

 HERKIMER MEMORIAL HOSPITAL INC

   

   INPATIENT ACUTE CARE

$ 170.00

A

     

 LITTLE FALLS HOSPITAL

   

   INPATIENT ACUTE CARE

$ 144.00

A

     

 MOHAWK VALLEY GENERAL HOSPITAL

   

   INPATIENT ACUTE CARE

$ 148.00

A

     

JEFFERSON

   

 CARTHAGE AREA HOSPITAL INC

   

   INPATIENT ACUTE CARE

$ 158.00

A,B

     

 EDWARD JOHN NOBLE

   

 HOSPITAL OF ALEXANDRIA BAY

   

   INPATIENT ACUTE CARE

$ 173.00

ALL INCLUSIVE

     

 HOUSE OF THE GOOD SAMARITAN

   

   INPATIENT ACUTE CARE

$ 167.00

A,B,C

     

 MERCY HOSPITAL OF WATERTOWN

   

   INPATIENT ACUTE CARE

$ 176.00

A,B,C

     

LEWIS

   

 LEWIS COUNTY GENERAL HOSPITAL

   

   INPATIENT ACUTE CARE

$ 160.00

B

     

MADISON

   

 COMMUNITY MEMORIAL HOSPITAL INC

   

   INPATIENT ACUTE CARE

$ 185.00

A

     

 ONEIDA CITY HOSPITAL

   

   INPATIENT ACUTE CARE

$ 154.00

A,D

     

ONEIDA

   

 CHILDRENS HOSPITAL AND

   

 REHABILITATION CENTER

   

   REHABILITATION

$ 177.00

A,C, OTHER: EMG

     

ONEIDA

   

 FAXTON HOSPITAL

   

   INPATIENT ACUTE CARE

$ 173.00

A,C, OTHER; EMG

     

 ROME HOSPITAL AND MURPHY MEMORIAL HOSPITAL

   

   INPATIENT ACUTE CARE

$ 154.00

A,C

     

 ROSE HOSPITAL

   

   INPATIENT ACUTE CARE

$ 144.00

A

     

 ST ELIZABETH HOSPITAL

   

   INPATIENT ACUTE CARE

$ 187.00

A

     

 ST LUKES MEMORIAL HOSPITAL CENTER

   

   INPATIENT ACUTE CARE

$ 188.00

A,C

     

ONONDAGA

   

 BENJAMIN RUSH CENTER

   

   PSYCHIATRIC CARE

$ 119.00

ALL INCLUSIVE

     

 COMMUNITY-GENERAL HOSPITAL OF GREATER

   

 SYRACUSE

   

   INPATIENT ACUTE CARE

$ 230.00

A

     

 CROUSE-IRVING MEMORIAL HOSPITAL

   

   INPATIENT ACUTE CARE

$ 271.00

A,B,D, OTHERS: Nuclear

   

Medicine, EEG, ECG

     

 ST JOSEPHS HOSPITAL HEALTH CENTER

   

   INPATIENT ACUTE CARE

$ 226.00

A,B,C

     

 STATE UNIVERSITY HOSPITAL UPSTATE

   

 MEDICAL CENTER

   

   INPATIENT ACUTE CARE

$ 247.00

A,C

     

OSWEGO

   

 ALBERT LINDLEY LEE MEMORIAL HOSPITAL

   

   INPATIENT ACUTE CARE

$ 159.00

A

     

 OSWEGO HOSPITAL

   

   INPATIENT ACUTE CARE

$ 168.00

A

     

ST. LAWRENCE

   

 A BARTON HEPBURN HOSPITAL

   

   INPATIENT ACUTE CARE

$ 197.00

A

     

 CENTRAL ST LAWRENCE HLTH SERVICES OF

   

 POTSDAM HOSP UNIT

   

   INPATIENT ACUTE CARE

$ 180.00

A

     

 CLIFTON-FINE HOSPITAL

   

   INPATIENT ACUTE CARE

$ 183.00

ALL INCLUSIVE

     

 EDWARD JOHN NOBLE HOSPITAL OF GOUVERNEUR

   

   INPATIENT ACUTE CARE

$ 128.00

ALL INCLUSIVE

     

 MASSENA MEMORIAL HOSPITAL

   

   INPATIENT ACUTE CARE

$ 170.00

A

     

TIOGA

   

 TIOGA GENERAL HOSPITAL

   

   INPATIENT ACUTE CARE

$ 163.00

A,C

     

TOMPKINS

   

 TOMPKINS COUNTY HOSPITAL

   

   INPATIENT ACUTE CARE

$ 216.00

A

     

A-ANESTHESIOLOGIST, B-RADIOLOGIST, C-PHYSIOTHERAPIST, D-PATHOLOGIST

WORKERS" COMPENSATION

 

HOSPITAL RATE SCHEDULE

 

NORTHEASTERN NEW YORK REGION

 
       
   

EFFECTIVE

 
 

DAILY

01/01/80 - 12/31/80

 
 

RATE

EXCLUSIONS:

 

ALBANY

     

 ALBANY MEDICAL CENTER HOSPITAL

     

   INPATIENT ACUTE CARE

$ 207.00

B

 
       

 CHILDS HOSPITAL

     

   INPATIENT ACUTE CARE

$ 160.00

A

 
       

 COHOES MEMORIAL HOSPITAL

     

   INPATIENT ACUTE CARE

$ 150.00

A,B

 
       

 MEMORIAL HOSPITAL

     

   INPATIENT ACUTE CARE

$ 195.00

A

 
       

 ST PETERS HOSPITAL

     

   INPATIENT ACUTE CARE

$ 202.00

A,B

 
       

CLINTON

     

 CHAMPLAIN VALLEY PHYSICIANS HOSPITAL

     

 MEDICAL CTR

     

   INPATIENT ACUTE CARE

$ 138.00

A,B

 
       

COLUMBIA

     

 COLUMBIA MEMORIAL HOSPITAL

     

   INPATIENT ACUTE CARE

$ 168.00

B

 
       

DELAWARE

     

 A LINDSAY & OLIVE B OCONNOR HOSPITAL

     

   INPATIENT ACUTE CARE

$ 169.00

A

 
       

 COMMUNITY HOSPITAL

     

   INPATIENT ACUTE CARE

$ 177.00

ALL INCLUSIVE

 
       

 DELAWARE VALLEY HOSPITAL INC

     

   INPATIENT ACUTE CARE

$ 201.00

ALL INCLUSIVE

 
       

 MARGARETVILLE MEMORIAL HOSPITAL

     

   INPATIENT ACUTE CARE

$ 195.00

ALL INCLUSIVE

 
       

 READ MEMORIAL HOSPITAL

     

   INPATIENT ACUTE CARE

$ 170.00

A,B

 
       

 THE HOSPITAL

     

   INPATIENT ACUTE CARE

$ 160.00

A,B, OTHER: Ultrasound,

 
   

Electro-Cardiology

 
       

ESSEX

     

 ELIZABETHTOWN COMMUNITY HOSPITAL

     

   INPATIENT ACUTE CARE

$ 163.00

B

 
       

 MOSES-LUDINGTON HOSPITAL

     

   INPATIENT ACUTE CARE

$ 159.00

A,B,C,D

 
       

 PLACID MEMORIAL HOSPITAL INC

     

   INPATIENT ACUTE CARE

$ 158.00

A

 
       

FRANKLIN

     

 ALICE HYDE MEMORIAL HOSPITAL

     

   INPATIENT ACUTE CARE

$ 143.00

B

 
       

 GENERAL HOSPITAL OF SARANAC LAKE

     

   INPATIENT ACUTE CARE

$ 155.00

A,B,C

 
       

 MERCY GENERAL HOSPITAL OF TUPPER LAKE

     

   INPATIENT ACUTE CARE

$ 164.00

A

 
       

FULTON

     

 JOHNSTOWN HOSPITAL

     

   INPATIENT ACUTE CARE

$ 162.00

A,C

 
       

 NATHAN LITTAUER HOSPITAL

     

   INPATIENT ACUTE CARE

$ 155.00

A

 
       

GREENE

     

 MEMORIAL HOSPITAL OF GREENE COUNTY

     

   INPATIENT ACUTE CARE

$ 177.00

ALL INCLUSIVE

 
       

MONTGOMERY

     

 AMSTERDAM MEMORIAL HOSPITAL

     

   INPATIENT ACUTE CARE

$ 157.00

A

 
       

 ST MARYS HOSPITAL AT AMSTERDAM

     

   INPATIENT ACUTE CARE

$ 153.00

A,C

 
       

OTSEGO

     

 AURELIA OSBORN FOX MEMORIAL HOSPITAL

     

   INPATIENT ACUTE CARE

$ 193.00

A,C, OTHER: Ear,Nose,Throa

 
       

 MARY IMOGENE BASSETT HOSPITAL

     

   INPATIENT ACUTE CARE

$ 185.00

ALL INCLUSIVE

 
       

RENSSELAER

     

 LEONARD HOSPITAL

     

   INPATIENT ACUTE CARE

$ 166.00

B,C

 
       

 SAMARITAN HOSPITAL

     

   INPATIENT ACUTE CARE

$ 169.00

A

 
       

 ST MARYS HOSPITAL OF TROY

     

   INPATIENT ACUTE CARE

$ 168.00

A,B, OTHER: Physical

 
   

Medicine

 
       

SARATOGA

     

 ADIRONDACK REGIONAL HOSPITAL

     

   INPATIENT ACUTE CARE

$ 136.00

ALL INCLUSIVE

 
       

 BENEDICT MEMORIAL HOSPITAL

     

   INPATIENT ACUTE CARE

$ 71.00

A,C

 
       

 SARATOGA HOSPITAL

     

   INPATIENT ACUTE CARE

$ 169.00

A,B

 
       

SCHENECTADY

     

 BELLEVUE MATERNITY HOSPITAL INC

     

   INPATIENT ACUTE CARE

$ 268.00

A

 
       

 ELLIS HOSPITAL

     

   INPATIENT ACUTE CARE

$ 183.00

A,B,C, OTHER; Nuclear

 
   

Medicine

 
       

 ST CLARES HOSPITAL

     

   INPATIENT ACUTE CARE

$ 180.00

A,B

 
       

 SUNNYVIEW HOSPITAL AND REHABILITATION

     

 CENTER

     

   INPATIENT ACUTE CARE

$ 160.00

A,C

 
       

SCHOHARIE

     

 COMMUNITY HOSPITAL OF SCHOHARIE

     

 COUNTY INC

     

   INPATIENT ACUTE CARE

$ 149.00

ALL INCLUSIVE

 
       

WARREN

     

 GLENS FALLS HOSPITAL

     

   INPATIENT ACUTE CARE

$ 173.00

A,B,C

 
       

WASHINGTON

     

 EMMA LAING STEVENS HOSPITAL

     

   INPATIENT ACUTE CARE

$ 145.00

ALL INCLUSIVE

 
       

 MARY MCCLELLAN HOSPITAL

     

   INPATIENT ACUTE CARE

$ 154.00

A

 
       

A-ANESTHESIOLOGIST, B-RADIOLOGIST, C-PHYSIOTHERAPIST, D-PATHOLOGIST

 

WORKERS" COMPENSATION

 

HOSPITAL RATE SCHEDULE

 

NORTHERN METROPOLITAN REGION

 
       
   

EFFECTIVE

 
 

DAILY

01/01/80 - 12/31/80

 
 

RATE

EXCLUSIONS:

 

DUTCHESS

     

 HIGHLAND HOSPITAL

     

   INPATIENT ACUTE CARE

$ 153.00

A

 
       

 NORTHERN DUTCHESS HOSPITAL

     

   INPATIENT ACUTE CARE

$ 166.00

A

 
       

 ST FRANCIS HOSPITAL

     

   INPATIENT ACUTE CARE

$ 202.00

A,B,C, OTHER: Psychiatric

 
       

 VASSAR BROTHERS HOSPITAL

     

   INPATIENT ACUTE CARE

$ 193.00

A,C, OTHER- Diagnostic

 
   

Radiology

 
       

ORANGE

     

 ARDEN HILL HOSPITAL

     

   INPATIENT ACUTE CARE

$ 223.00

A,C

 
       

 CORNWALL HOSPITAL

     

   INPATIENT ACUTE CARE

$ 170.00

A

 
       

 DOCTORS SUNNYSIDE HOSPITAL

     

   INPATIENT ACUTE CARE

$ 165.00

ALL INCLUSIVE

 
       

 E A HORTON MEMORIAL HOSPITAL

     

   INPATIENT ACUTE CARE

$ 183.00

A

 
       

 FALKIRK HOSPITAL

     

   PSYCHIATRIC CARE

$ 125.00

ALL INCLUSIVE

 
       

 ST ANTHONY COMMUNITY HOSPITAL

     

   INPATIENT ACUTE CARE

$ 187.00

A

 
       

 ST FRANCIS HOSPITAL OF PORT JERVIS NEW

     

 YORK

     

   INPATIENT ACUTE CARE

$ 185.00

A,C

 
       

 ST LUKES HOSPITAL OF NEWBURGH

     

   INPATIENT ACUTE CARE

$ 207.00

A

 
       

 TUXEDO MEMORIAL HOSPITAL

     

   INPATIENT ACUTE CARE

$ 143.00

A

 
       

PUTNAM

     

 JULIA L BUTTERFIELD MEMORIAL HOSPITAL

     

   INPATIENT ACUTE CARE

$ 94.00

ALL INCLUSIVE

 
       

 PUTNAM COMMUNITY HOSPITAL

     

   INPATIENT ACUTE CARE

$ 204.00

A

 
       

ROCKLAND

     

 COMMUNITY HOSPITAL OF ROCKLAND COUNTY

     

   INPATIENT ACUTE CARE

$ 129.00

A

 
       

 GOOD SAMARITAN HOSPITAL OF SUFFERN

     

   INPATIENT ACUTE CARE

$ 246.00

A

 
       

 HELEN HAYES HOSPITAL

     

   INPATIENT ACUTE CARE

$ 260.00

ALL INCLUSIVE

 
       

 NYACK HOSPITAL

     

   INPATIENT ACUTE CARE

$ 230.00

A,B

 
       

 SUMMIT PARK HOSPITAL-ROCKLAND COUNTY

     

 INFIRMARY

     

   INPATIENT ACUTE CARE

$ 251.00

ALL INCLUSIVE

 

   PSYCHIATRIC CARE

$ 119.00

ALL INCLUSIVE

 
       

SULLIVAN

     

 COMMUNITY GENERAL HOSPITAL OF SULLIVAN

     

 COUNTY

     

   INPATIENT ACUTE CARE

$ 256.00

A

 
       

 COMMUNITY GENERAL HOSPITAL OF SULLIVAN

     

 COUNTY G HERMAN DIV

     

   INPATIENT ACUTE CARE

$ 150.00

A

 
       

 HAMILTON AVENUE HOSPITAL

     

   INPATIENT ACUTE CARE

$ 138.00

A

 
       

A-ANESTHESIOLOGIST, B-RADIOLOGIST, C-PHYSIOTHERAPIST, D-PATHOLOGIST

 
                         

[See table in printed version.]

WORKERS" COMPENSATION

HOSPITAL RATE SCHEDULE

NEW YORK CITY REGION

     
   

EFFECTIVE

 

DAILY

01/01/80 - 12/31/80

 

RATE

EXCLUSIONS:

ASTORIA GENERAL HOSPITAL

   

   INPATIENT ACUTE CARE

$ 194.00

A,C, OTHER: EEG,

   

Nuclear Medicine

     

BAPTIST HOSPITAL OF NEW YORK

   

   INPATIENT ACUTE CARE

$ 144.00

A

     

BEEKMAN DOWNTOWN HOSPITAL

   

   INPATIENT ACUTE CARE

$ 273.00

A

     

BETH ISRAEL MEDICAL CENTER

   

   INPATIENT ACUTE CARE

$ 344.00

A

     

BOOTH MEMORIAL MEDICAL CENTER

   

   INPATIENT ACUTE CARE

$ 287.00

A

     

BOULEVARD HOSPITAL

   

   INPATIENT ACUTE CARE

$ 174.00

A

     

BRONX-LEBANON HOSPITAL CENTER-FULTON DIVISION

$ 304.00

A,C

   INPATIENT ACUTE CARE 1/1/80--2/15/80

   

   2/16/80--12/31/80

268.00

 
     

BROOKDALE HOSPITAL MEDICAL CENTER

   

   INPATIENT ACUTE CARE

$ 317.00

A,C

     

BROOKLYN HOSPITAL

   

   INPATIENT ACUTE CARE

$ 286.00

A

     

CABRINI HEALTH CARE CTR

   

   INPATIENT ACUTE CARE

$ 273.00

A,C, OTHER: EEG,

   

EKG, Sonography

     

CALEDONIAN HOSPITAL OF THE CITY OF NY

   

   INPATIENT ACUTE CARE

$ 196.00

A

     

CALVARY HOSPITAL

   

   INPATIENT ACUTE CARE

$ 332.00

ALL INCLUSIVE

     

CATHOLIC MEDICAL CENTER

   

   INPATIENT ACUTE CARE

$ 294.00

ALL INCLUSIVE

     

CMC ST JOHN'S QUEENS DIV

   

   INPATIENT ACUTE CARE

$ 294.00

A

     

COMMUNITY HOSPITAL OF BROOKLYN INC

   

   INPATIENT ACUTE CARE

$ 172.00

A Nuclear Medicine,

   

Ultra Sound

     

DEEPDALE GENERAL HOSPITAL

   

   INPATIENT ACUTE CARE

$ 199.00

A,C

     

DOCTORS HOSPITAL INC

   

   INPATIENT ACUTE CARE

$ 223.00

A,C

     

DOCTORS HOSPITAL OF STATEN ISLAND

   

   INPATIENT ACUTE CARE

$ 204.00

A

     

FLATBUSH GENERAL HOSPITAL

   

   INPATIENT ACUTE CARE

$ 196.00

ALL INCLUSIVE

     

FLUSHING HOSPITAL AND MEDICAL CENTER

   

   INPATIENT ACUTE CARE

$ 256.00

A

     

GRACIE SQUARE GENERAL HOSPITAL

   

   INPATIENT ACUTE CARE

$ 217.00

ALL INCLUSIVE

   PSYCHIATRIC CARE

$ 149.00

ALL INCLUSIVE

     

H I P HOSPITAL INC

   

   INPATIENT ACUTE CARE

$ 257.00

A

     

HILLCREST GENERAL HOSPITAL-GHI

   

   INPATIENT ACUTE CARE

$ 245.00

A

     

HOSPITAL FOR JOINT DISEASES AND MEDICAL CENTER

   

ORTHOPEDIC INSTI

   

   INPATIENT ACUTE CARE

$ 466.00

A

     

HOSPITAL FOR SPECIAL SURGERY

   

   INPATIENT ACUTE CARE

$ 328.00

A

     

INSTITUTE OF REHAB MEDICINE NY UNIVERSITY

   

REHABILITATION

$ 292.00

A,C,D

     

INTERBORO GENERAL HOSPITAL

   

   INPATIENT ACUTE CARE

$ 221.00

A

     

JAMAICA HOSPITAL

   

   INPATIENT ACUTE CARE

$ 258.00

A,C

     

JEWISH HOSPITAL AND MEDICAL CENTER OF BROOKLYN

   

   INPATIENT ACUTE CARE

$ 258.00

A

     

JEWISH MEMORIAL HOSPITAL

   

   INPATIENT ACUTE CARE

$ 198.00

A

     

JOINT DISEASES NORTH GENERAL HOSPITAL

   

   INPATIENT ACUTE CARE

$ 239.00

A

     

KINGS HIGHWAY HOSPITAL

   

   INPATIENT ACUTE CARE

$ 203.00

A,C

     

KINGSBROOK JEWISH MEDICAL CENTER

   

   INPATIENT ACUTE CARE

$ 254.00

A,B,C,D

     

LENOX HILL HOSPITAL

   

   INPATIENT ACUTE CARE

$ 324.00

A

     

LEROY HOSPITAL

   

   INPATIENT ACUTE CARE

$ 210.00

A

     

LONG ISLAND COLLEGE HOSPITAL

   

   INPATIENT ACUTE CARE

$ 319.00

A

     

LONG ISLAND JEWISH-HILLSIDE MED CTR

   

   INPATIENT ACUTE CARE

$ 342.00

A

     

LUTHERAN MEDICAL CENTER

   

   INPATIENT ACUTE CARE

$ 298.00

A

     

MAIMONIDES MEDICAL CENTER

   

   INPATIENT ACUTE CARE

$ 296.00

A

     

MANHATTAN EYE EAR AND THROAT HOSPITAL

   

   INPATIENT ACUTE CARE

$ 230.00

A,C

     

MEDICAL ARTS CENTER HOSPITAL

   

   INPATIENT ACUTE CARE

$ 199.00

A,C

     

MEMORIAL HOSPITAL FOR CANCER

   

 AND ALLIED DISEASES

   

   INPATIENT ACUTE CARE

$ 501.00

ALL INCLUSIVE

     

METHODIST HOSPITAL OF BROOKLYN

   

   INPATIENT ACUTE CARE

$ 267.00

A

     

MISERICORDIA HOSPITAL MEDICAL CENTER

   

   INPATIENT ACUTE CARE

$ 230.00

A,D, OTHER:

   

Ambulance

     

MONTEFIORE HOSPITAL & MEDICAL CENTER

   

   INPATIENT ACUTE CARE

$ 389.00

A

     

MOUNT SINAI HOSPITAL

   

   INPATIENT ACUTE CARE

$ 382.00

A,C

     

NY EYE AND EAR INFIRMARY

   

   INPATIENT ACUTE CARE

$ 252.00

A

     

NY INFIRMARY

   

   INPATIENT ACUTE CARE

$ 273.00

A

     

NY UNIVERSITY MEDICAL CENTER

   

   INPATIENT ACUTE CARE

$ 337.00

A,C

     

PARKWAY HOSPITAL

   

   INPATIENT ACUTE CARE

$ 218.00

A,C

     

PARSONS HOSPITAL

   

   INPATIENT ACUTE CARE

$ 181.00

A

     

PAYNE WHITNEY AND NEW YORK HOSPITAL COMBINED

   

   INPATIENT ACUTE CARE

$ 381.00

A

     

PELHAM BAY GENERAL HOSPITAL

   

   INPATIENT ACUTE CARE

$ 187.00

A,B,C, OTHER: EKG,

   

EEG

     

PENINSULA HOSPITAL CENTER

   

   INPATIENT ACUTE CARE

$ 220.00

A

     

PHYSICIANS HOSPITAL

   

   INPATIENT ACUTE CARE

$ 208.00

A

     

PRESBYTERIAN HOSPITAL IN THE CITY OF NEW YORK

   

   INPATIENT ACUTE CARE

$ 351.00

A,B

     

PROSPECT HOSPITAL

   

   INPATIENT ACUTE CARE

$ 168.00

A

     

RICHMOND MEMORIAL HOSPITAL AND HEALTH CENTER

   

   INPATIENT ACUTE CARE

$ 215.00

A

     

ROCKEFELLER UNIVERSITY HOSPITAL

   

   INPATIENT ACUTE CARE

$ .00

ALL INCLUSIVE

     

ROOSEVELT HOSPITAL

   

   INPATIENT ACUTE CARE

$ 330.00

A

   DETOXIFICATION UNIT

$ 88.00

A

     

ST BARNABAS HOSPITAL

   

   INPATIENT ACUTE CARE

$ 236.00

ALL INCLUSIVE

     

ST CLARES HOSPITAL AND HEALTH CENTER

   

   INPATIENT ACUTE CARE

$ 246.00

A

     

ST ELIZABETHS DIVISION OF ST CLARES

   

HOSPITAL AND HEALTH CENTER

   

   INPATIENT ACUTE CARE

$ 246.00

A

     

ST JOHNS EPISCOPAL HOSPITAL

   

   INPATIENT ACUTE CARE

$ 236.00

A

     

ST JOHNS EPISCOPAL HOSPITAL-SO SHORE DIV

   

   INPATIENT ACUTE CARE

$ 236.00

A

     

ST LUKES HOSPITAL CENTER

   

   INPATIENT ACUTE CARE

$ 330.00

A

     

ST MARYS HOSPITAL OF BROOKLYN

   

   INPATIENT ACUTE CARE

$ 343.00

ALL INCLUSIVE

     

ST VINCENTS HOSPITAL AND MEDICAL CENTER OF NY

   

   INPATIENT ACUTE CARE

$ 315.00

A

     

ST VINCENTS MEDICAL CENTER OF RICHMOND

   

   INPATIENT ACUTE CARE

$ 272.00

ALL INCLUSIVE

     

STATE UNIVERSITY HOSPITAL DOWNSTATE MEDICAL

   

CENTER

   

   INPATIENT ACUTE CARE

$ 275.00

A

     

STATEN ISLAND HOSPITAL

   

   INPATIENT ACUTE CARE

$ 288.00

A

     

TERRACE HEIGHTS HOSPITAL

   

   INPATIENT ACUTE CARE

$ 201.00

A

     

UNION HOSPITAL OF THE BRONX

   

   INPATIENT ACUTE CARE

$ 172.00

A,C

     

VICTORY MEMORIAL HOSPITAL

   

   INPATIENT ACUTE CARE

$ 192.00

A

     

WESTCHESTER SQUARE HOSPITAL

   

   INPATIENT ACUTE CARE

$ 168.00

A,C, OTHER: Nuclear

     

WYCKOFF HEIGHTS HOSPITAL

   

   INPATIENT ACUTE CARE

$ 221.00

A,C

     

HEALTH AND HOSPITAL CORPORATION

   
     

BELLEVUE HOSPITAL CENTER

   

   INPATIENT ACUTE CARE

$ 298.00

ALL INCLUSIVE

   EXCLUDING PHYSICIANS

$ 288.00

 
     

BIRD S COLER MEMORIAL HOSPITAL AND HOME

   

   INPATIENT ACUTE CARE

$ 229.00

ALL INCLUSIVE

     

BRONX MUNICIPAL HOSPITAL CENTER

   

   INPATIENT ACUTE CARE

$ 311.00

ALL INCLUSIVE

     

CITY HOSPITAL CENTER AT ELMHURST

   

   INPATIENT ACUTE CARE

$ 289.00

ALL INCLUSIVE

     

CONEY ISLAND HOSPITAL

   

   INPATIENT ACUTE CARE

$ 309.00

ALL INCLUSIVE

   EXCLUDING PHYSICIANS

301.00

 
     

CUMBERLAND HOSPITAL

   

   INPATIENT ACUTE CARE

$ 336.00

ALL INCLUSIVE

     

GOLDWATER MEMORIAL HOSPITAL

   

   INPATIENT ACUTE CARE

$ 184.00

ALL INCLUSIVE

     

GREENPOINT HOSPITAL

   

   INPATIENT ACUTE CARE

$ 323.00

ALL INCLUSIVE

     

HARLEM HOSPITAL CENTER

   

   INPATIENT ACUTE CARE

$ 288.00

ALL INCLUSIVE

   EXCLUDING PHYSICIANS

272.00

 
     

KINGS COUNTY HOSPITAL CENTER

   

   INPATIENT ACUTE CARE

$ 292.00

ALL INCLUSIVE

     

LINCOLN MEDICAL & MENTAL HEALTH CENTER

   

   INPATIENT ACUTE CARE

$ 382.00

ALL INCLUSIVE

     

METROPOLITAN HOSPITAL CENTER

   

   INPATIENT ACUTE CARE

$ 374.00

ALL INCLUSIVE

   EXCLUSING PHYSICIANS

358.00

 
     

NORTH CENTRAL BRONX HOSPITAL

   

   INPATIENT ACUTE CARE

$ 417.00

ALL INCLUSIVE

     

QUEENS HOSPITAL CENTER

   

   INPATIENT ACUTE CARE

$ 290.00

ALL INCLUSIVE

     

SYDENHAM HOSPITAL

   

   INPATIENT ACUTE CARE

$ 250.00

ALL INCLUSIVE

     

A-ANESTHESIOLOGIST, B-RADIOLOGIST, C-PHYSIOTHERAPIST, D-PATHOLOGIST