Procedure Code	Procedure Description	Pricing Indicator	Rate Type	Mod1	Mod2	Mod3	Mod4	Max Fee	Max Fee Eff. Date	Max Fee End Date	PA
DD101	PARTICIPANT DIRECTED-GOODS AND SERVICES	MAXDNY	WVR					NA	NA	NA	N
DD102	PARTICIPANT/FAMILY STABILITY ASSISTANCE	MAXDNY	WVR					NA	NA	NA	N
DD103	SUPPORT BROKERAGE	MAXDNY	WVR					NA	NA	NA	N
DD104	RESIDENTIAL RESPITE	MAXDNY	WVR					NA	NA	NA	N
DD105	COMMUNITY RESPITE	MAXDNY	WVR					NA	NA	NA	N
DD106	CLINICAL/THERAPEUTIC INTERVENTION	MAXDNY	WVR					NA	NA	NA	N
DD107	ADULT DAY SUPPORT	MAXDNY	WVR					NA	NA	NA	N
DD108	VOCATIONAL HABILITATION	MAXDNY	WVR					NA	NA	NA	N
DD110	NON-MEDICAL TRANSPORTATION	MAXDNY	WVR					NA	NA	NA	N
DD111	REMOTE MONITORING	MAXDNY	WVR					NA	NA	NA	N
DD113	FUNCTIONAL BEHAVIORAL ASSESSMENT	MAXDNY	WVR					NA	NA	NA	N
DD178	CP-BENEFITS EDUC & ANAYLSIS SELF; 1 UNIT	MAXDNY	WVR					NA	NA	NA	N
DD179	CP-CAREER DISC GRP A & A-1 SELF ; 1 UNIT	MAXDNY	WVR					NA	NA	NA	N
DD180	CP-CAREER DSCOVERY GROUP B SELF; 1 UNIT	MAXDNY	WVR					NA	NA	NA	N
DD181	CP-CAREER DSCOVERY GROUP C SELF; 1 UNIT	MAXDNY	WVR					NA	NA	NA	N
DD182	CP-CAREER EXPLR AGNCY SELF; 15 MIN/UNIT	MAXDNY	WVR					NA	NA	NA	N
DD183	CP-CAREER EXPLR INDP SELF; 15 MIN UNIT	MAXDNY	WVR					NA	NA	NA	N
DD183	CP-CAREER EXPLR INDP SELF; 15 MIN UNIT	MAXDNY	OVR					NA	NA	NA	N
DD184	CP-SELF EMPLOYMENT PLAN SELF; 1 UNIT	MAXDNY	WVR					NA	NA	NA	N
DD185	CP-JOB DEVELPMNT AGNCY SELF; 15 MIN UNIT	MAXDNY	WVR					NA	NA	NA	N
DD186	CP-JOB DEVELPMNT INDP SELF; 15 MIN UNIT	MAXDNY	WVR					NA	NA	NA	N
DD186	CP-JOB DEVELPMNT INDP SELF; 15 MIN UNIT	MAXDNY	OVR					NA	NA	NA	N
DD187	CP-EMPLY LAUNCH AGNCY SELF; 15 MIN UNIT	MAXDNY	WVR					NA	NA	NA	N
DD188	CP-EMPL LAUNCH INDP SELF; 15 MIN UNIT	MAXDNY	WVR					NA	NA	NA	N
DD188	CP-EMPL LAUNCH INDP SELF; 15 MIN UNIT	MAXDNY	OVR					NA	NA	NA	N
DD189	CP-SITUATIONAL OB & ASSESS SELF; 1 UNIT	MAXDNY	WVR					NA	NA	NA	N
DD190	CP-WKSITE ACCESS AGNCY SELF; 15 MIN UNIT	MAXDNY	WVR					NA	NA	NA	N
DD191	CP-WRKSITE ACCESS INDP SELF; 15 MIN UNIT	MAXDNY	WVR					NA	NA	NA	N
DD191	CP-WRKSITE ACCESS INDP SELF; 15 MIN UNIT	MAXDNY	OVR					NA	NA	NA	N
DD196	IND EMPL SUPPORT SELF AGNCY; 15 MIN UNIT	MAXDNY	WVR					NA	NA	NA	N
DD197	IND EMPL SUPPORT SELF INDP; 15 MIN UNIT	MAXDNY	WVR					NA	NA	NA	N
DD197	IND EMPL SUPPORT SELF INDP; 15 MIN UNIT	MAXDNY	OVR					NA	NA	NA	N
DD206	GRP EMPL SUPPORT SELF GRP A; 15 MIN UNIT	MAXDNY	WVR					NA	NA	NA	N
DD207	GRP EMPL SUPP SELF GRP A-1; 15 MIN UNIT	MAXDNY	WVR					NA	NA	NA	N
DD208	GRP EMPL SUPPRT SELF GRP B; 15 MIN UNIT	MAXDNY	WVR					NA	NA	NA	N
DD209	GRP EMPL SUPPORT SELF GRP C; 15 MIN UNIT	MAXDNY	WVR					NA	NA	NA	N
DD210	VOCHAB-SELF GROUP A-1; 15 MINUTE UNIT	MAXDNY	WVR					NA	NA	NA	N
DD211	VOCHAB-SELFGROUP A; 15 MINUTE UNIT	MAXDNY	WVR					NA	NA	NA	N
DD212	VOCHAB-SELF GROUP B; 15 MINUTE UNIT	MAXDNY	WVR					NA	NA	NA	N
DD213	VOCHAB-SELF GROUP C; 15 MINUTE UNIT	MAXDNY	WVR					NA	NA	NA	N
DD214	ADULT DAY SUPPT-SELF GRP A-1; 15 MINUTE	MAXDNY	WVR					NA	NA	NA	N
DD215	ADULT DAY SUPPT-SELF GROUP A; 15 MINUTE	MAXDNY	WVR					NA	NA	NA	N
DD216	ADULT DAY SUPPT-SELF GROUP B; 15 MINUTE	MAXDNY	WVR					NA	NA	NA	N
DD217	ADULT DAY SUPPT- SELF GROUP C; 15 MINUTE	MAXDNY	WVR					NA	NA	NA	N
DD232	GROUP EMPLMNT SUPPORT SELF GRP A; DAILY	MAXDNY	WVR					NA	NA	NA	N
DD233	GROUP EMPLMNT SUPPORT SELF GRP A1; DAILY	MAXDNY	WVR					NA	NA	NA	N
DD234	GROUP EMPLMNT SUPPORT SELF GRP B; DAILY	MAXDNY	WVR					NA	NA	NA	N
DD235	GROUP EMPLMNT SUPPORT SELF GRP C; DAILY	MAXDNY	WVR					NA	NA	NA	N
DD244	SLFW AGENCY PARTICIPNT DIR. HPC; 15 MIN.	MAXDNY	WVR					NA	NA	NA	N
DD245	SLFW AGENCY PART/DIR. OSOC HPC; 15 MIN.	MAXDNY	WVR					NA	NA	NA	N
DD246	SLFW INDEP. PARTICIPNT DIR. HPC; 15 MIN.	MAXDNY	WVR					NA	NA	NA	N
DD246	SLFW INDEP. PARTICIPNT DIR. HPC; 15 MIN.	MAXDNY	OVR					NA	NA	NA	N
DD247	SLFW INDEP. PART/DIR. OSOC HPC; 15 MIN.	MAXDNY	WVR					NA	NA	NA	N
DD247	SLFW INDEP. PART/DIR. OSOC HPC; 15 MIN.	MAXDNY	OVR					NA	NA	NA	N
DD248	SELFW TRANSPORTATION; 1 MILE UNIT	MAXDNY	WVR					NA	NA	NA	N
DD248	SELFW TRANSPORTATION; 1 MILE UNIT	MAXDNY	OTH					NA	NA	NA	N
DD275	SELF-ASSISTIVE TECHNOLOGY CONSULTATION	MAXDNY	WVR					NA	NA	NA	N
DD276	SELF-ASSISTIVE TECHNOLOGY EQUIPMENT	MAXDNY	WVR					NA	NA	NA	N
DD277	SELF-ASSISTIVE TECHNOLOGY SUPPORT	MAXDNY	WVR					NA	NA	NA	N
DD302	SELF - BEST DAY UNIT - A1	MAXDNY	WVR					NA	NA	NA	N
DD303	SELF - BEST DAY UNIT - A	MAXDNY	WVR					NA	NA	NA	N
DD304	SELF - BEST DAY UNIT - B	MAXDNY	WVR					NA	NA	NA	N
DD305	SELF - BEST DAY UNIT - C	MAXDNY	WVR					NA	NA	NA	N
DD306	SELF - BEST 15 MINUTE UNIT - A1	MAXDNY	WVR					NA	NA	NA	N
DD307	SELF - BEST 15 MINUTE UNIT - A	MAXDNY	WVR					NA	NA	NA	N
DD308	SELF - BEST 15 MINUTE UNIT - B	MAXDNY	WVR					NA	NA	NA	N
DD309	SELF - BEST 15 MINUTE UNIT - C	MAXDNY	WVR					NA	NA	NA	N
DD310	SELF - BEST 15 MIN UNIT W/INT - A1	MAXDNY	WVR					NA	NA	NA	N
DD311	SELF - BEST 15 MIN UNIT W/INT - A	MAXDNY	WVR					NA	NA	NA	N
DD312	SELF - BEST 15 MIN UNIT W/INT - B	MAXDNY	WVR					NA	NA	NA	N
DD313	SELF - BEST 15 MIN UNIT W/INT - C	MAXDNY	WVR					NA	NA	NA	N
DD322	SELF - SELF DIRECTED TRANSPORTATION-ITEM	MAXDNY	WVR					NA	NA	NA	N
DD323	SELF - SELF DIR TRANS - MILE - MOD VEH	MAXDNY	WVR					NA	NA	NA	N
DD324	SELF - SLF DIR TRAN - MILE - NON MOD VEH	MAXDNY	WVR					NA	NA	NA	N
DD325	SELF - SELF DIRECTED TRANSPORTATION-TRIP	MAXDNY	WVR					NA	NA	NA	N
DD326	SELF - HOME DELIVERED MEALS	MAXDNY	WVR					NA	NA	NA	N